{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T16:14:55Z","timestamp":1785428095204,"version":"3.56.0"},"reference-count":32,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"crossref","award":["R01AG077677-04"],"award-info":[{"award-number":["R01AG077677-04"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"crossref"}]},{"award":["R01AG077677-04"],"award-info":[{"award-number":["R01AG077677-04"]}],"id":[{"id":"https:\/\/ror.org\/049v75w11","id-type":"ROR","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006827","name":"State of Florida Department of Health","doi-asserted-by":"publisher","award":["23A10"],"award-info":[{"award-number":["23A10"]}],"id":[{"id":"10.13039\/100006827","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100006827","name":"State of Florida Department of Health","doi-asserted-by":"publisher","award":["COHFA"],"award-info":[{"award-number":["COHFA"]}],"id":[{"id":"10.13039\/100006827","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Emerging evidence suggests that systemic physiological factors may influence plasma biomarker concentrations of Alzheimer\u2019s disease (AD) and related neurodegenerative processes, potentially affecting their specificity for central nervous system pathology. This study examined the relationship of demographic factors and medical comorbidities with plasma biomarkers of AD and neurodegeneration in a community-dwelling cohort of Black\/African American (B\/AA) older adults (N = 141). Participants underwent plasma assessment of phosphorylated tau at threonine 217 (p-Tau217), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL). Results showed associations between plasma p-Tau217 and amyloid PET positivity, and significant intercorrelations among p-Tau217, GFAP, and NfL. Stepwise regression models incorporated demographics, amyloid PET status, and laboratory measures of renal, metabolic, and lipid function as predictors for each biomarker. p-Tau217 was primarily predicted by amyloid PET and renal function; GFAP by age and sex; and NfL by renal function, age, and sex. Findings indicate plasma biomarker concentrations in B\/AA older adults reflect both central AD-related pathology and systemic physiological factors, particularly renal function, and demographic influences. Results underscore the importance of accounting for comorbid medical conditions and demographic characteristics when interpreting blood-based biomarkers and highlight the need for comprehensive medical phenotyping to improve diagnostic specificity and clinical utility.<\/jats:p>","DOI":"10.3390\/biom16050747","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T10:07:47Z","timestamp":1779444467000},"page":"747","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Common Medical Comorbidities, Demographic Factors and Levels of Plasma Biomarkers of Alzheimer\u2019s Disease and Neurodegeneration in Black\/African American Older Adults"],"prefix":"10.3390","volume":"16","author":[{"given":"Rosie","family":"Cid","sequence":"first","affiliation":[{"name":"Center for Cognitive Neuroscience and Aging (CNSA), Miller School of Medicine, University of Miami, Miami, FL 33146, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Ortega","sequence":"additional","affiliation":[{"name":"Center for Cognitive Neuroscience and Aging (CNSA), Miller School of Medicine, University of Miami, Miami, FL 33146, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsten","family":"Crenshaw","sequence":"additional","affiliation":[{"name":"Center for Cognitive Neuroscience and Aging (CNSA), Miller School of Medicine, University of Miami, Miami, FL 33146, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5460-8834","authenticated-orcid":false,"given":"Juan Pablo","family":"de Rivero Vaccari","sequence":"additional","affiliation":[{"name":"Department of Neurological Surgery and The Miami Project to Cure Paralysis, Miller School of Medicine, University of Miami, Miami, FL 33146, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3231-9134","authenticated-orcid":false,"given":"Minerva","family":"Carrasquillo","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Mayo Clinic, Jacksonville, FL 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Vaillancourt","sequence":"additional","affiliation":[{"name":"Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2913-2878","authenticated-orcid":false,"given":"D.","family":"Zheng","sequence":"additional","affiliation":[{"name":"Center for Cognitive Neuroscience and Aging (CNSA), Miller School of Medicine, University of Miami, Miami, FL 33146, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-0172-5990","authenticated-orcid":false,"given":"Dylan","family":"Hinton","sequence":"additional","affiliation":[{"name":"Center for Cognitive Neuroscience and Aging (CNSA), Miller School of Medicine, University of Miami, Miami, FL 33146, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Efrosyni","family":"Sfakianaki","sequence":"additional","affiliation":[{"name":"Division of Nuclear Medicine, Department of Radiology, Miller School of Medicine, University of Miami, Miami, FL 33146, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Crocco","sequence":"additional","affiliation":[{"name":"Center for Cognitive Neuroscience and Aging (CNSA), Miller School of Medicine, University of Miami, Miami, FL 33146, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5818-3725","authenticated-orcid":false,"given":"Heidi","family":"Casellas","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Mayo Clinic, Jacksonville, FL 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsey","family":"Kuchenbecker","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Mayo