Marks JD, Syrjanen JA, Graff-Radford J, et al. - Plasma neurofilament light chain (NfL) is superior to plasma total tau protein (T-Tau) as a prognostic marker of cognitive decline and neuroimaging changes. Plasma T-tau added cross-sectional value to NfL in specific contexts.

• In this study of 995 participants from the Mayo Clinic Study of Aging cohort who were without dementia and had concurrent plasma NfL and T-tau, cognitive status, and neuroimaging data.

• A more strong association of plasma NfL with all cognitive and neuroimaging outcomes was evident at baseline.

• Combination of both increased NfL and T-tau at baseline, vs elevated levels of either alone, was found to be more strongly linked at cross-section with worse global cognition and memory, and with neuroimaging measures such as temporal cortex thickness and elevated number of infarcts.

• Longitudinal analyses revealed that baseline plasma T-tau did not add to the prognostic worth of baseline plasma NfL.

• Similar findings were obtained using Alzheimer’s Disease Neuroimaging Initiative data.