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Alzheimer Disease Blood Biomarkers and Cognition Among Individuals With Diabetes and Overweight or Obesity
Mielke MM, Evans JK, Neiberg RH, Molina-Henry DP, Marcovina SM, Johnson KC, Carmichael OT, Rapp SR et al.. JAMA network open, 2025-02-03
Topic: Amyloid, tau and blood-test diagnosis
Results The mean (SD) baseline age of 758 participants was 61.5 (6.1) years, and 424 participants [55.9%] were female. Increasing baseline BBM levels were not associated with any cognitive composite z score. Increasing levels of NfL (β = -0.032 [SE, 0.013]; P = .01) and GFAP (β = -0.087 [SE, 0.025]; P Conclusions and relevance In this study of participants with T2D and overweight or obesity, increasing plasma NfL and GFAP levels over time, but not Aβ42/40 or pTau-181 levels, were associated with cognitive decline and incident cognitive impairment. These results suggest that plasma NfL and GFAP may be important biomarkers of cognitive change among this patient population.
Key findings
- Results The mean (SD) baseline age of 758 participants was 61.5 (6.1) years, and 424 participants [55.9%] were female.
- Increasing baseline BBM levels were not associated with any cognitive composite z score.
- Increasing levels of NfL (β = -0.032 [SE, 0.013]; P = .01) and GFAP (β = -0.087 [SE, 0.025]; P < .001), but not the Aβ42/40 ratio (β = 0.006 [SE, 0.040]; P = .88) or pTau-181 (β = 0.026 [SE, 0.025]; P = .31), were associated with worsening cognitive function and incident mild cognitive impairment or probable dementia.
- These results suggest that plasma NfL and GFAP may be important biomarkers of cognitive change among this patient population.
Why it matters
Among 758 people with type 2 diabetes and overweight or obesity, rising plasma NfL and GFAP levels over time were associated with cognitive decline, while Aβ42/40 and pTau-181 were not. This is an observational biomarker study and does not test any treatment or prevention for Alzheimer's disease.
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Study details
- Study designcohort study
- Participants758
- Effect size55.9%
- Evidence strengthHigh
How this study scored 73/100
Published in a leading specialty journal, and it is a randomised controlled trial.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (JAMA network open) |
| Journal's citation record | 2 / 4 | JAMA Network Open: journal h-index 235 (OpenAlex, 2026-10-29) |
| Study design | 11 / 12 | A randomised controlled trial (from PubMed type “Randomized Controlled Trial”) |
| Strength of evidence | 5 / 5 | Rated “high” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 758 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 1 / 2 | Randomised (as stated in the record) |
| Times cited | 3 / 7 | Cited 30 times (OpenAlex, 2026-10-10) |
| Citations per year | 3 / 5 | 10.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 4 / 6 | Cited 19.0× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 3 other studies in this library |
| Still being cited | 2 / 4 | Cited 30 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Kathleen M. Hayden: h-index 49 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of Southern California: institution h-index 1,521 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 8 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 39913137) |
| Free to read | 2 / 2 | Free to read |
| Total | 73 / 100 | — |
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Read the original
- DOI: 10.1001/jamanetworkopen.2024.58149
- PubMed: 39913137
- Original source →
- Free full text: JAMA Network Open →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Mielke, M. M., Evans, J. K., Neiberg, R. H., Molina-Henry, D. P., Marcovina, S. M., Johnson, K. C., et al. (2025). Alzheimer Disease Blood Biomarkers and Cognition Among Individuals With Diabetes and Overweight or Obesity. JAMA network open. https://doi.org/10.1001/jamanetworkopen.2024.58149
Vancouver
Mielke MM, Evans JK, Neiberg RH, Molina-Henry DP, Marcovina SM, Johnson KC, et al. Alzheimer Disease Blood Biomarkers and Cognition Among Individuals With Diabetes and Overweight or Obesity. JAMA network open. 2025. doi:10.1001/jamanetworkopen.2024.58149. PMID: 39913137.
BibTeX
@article{mielke2025-39913137,
author = {Mielke, M. M. and Evans, J. K. and Neiberg, R. H. and Molina-Henry, D. P. and Marcovina, S. M. and Johnson, K. C. and Carmichael, O. T. and Rapp, SR. and others},
title = {{Alzheimer Disease Blood Biomarkers and Cognition Among Individuals With Diabetes and Overweight or Obesity}},
journal = {JAMA network open},
year = {2025},
doi = {10.1001/jamanetworkopen.2024.58149},
pmid = {39913137},
url = {https://doi.org/10.1001/jamanetworkopen.2024.58149}
}
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