Author Identifier (ORCID)
Tenielle Porter: https://orcid.org/0000-0002-7887-6622
Simon M. Laws: https://orcid.org/0000-0002-4355-7082
Abstract
Introduction: Young-onset neurocognitive symptoms result from a heterogeneous group of neurological and psychiatric disorders which present a diagnostic challenge. To identify such factors, we analysed the Biomarkers in Younger-Onset Neurocognitive Disorders cohort, a study of individuals < 65 years old presenting with neurocognitive symptoms for a diagnosis and who have undergone cognitive and biomarker analyses. Methods: Sixty-five participants (median age at assessment of 56 years, 45% female) were recruited during their index presentation to the Royal Melbourne Hospital Neuropsychiatry Centre, a tertiary specialist service in Melbourne, Australia, and categorized as either early-onset Alzheimer’s disease (n = 18), non-Alzheimer’s disease neurodegeneration (n = 23) or primary psychiatric disorders (n = 24). Levels of neurofilament light chain, glial fibrillary acidic protein and phosphorylated-tau 181, apolipoprotein E genotype and late-onset Alzheimer’s disease polygenic risk scores were determined. Information-theoretic model selection identified discriminatory factors.
Results: Neurofilament light chain, glial fibrillary acidic protein and phosphorylated-tau 181 levels were elevated in early-onset Alzheimer’s disease compared with other diagnostic categories. A multi-omic model selection identified that a combination of cognitive and blood biomarkers, but not the polygenic risk score, discriminated between early-onset Alzheimer’s disease and primary psychiatric disorders (area under the curve ⩾ 0.975, 95% confidence interval: 0.825–1.000). Phosphorylated-tau 181 alone significantly discriminated between early-onset Alzheimer’s disease and non-Alzheimer’s disease neurodegeneration causes (area under the curve = 0.950, 95% confidence interval: 0.877–1.00).
Discussion: Discriminating between early-onset Alzheimer’s disease, non-Alzheimer’s disease neurodegeneration and primary psychiatric disorders causes of young-onset neurocognitive symptoms is possible by combining cognitive profiles with blood biomarkers. These results support utilizing blood biomarkers for the work-up of young-onset neurocognitive symptoms and highlight the need for the development of a young-onset Alzheimer’s disease-specific polygenic risk score.
Document Type
Journal Article
Date of Publication
1-1-2025
Publication Title
Australian and New Zealand Journal of Psychiatry
Publisher
Sage
School
Centre for Precision Health / School of Medical and Health Sciences
RAS ID
76770
Funders
Melbourne Genomics Health Alliance Genomics Immersion Fellowship
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.
Comments
Bhalala, O. G., Beamish, J., Eratne, D., Summerell, P., Porter, T., Laws, S. M., ... & Loi, S. M. (2025). Blood biomarker profiles in young-onset neurocognitive disorders: A cohort study. Australian & New Zealand Journal of Psychiatry, 59(4), 378-388. https://doi.org/10.1177/00048674241312805