Abstract

AbstractBackgroundBefore onset of Alzheimer’s dementia, aggregation of amyloid‐beta (Aβ) is thought to drive accumulation of Tau, followed by neurodegeneration (indexed here by neurofilament light chain [NFL]). Why or how Aβ increases Tau accumulation remains unclear. Using genetically informative twins aged 61.4 to 73.3 years, we sought to: (1) identify genetic and environmental influences on plasma Aβ (Aβ40, Aβ42, Aβ42/40), total Tau (t‐Tau), and NFL; (2) determine if their genetic and environmental influences are correlated with one another; (3) determine if Aβ40 and Aβ42 causally impact Tau levels; (4) measure associations between biomarkers and APOE‐ε4 status; and (5) measure associations between these biomarkers and mild cognitive impairment (MCI).MethodData were from 1,035 male twins in the Vietnam Era Twin Study of Aging. Average age was 67.1 years (SD = 2.6). Twin models were used to estimate heritability, genetic and environmental correlations, model the direction of causation between biomarkers, and associations with APOE‐ε4 status. Mixed effect linear regressions were applied to regress MCI on biomarkers.ResultHeritability for Aβ40, Aβ42, t‐Tau and NFL ranged from 43% to 51%, whereas Aβ42/40 heritability was not significantly different from zero. Phenotypic correlations between t‐Tau and Aβ40 (rP = 0.01) and Aβ42 (rP = 0.14) were small. Genetic correlations between t‐Tau and Aβ40 (rG = ‐0.05) and Aβ42 (rG = 0.05) were also very small. In contrast, genetic correlations between NFL and Aβ40 and Aβ42 were higher (rG ranging = 0.31‐0.37). We found no evidence to suggest that Aβ40 or Aβ42 causally impacts t‐Tau. APOE‐ε4 accounted for a significant, but very small amount of variance in Aβ40 and Aβ42. Finally, none of the biomarkers was significantly associated with MCI, which affected 15.1% of the sample.ConclusionBoth Aβ40 or Aβ42 appear heritable, but have very little phenotypic and genetic association with t‐Tau. The associations between the amyloid‐beta biomarkers and t‐Tau are mostly explained by non‐shared environmental factors, and the direction of causation is unclear. The small associations between APOE‐ε4 and the biomarkers, including their lack of association with MCI, may stem from the low sensitivity of plasma biomarkers, the relatively young age or the low proportion of MCI cases in this community‐dwelling sample.

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