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Biomarkers / Plasma Biomarkers / Alzheimer Disease · Journal article
Neurobiology of Aging · July 30, 2026
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This twin study quantifies the heritability and genetic correlations of six Alzheimer's-related plasma biomarkers in cognitively normal older adults aged 65–85. Heritability estimates ranged from 0.39 to 0.66, genetic correlations between biomarkers ranged from 0.32 to 0.67, and p-tau181 and p-tau217 showed significant inverse associations with cognitive performance, providing insight into shared genetic architecture among these diagnostic markers.
Twin study with multivariate heritability models and linear mixed-effect regression. Twin pairs aged 65–85 without Alzheimer's disease or related dementia diagnosis. n = 696.
Heritability estimates ranged from 0.39 (p-tau181) to 0.66 (GFAP) Phenotypic associations ranged from 0.22 (p-tau181 and GFAP) to 0.73 (p-tau181 and p-tau217) Genetic correlations ranged from 0.32 to 0.67, strongest between p-tau181 and p-tau217
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These findings characterize the genetic basis of Alzheimer's plasma biomarkers in cognitively normal older adults, informing interpretation of biomarker associations and guiding future gene-finding studies. However, because the cohort lacks clinical disease outcomes, the relevance to active pathology or symptomatic stages remains unclear.
Twin study establishing heritability and genetic correlations among Alzheimer's plasma biomarkers in a cognitively normal cohort, providing mechanistic insight but using surrogate biomarkers rather than clinical outcomes.
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These findings characterize the genetic basis of Alzheimer's plasma biomarkers in cognitively normal older adults, informing interpretation of biomarker associations and guiding future gene-finding studies. However, because the cohort lacks clinical disease outcomes, the relevance to active pathology or symptomatic stages remains unclear.
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Alzheimer's disease-related plasma biomarker interrelationships and factors underlying these associations remain poorly understood. To address this, we studied the heritability of plasma biomarkers and their associations with cognition. This study included 696 twins, aged 65-85, without a diagnosis of Alzheimer's disease or related dementias. Plasma amyloid beta 42 and 40, phosphorylated tau (p-tau) 181 and 217, neurofilament light chain (NfL) and glial fibrillary acidic protein (GFAP) were quantified with Simoa HD-X, and cognition was assessed with cCOG. Heritability of plasma biomarkers was assessed with multivariate twin models and associations with cognition with linear mixed effect models. Phenotypic associations varied from 0.22 between p-tau181 and GFAP to 0.73 between p-tau181 and p-tau217, and the heritability estimates ranged from 0.39 (p-tau181) to 0.66 (GFAP). Genetic and environmental correlations were 0.32-0.67 and 0.06-0.78, with the strongest correlations observed between p-tau181 and p-tau217. P-tau181 and p-tau217 were associated with cognition (β = -0.12; 95% CI: -0.19--0.04 and β = -0.19; 95% CI: -0.26--0.12, respectively). The observed phenotypic and genetic associations highlight shared underlying mechanisms among plasma biomarkers. Despite p-tau181 and p-tau217 having the strongest genetic and environmental correlations, neither approached unity, implying unique genetic and environmental factors. Our results offer insight into the genetic architecture of diagnostic and progression markers of Alzheimer's disease and inform their use in future gene-finding studies.
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