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Social isolation, loneliness, and blood-based AD/ADRD biomarkers in a nationally-representative study of middle-aged and older adults
Flores Romero KR, Gutierrez S, Zimmerman SC, Pederson AM, Thoma M, Chen R, Kotwal A, Glymour M et al.. medRxiv, 2026-08-10
Topic: Plasma and spinal-fluid biomarkers
Results At the analytic baseline, respondents were a mean age of 64 (9.5) years, 59% female, and 25% APOE ɛ4 carriers. Multiple patterns of social isolation (vs. no social isolation) were associated with higher NfL, including persistent severe social isolation ( β : 0.31), new-onset moderate-to-severe social isolation ( β : 0.14), and resolving moderate-to-severe social isolation ( β : 0.20). Persistent severe social isolation was associated with lower GFAP ( β : − 0.31) while persistent loneliness and, for men, new-onset loneliness were associated with higher GFAP ( β persistent : 0.16; β new onset _ men : 0.25). New-onset severe social isolation was associated with a lower Aβ42/40 ratio ( β : − 0.25) while resolving moderate-to-severe social isolation and, for men, persistent severe social isolation were each associated with higher p-tau181 ( β resolving : 0.11; β persistent _ men : 0.41). Conclusions Social isolation was associated with elevated blood-based biomarkers of neuronal injury, with variation by patterns of exposure over time.
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APA 7th
Flores Romero, K. R., Gutierrez, S., Zimmerman, S. C., Pederson, A. M., Thoma, M., Chen, R., et al. (2026). Social isolation, loneliness, and blood-based AD/ADRD biomarkers in a nationally-representative study of middle-aged and older adults. medRxiv. https://doi.org/10.64898/2026.08.06.26359882
Vancouver
Flores Romero KR, Gutierrez S, Zimmerman SC, Pederson AM, Thoma M, Chen R, et al. Social isolation, loneliness, and blood-based AD/ADRD biomarkers in a nationally-representative study of middle-aged and older adults. medRxiv. 2026. doi:10.64898/2026.08.06.26359882.
BibTeX
@article{floresromero2026-1c8d3cb2,
author = {Flores Romero, K. R. and Gutierrez, S. and Zimmerman, S. C. and Pederson, A. M. and Thoma, M. and Chen, R. and Kotwal, A. and Glymour, M. and others},
title = {{Social isolation, loneliness, and blood-based AD/ADRD biomarkers in a nationally-representative study of middle-aged and older adults}},
journal = {medRxiv},
year = {2026},
doi = {10.64898/2026.08.06.26359882},
url = {https://doi.org/10.64898/2026.08.06.26359882}
}
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Key findings
- Results At the analytic baseline, respondents were a mean age of 64 (9.5) years, 59% female, and 25% APOE ɛ4 carriers.
- Multiple patterns of social isolation (vs. no social isolation) were associated with higher NfL, including persistent severe social isolation ( β : 0.31), new-onset moderate-to-severe social isolation ( β : 0.14), and resolving moderate-to-severe social isolation ( β : 0.20).
- Persistent severe social isolation was associated with lower GFAP ( β : − 0.31) while persistent loneliness and, for men, new-onset loneliness were associated with higher GFAP ( β persistent : 0.16; β new onset _ men : 0.25).
- New-onset severe social isolation was associated with a lower Aβ42/40 ratio ( β : − 0.25) while resolving moderate-to-severe social isolation and, for men, persistent severe social isolation were each associated with higher p-tau181 ( β resolving : 0.11; β persistent _ men : 0.41).
- Conclusions Social isolation was associated with elevated blood-based biomarkers of neuronal injury, with variation by patterns of exposure over time.
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Study details
- Participants3,862
- Evidence strengthLow
How this study scored 16/100
Preprint — not yet peer-reviewed. It scored 31 on the same rubric, but non-peer-reviewed sources are capped at 16, so it shows as 16. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 19 of the 62 points we could judge it on, which is 31 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 2 / 10 | Tier 4 — not a peer-reviewed journal (medRxiv) |
| Journal's citation record | 0 / 4 | Not a journal article, so the journal's record does not count |
| 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 | 4 / 10 | Preprint — not yet peer-reviewed. Hosted on a preprint server. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 3 / 4 | 3,862 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 19 / 62 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 19 of the 62 points we could judge it on is 31 out of 100. |
| Total | 31 / 100 | Capped to 16 because this is not a peer-reviewed article. |
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