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At baseline, peak width of skeletonized mean diffusivity (PSMD) was assessed from diffusion tensor imaging. Plasma phosphorylated tau 217 (p\u2010tau217) and neurofilament light chain (NfL) were measured using a single\u2010molecule immune\u2010array assay. Cognitive function was evaluated using Mini\u2010Mental State Examination (MMSE) and domain\u2010specific cognitive tests.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Participants with high\u2010level PSMD, p\u2010tau217, and NfL showed the fastest decline of MMSE (\u03b2\u00a0=\u00a0\u22120.30) and the highest dementia incidence of 3.54\/100 person\u2010years. A combination model with three markers demonstrated a good predictive value for dementia, incorporating age, sex, education, and apolipoprotein E (area under the curve\u00a0=\u00a00.93, 95% confidence interval\u00a0=\u00a00.86, 0.99).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Combining co\u2010pathology markers may identify individuals with a high risk of cognitive decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Peak width of skeletonized mean diffusivity (PSMD) was correlated with long\u2010term cognitive decline, and this correlation was modified by plasma phosphorylated tau (p\u2010tau)217 and neurofilament light chain (NfL).<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Participants with high levels of PSMD, p\u2010tau217, and NfL showed the fastest cognitive decline and the highest risk of dementia.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>A combination of the three markers exhibited a good predictive value of incident dementia over a 10\u2010year follow\u2010up period.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.14594","type":"journal-article","created":{"date-parts":[[2025,2,12]],"date-time":"2025-02-12T04:00:16Z","timestamp":1739332816000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["White matter injury, plasma Alzheimer's disease, and neurodegenerative biomarkers on cognitive decline in community\u2010dwelling older adults: A 10\u2010year longitudinal study"],"prefix":"10.1002","volume":"21","author":[{"given":"Qili","family":"Hu","sequence":"first","affiliation":[{"name":"Department of Radiology Huashan Hospital, State Key Laboratory of Medical Neurobiology, Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaowen","family":"Zhou","sequence":"additional","affiliation":[{"name":"Institute of Neurology Huashan Hospital, Fudan University  Shanghai China"},{"name":"National Clinical Research Center for Aging and Medicine Huashan Hospital Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders Huashan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenxu","family":"Xiao","sequence":"additional","affiliation":[{"name":"Institute of Neurology Huashan Hospital, Fudan University  Shanghai China"},{"name":"National Clinical Research Center for Aging and Medicine Huashan Hospital Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders Huashan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qianhua","family":"Zhao","sequence":"additional","affiliation":[{"name":"Institute of Neurology Huashan Hospital, Fudan University  Shanghai China"},{"name":"National Clinical Research Center for Aging and Medicine Huashan Hospital Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders Huashan Hospital Fudan University  Shanghai China"},{"name":"MOE Frontiers Center for Brain Science Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ding","family":"Ding","sequence":"additional","affiliation":[{"name":"Institute of Neurology Huashan Hospital, Fudan University  Shanghai China"},{"name":"National Clinical Research Center for Aging and Medicine Huashan Hospital Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders Huashan Hospital Fudan University  Shanghai China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Radiology Huashan Hospital, State Key Laboratory of Medical Neurobiology, Fudan University  Shanghai China"},{"name":"National Clinical Research Center for Aging and Medicine Huashan Hospital Fudan University  Shanghai China"},{"name":"National Center for Neurological Disorders Huashan Hospital Fudan University  Shanghai 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