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Independent and interactive contributions of white matter hyperintensities and Alzheimer’s disease imaging and plasma biomarkers to cognitive decline in older adults without dementia
Dario Bachmann, Christoph Gericke, Maha Wybitul, Antje Saake, Sandro T. Studer, Katrin Rauen, Esmeralda Gruber, Andreas Buchmann et al.. Alzheimer s Research & Therapy, 2026-03-30
Topic: Amyloid, tau and blood-test diagnosis
Individual biomarkers significantly predict decline across multiple cognitive domains. WMHs independently predicted decline in processing speed/attention (β = -0.024, 95% CI -0.045 to -0.004, P = 0.022) and executive functions (β = -0.025, 95% CI -0.042 to -0.007, P = 0.005) and interacted with imaging and plasma biomarkers to accelerate cognitive decline across nearly all domains, with the strongest effect observed in episodic memory (β = -0.042, 95% CI -0.057 to -0.027, P < 0.001). Additionally, significant progression in the CDR-SOB was only observed in individuals with both elevated Aβ and WMH volume. Multigroup path analysis identified the interaction between Aβ PET and WMH volume as the most robust interaction associated with faster decline. Coexisting AD pathology and WMHs interacted to predict faster cognitive decline, most pronounced in episodic memory but also across other cognitive domains. Aβ PET was the main factor interacting with WMHs to predict episodic memory decline, but significant interactions were also observed for hippocampal volume, plasma p-tau217, and GFAP. Consideration of Aβ PET and blood-based biomarkers in the context of an individual’s WMH volume may improve the prognostic value of these biomarkers.
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APA 7th
Bachmann, D., Gericke, C., Wybitul, M., Saake, A., Studer, S. T., Rauen, K., et al. (2026). Independent and interactive contributions of white matter hyperintensities and Alzheimer’s disease imaging and plasma biomarkers to cognitive decline in older adults without dementia. Alzheimer s Research & Therapy. https://doi.org/10.1186/s13195-026-02038-z
Vancouver
Bachmann D, Gericke C, Wybitul M, Saake A, Studer ST, Rauen K, et al. Independent and interactive contributions of white matter hyperintensities and Alzheimer’s disease imaging and plasma biomarkers to cognitive decline in older adults without dementia. Alzheimer s Research & Therapy. 2026. doi:10.1186/s13195-026-02038-z. PMID: 41906163.
BibTeX
@article{bachmann2026-41906163,
author = {Bachmann, Dario and Gericke, Christoph and Wybitul, Maha and Saake, Antje and Studer, Sandro T. and Rauen, Katrin and Gruber, Esmeralda and Buchmann, Andreas and others},
title = {{Independent and interactive contributions of white matter hyperintensities and Alzheimer’s disease imaging and plasma biomarkers to cognitive decline in older adults without dementia}},
journal = {Alzheimer s Research \& Therapy},
year = {2026},
doi = {10.1186/s13195-026-02038-z},
pmid = {41906163},
url = {https://doi.org/10.1186/s13195-026-02038-z}
}
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.
Key findings
- Individual biomarkers significantly predict decline across multiple cognitive domains.
- WMHs independently predicted decline in processing speed/attention (β = -0.024, 95% CI -0.045 to -0.004, P = 0.022) and executive functions (β = -0.025, 95% CI -0.042 to -0.007, P = 0.005) and interacted with imaging and plasma biomarkers to accelerate cognitive decline across nearly all domains, with the strongest effect observed in episodic memory (β = -0.042, 95% CI -0.057 to -0.027, P < 0.001).
- Additionally, significant progression in the CDR-SOB was only observed in individuals with both elevated Aβ and WMH volume.
- Multigroup path analysis identified the interaction between Aβ PET and WMH volume as the most robust interaction associated with faster decline.
- Coexisting AD pathology and WMHs interacted to predict faster cognitive decline, most pronounced in episodic memory but also across other cognitive domains.
Why it matters
In older adults without dementia, white matter hyperintensities independently predicted decline in processing speed and executive function, and interacted with amyloid PET and plasma biomarkers to predict faster cognitive decline, most strongly in episodic memory. The authors suggest that considering amyloid PET and blood-based biomarkers alongside a person's white matter hyperintensity volume may improve the prognostic value of these biomarkers.
Study details
- Evidence strengthLow
How this study scored 41/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s Research & Therapy) |
| Journal's citation record | 1 / 4 | Alzheimer s Research & Therapy: journal h-index 146 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 2 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 1.0 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 4 / 6 | Cited 9.5× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 0 / 4 | Cited 2 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Anton Franz Gietl: h-index 26 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University College London: institution h-index 2,029 (OpenAlex) |
| Multi-centre collaboration | 3 / 3 | OpenAlex lists 14 institution(s) in 6 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41906163) |
| Free to read | 2 / 2 | Free to read |
| Total | 41 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1186/s13195-026-02038-z
- PubMed: 41906163
- Original source →
- Free full text: Alzheimer s Research & Therapy →
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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