Clinic, Jacksonville, FL 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sofia","family":"Ramirez","sequence":"additional","affiliation":[{"name":"Center for Cognitive Neuroscience and Aging (CNSA), Miller School of Medicine, University of Miami, Miami, FL 33146, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tan","family":"Abascal","sequence":"additional","affiliation":[{"name":"Center for Cognitive Neuroscience and Aging (CNSA), Miller School of Medicine, University of Miami, Miami, FL 33146, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Triana","family":"Abel","sequence":"additional","affiliation":[{"name":"Center for Cognitive Neuroscience and Aging (CNSA), Miller School of Medicine, University of Miami, Miami, FL 33146, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei-En","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Applied Physiology and Kinesiology, University of Florida, Gainesville, FL 32611, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8060-6309","authenticated-orcid":false,"given":"Ranjan","family":"Duara","sequence":"additional","affiliation":[{"name":"Wien Center for Alzheimer\u2019s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL 33140, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nil\u00fcfer","family":"Ertekin-Taner","sequence":"additional","affiliation":[{"name":"Department of Neuroscience, Mayo Clinic, Jacksonville, FL 55905, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6788-2798","authenticated-orcid":false,"given":"David","family":"Loewenstein","sequence":"additional","affiliation":[{"name":"Center for Cognitive Neuroscience and Aging (CNSA), Miller School of Medicine, University of Miami, Miami, FL 33146, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"ref_1","unstructured":"Alzheimer\u2019s Association (2026, March 03). Alzheimer\u2019s Disease Facts and Figures. Available online: https:\/\/www.alz.org\/media\/Documents\/alzheimers-facts-and-figures.pdf."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.jalz.2016.06.2360","article-title":"Systematic Review of Dementia Prevalence and Incidence in United States Race\/Ethnic Populations","volume":"13","author":"Mehta","year":"2017","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1488","DOI":"10.1001\/jama.2022.3550","article-title":"Association of Race and Ethnicity with Incidence of Dementia Among Older Adults","volume":"327","author":"Kornblith","year":"2022","journal-title":"JAMA"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"679","DOI":"10.1097\/MLR.0000000000001577","article-title":"Dementia Diagnosis Disparities by Race and Ethnicity","volume":"59","author":"Lin","year":"2021","journal-title":"Med. Care"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1966","DOI":"10.1002\/alz.12362","article-title":"Population Estimate of People with Clinical Alzheimer\u2019s Disease and Mild Cognitive Impairment in the United States (2020\u20132060)","volume":"17","author":"Rajan","year":"2021","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1007\/s40471-023-00337-9","article-title":"Environmental, Sociocultural, Behavioral, and Biological Factors Associated with Cognitive Decline, Alzheimer\u2019s Disease, and Other Types of Dementia in Black Americans","volume":"10","author":"Byrd","year":"2023","journal-title":"Curr. Epidemiol. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Habibzadeh, P., and Albrecht, J. (2024). Association Between Race and Comorbid Conditions Among Older Adults with Dementia. J. Clin. Med., 13.","DOI":"10.3390\/jcm13216368"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"518","DOI":"10.1002\/ana.26847","article-title":"Disparate Dementia Risk Factors Are Associated with Cognitive Impairment and Rates of Decline in African Americans","volume":"95","author":"Lachner","year":"2024","journal-title":"Ann. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Zheng, D.D., Loewenstein, D.A., Christ, S.L., Feaster, D.J., Lam, B.L., McCollister, K.E., Curiel-Cid, R.E., and Lee, D.J. (2021). Multimorbidity Patterns and Their Relationship to Mortality in the US Older Adult Population. PLoS ONE, 16.","DOI":"10.1371\/journal.pone.0245053"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"fcad057","DOI":"10.1093\/braincomms\/fcad057","article-title":"Plasma Phosphorylated Tau 217 in Preclinical Alzheimer\u2019s Disease","volume":"5","author":"Jonaitis","year":"2023","journal-title":"Brain Commun."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1186\/s13195-024-01513-9","article-title":"Diagnostic Performance of Plasma pTau217, pTau181, A\u03b21-42 and A\u03b21-40 in the LUMIPULSE Automated Platform for the Detection of Alzheimer Disease","volume":"16","author":"Arranz","year":"2024","journal-title":"Alzheimers Res. Ther."