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Plasmalogens and their Associations with Brain Function and Structure in Older Community Dwelling African Americans

Weaver, A.; Shah, R. C.; Du, L.; Barnes, L. L.; Senanayake, V.; Goodenowe, D.

2026-03-27 neurology
10.64898/2026.03.26.26349429 medRxiv
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ABSTRACT BACKGROUND: Recent studies consisting primarily of white participants have found lowered plasmalogen levels to be associated with lower cognitive function. We explore the association of blood plasmalogen levels with global cognition and brain imaging metrics in older African Americans. METHODS: Included in these cross-sectional analyses were participants in the Minority Aging Research Study (MARS) and the Rush Clinical Core without dementia, available serum lipid levels, and a concurrent cognitive function assessment. A plasmalogen biosynthesis value (PBV) was calculated for each participant utilizing five ratios of four key glycerophospholipids. A linear regression model of global cognition was constructed with PBV, adjusted for sex, age, education, total cholesterol, and body mass index. In participants with 3T MRI brain imaging, the association between PBV and white matter hyperintensities (WMH) was explored. RESULTS: Of the 298 participants, the mean age was 74.6 years, mean education was 15.6 years, and 84% were women. The median PBV was 0.42 (interquartile range: 0.22 to 1.14). A unit higher in PBV was suggestively associated with a 0.17 {beta}-unit higher cognitive z-score (SE =0.09, p = 0.06). In 254 participants with MRI data, an increase in log10 SD of PBV suggested the less white matter hyperintensities (estimate = -0.20, SE = 0.12, p = 0.08). DISCUSSION: In older African Americans, higher PBV was associated with higher level of global cognition, and potentially lower levels of brain white matter hyperintensities. Larger studies are needed in additional cohorts to determine if PBV is associated with annual rate of change in cognitive function.

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