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<p>Deep learning-based brain age models quantify regional deviations from normative aging and may capture structural changes relevant to dementia risk. Plasma phosphorylated tau-217 (p-tau217) is a scalable Alzheimer’s disease biomarker, but its relationship to brain aging and cognition in cognitively unimpaired adults is unclear. In this cross-sectional study, we tested whether brain age patterns serve as indirect pathways linking plasma p-tau217 to cognition in the Aging Brain Cohort (ABC). Neuroimaging data from 518 adults (mean age = 43.7 years, 70.8% female) were analyzed using a validated deep learning brain age model, and decomposed via exploratory factor analysis into six gradients: frontal, dorsal, ventral, left frontotemporal, right frontotemporoparietal, and bilateral parietal. In a parallel mediation model including all six gradients as simultaneous mediators in adults aged ≥60 years (<i>N</i> = 71), a significant specific indirect effect of plasma p-tau217 on Montreal Cognitive Assessment (MoCA) scores was observed through accelerated right frontotemporoparietal aging (<i>β</i> = −0.111, 95% CI [−0.313, −0.010], <i>p</i> = 0.031). No other indirect pathways were significant, and neither the total nor direct effect was significant. These findings suggest a specific brain aging phenotype as a potential intermediate pathway linking tau-related pathology to cognition prior to clinical impairment.</p>

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Brain age gradients as intermediate phenotypes linking plasma p-tau217 to cognition in community-dwelling older adults

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年7月8日

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  • Nicholas Riccardi,
  • Ansley Martin,
  • Dariusz Pytel,
  • Sarah Newman-Norlund,
  • Steven L. Carroll,
  • Chris Rorden,
  • Julius Fridriksson,
  • Leonardo Bonilha

摘要

Deep learning-based brain age models quantify regional deviations from normative aging and may capture structural changes relevant to dementia risk. Plasma phosphorylated tau-217 (p-tau217) is a scalable Alzheimer’s disease biomarker, but its relationship to brain aging and cognition in cognitively unimpaired adults is unclear. In this cross-sectional study, we tested whether brain age patterns serve as indirect pathways linking plasma p-tau217 to cognition in the Aging Brain Cohort (ABC). Neuroimaging data from 518 adults (mean age = 43.7 years, 70.8% female) were analyzed using a validated deep learning brain age model, and decomposed via exploratory factor analysis into six gradients: frontal, dorsal, ventral, left frontotemporal, right frontotemporoparietal, and bilateral parietal. In a parallel mediation model including all six gradients as simultaneous mediators in adults aged ≥60 years (N = 71), a significant specific indirect effect of plasma p-tau217 on Montreal Cognitive Assessment (MoCA) scores was observed through accelerated right frontotemporoparietal aging (β = −0.111, 95% CI [−0.313, −0.010], p = 0.031). No other indirect pathways were significant, and neither the total nor direct effect was significant. These findings suggest a specific brain aging phenotype as a potential intermediate pathway linking tau-related pathology to cognition prior to clinical impairment.