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"8216","DOI":"10.1002\/alz.14184","article-title":"Recommendations for Clinical Implementation of Blood-based Biomarkers for Alzheimer\u2019s Disease","volume":"20","author":"Mielke","year":"2024","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1002\/alz.12647","article-title":"Medical Comorbidities and Ethnicity Impact Plasma Alzheimer\u2019s Disease Biomarkers: Important Considerations for Clinical Trials and Practice","volume":"19","author":"Petersen","year":"2023","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1038\/s41582-024-00989-1","article-title":"Alzheimer Disease Blood Biomarkers: Considerations for Population-Level Use","volume":"20","author":"Mielke","year":"2024","journal-title":"Nat. Rev. Neurol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1128","DOI":"10.1002\/alz.12466","article-title":"Associations of Amyloid and Neurodegeneration Plasma Biomarkers with Comorbidities","volume":"18","author":"Syrjanen","year":"2022","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"411","DOI":"10.1136\/jnnp-2022-330540","article-title":"Plasma Phosphorylated Tau 181 Predicts Amyloid Status and Conversion to Dementia Stage Dependent on Renal Function","volume":"94","author":"Lehmann","year":"2023","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1002\/alz.12787","article-title":"Confounding Factors of Alzheimer\u2019s Disease Plasma Biomarkers and Their Impact on Clinical Performance","volume":"19","author":"Janelidze","year":"2023","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1186\/s40035-023-00371-z","article-title":"The Potential Impact of Clinical Factors on Blood-Based Biomarkers for Alzheimer\u2019s Disease","volume":"12","author":"Pan","year":"2023","journal-title":"Transl. Neurodegener."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"7841","DOI":"10.1038\/s41598-022-11557-2","article-title":"Circulating Neurofilament Is Linked with Morbid Obesity, Renal Function, and Brain Density","volume":"12","author":"Rebelos","year":"2022","journal-title":"Sci. Rep."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1001\/jamaneurol.2023.5319","article-title":"Diagnostic Accuracy of a Plasma Phosphorylated Tau 217 Immunoassay for Alzheimer Disease Pathology","volume":"81","author":"Ashton","year":"2024","journal-title":"JAMA Neurol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"740","DOI":"10.1016\/S1474-4422(25)00227-3","article-title":"Blood Phosphorylated Tau for the Diagnosis of Alzheimer\u2019s Disease: A Systematic Review and Meta-Analysis","volume":"24","author":"Therriault","year":"2025","journal-title":"Lancet Neurol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"e70","DOI":"10.1515\/cclm-2025-1192","article-title":"Comparative Analysis of Plasma P-Tau217 Immunoassays: Challenges for Standardization and Harmonization","volume":"64","author":"Arslan","year":"2026","journal-title":"Clin. Chem. Lab. Med. (CCLM)"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"e70288","DOI":"10.1002\/alz.70288","article-title":"The Performance of Plasma P-tau217 in Black Middle-aged and Older Adults","volume":"21","author":"Ennis","year":"2025","journal-title":"Alzheimer\u2019s Dement."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"e214931","DOI":"10.1212\/WNL.0000000000214931","article-title":"Influence of Decreased Kidney Function on Plasma Biomarkers of Neurodegenerative Disorders in Routine Care: Confirmation of the Interest of Ratios","volume":"106","author":"Cristol","year":"2026","journal-title":"Neurology"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"e210287","DOI":"10.1212\/WNL.0000000000210287","article-title":"Quantitative Assessment of the Effect of Chronic Kidney Disease on Plasma P-Tau217 Concentrations","volume":"104","author":"Bornhorst","year":"2025","journal-title":"Neurology"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"50","DOI":"10.1186\/s13195-026-01970-4","article-title":"Blood-Based Biomarkers for Alzheimer\u2019s Disease: Influence of Kidney Function","volume":"18","author":"Gaetani","year":"2026","journal-title":"Alzheimers Res. Ther."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1177\/13872877251375101","article-title":"Integrating kidney function assessment into the clinical interpretation of plasma Alzheimer\u2019s disease biomarkers","volume":"108","author":"Arslan","year":"2025","journal-title":"J. Alzheimer\u2019s Dis."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"e976","DOI":"10.1212\/WNL.0000000000006128","article-title":"Utilizing Semantic Intrusions to Identify Amyloid Positivity in Mild Cognitive Impairment","volume":"91","author":"Loewenstein","year":"2018","journal-title":"Neurology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"e214317","DOI":"10.1212\/WNL.0000000000214317","article-title":"Assessing Cognitive Decline and Dementia Risk in Black and White Older Adults with Blood Biomarkers pTau217, GFAP, NfL, and A\u03b2 Ratio","volume":"105","author":"Capuano","year":"2025","journal-title":"Neurology"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"e2299","DOI":"10.1212\/WNL.0000000000207923","article-title":"Association Between Triglycerides and Risk of Dementia in Community-Dwelling Older Adults","volume":"101","author":"Zhou","year":"2023","journal-title":"Neurology"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e213355","DOI":"10.1212\/WNL.0000000000213355","article-title":"Cholesterol Variability and Dementia Risk","volume":"104","author":"Ferguson","year":"2025","journal-title":"Neurology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"e2088","DOI":"10.1212\/WNL.0000000000009436","article-title":"Serum Triglycerides in Alzheimer Disease","volume":"94","author":"Bernath","year":"2020","journal-title":"Neurology"}],"container-title":["Biomolecules"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2218-273X\/16\/5\/747\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T18:32:12Z","timestamp":1780511532000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2218-273X\/16\/5\/747"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,19]]},"references-count":32,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5]]}},"alternative-id":["biom16050747"],"URL":"https:\/\/doi.org\/10.3390\/biom16050747","relation":{},"ISSN":["2218-273X"],"issn-type":[{"value":"2218-273X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5,19]]}}}