Depressive Symptoms and Amyloid Pathology
: Wiels, Wietse A.; Oomens, Julie E.; Engelborghs, Sebastiaan; Baeken, Chris; von Arnim, Christine A.F.; Boada, Mercè; Didic, Mira; Dubois, Bruno; Fladby, Tormod; van der Flier, Wiesje M.; Frisoni, Giovanni B.; Fröhlich, Lutz; Gill, Kiran Dip; Grimmer, Timo; Hildebrandt, Helmut; Hort, Jakub; Itoh, Yoshiaki; Iwatsubo, Takeshi; Klimkowicz-Mrowiec, Aleksandra; Lee, Dong Young; Lleó, Alberto; Martinez-Lage, Pablo; de Mendonça, Alexandre; Meyer, Philipp T.; Kapaki, Elisabeth N.; Parchi, Piero; Pardini, Matteo; Parnetti, Lucilla; Popp, Julius; Rami, Lorena; Reiman, Eric M.; Rinne, Juha O.; Rodrigue, Karen M.; Sánchez-Juan, Pascual; Santana, Isabel; Sarazin, Marie; Scarmeas, Nikolaos; Skoog, Ingmar; Snyder, Peter J.; Sperling, Reisa A.; Villeneuve, Sylvia; Wallin, Anders; Wiltfang, Jens; Zetterberg, Henrik; Ossenkoppele, Rik; Verhey, Frans R. J.; Vos, Stephanie J. B.; Visser, Pieter Jelle; Jansen, Willemijn J.; Alcolea, Daniel; Altomare, Daniele; Baiardi, Simone; Baldeiras, Ines; Bateman, Randall J.; Blennow, Kaj; Bottlaender, Michel; den Braber, Anouk; van Buchem, Mark A.; Byun, Min Soo; Cerman, Jiří; Chen, Kewei; Chipi, Elena; Day, Gregory S.; Drzezga, Alexander; Eckerström, Marie; Ekblad, Laura L.; Epelbaum, Stéphane; Förster, Stefan; Fortea, Juan; Freund-Levi, Yvonne; Frings, Lars; Guedj, Eric; Hausner, Lucrezia; Hellwig, Sabine; Huey, Edward D.; Jiménez-Bonilla, Julio F.; Johnson, Keith A.; Juaristi, Ane Iriondo; Kandimalla, Ramesh; Paraskevas, George; Kern, Silke; Kirsebom, Bjørn-Eivind S.; Kornhuber, Johannes; Lagarde, Julien; Landau, Susan M.; Legdeur, Nienke; Llibre Guerra, Jorge J.; Maserejian, Nancy N.; Marquié, Marta; Minatani, Shinobu; Morbelli, Silvia Daniela; Mroczko, Barbara; Ntanasi, Eva; de Oliveira, Catarina Resende; Olivieri, Pauline; Orellana, Adelina; Perrin, Richard J.; Peters, Oliver; Prabhakar, Sudesh; Ramakers, Inez H.; Rodríguez-Rodriguez, Eloy; Ruiz, Agustín; Rüther, Eckart; Selnes, Per; Silva, Dina; Soininen, Hilkka; Spiru, Luiza; Takeda, Akitoshi; Teichmann, Marc; Tijms, Betty M.; Teunissen, Charlotte E.; Thompson, Loisa I.; Vogelgsangs, Jonathan; Vöglein, Jonathan; Waldemar, Gunhild; Wallin, Åsa K.; Yannakoulia, Mary; Yi, Dahyun; Zettergren, Anna.
Publisher: American Medical Association
: 2025
: JAMA Psychiatry
: JAMA Psychiatry
: 82
: 3
: 296
: 310
: 2168-622X
: 2168-6238
DOI: https://doi.org/10.1001/jamapsychiatry.2024.4305(external)
: https://doi.org/10.1001/jamapsychiatry.2024.4305(external)
: https://hdl.handle.net/11585/1011778(external)
Importance Depressive symptoms are associated with cognitive decline in older individuals. Uncertainty about underlying mechanisms hampers diagnostic and therapeutic efforts. This large-scale study aimed to elucidate the association between depressive symptoms and amyloid pathology.
Objective To examine the association between depressive symptoms and amyloid pathology and its dependency on age, sex, education, and APOE genotype in older individuals without dementia.
Design, Setting, and Participants Cross-sectional analyses were performed using data from the Amyloid Biomarker Study data pooling initiative. Data from 49 research, population-based, and memory clinic studies were pooled and harmonized. The Amyloid Biomarker Study has been collecting data since 2012 and data collection is ongoing. At the time of analysis, 95 centers were included in the Amyloid Biomarker Study. The study included 9746 individuals with normal cognition (NC) and 3023 participants with mild cognitive impairment (MCI) aged between 34 and 100 years for whom data on amyloid biomarkers, presence of depressive symptoms, and age were available. Data were analyzed from December 2022 to February 2024.
Main Outcomes and Measures Amyloid-β1-42 levels in cerebrospinal fluid or amyloid positron emission tomography scans were used to determine presence or absence of amyloid pathology. Presence of depressive symptoms was determined on the basis of validated depression rating scale scores, evidence of a current clinical diagnosis of depression, or self-reported depressive symptoms.
Results In individuals with NC (mean [SD] age, 68.6 [8.9] years; 5664 [58.2%] female; 3002 [34.0%] APOE ε4 carriers; 937 [9.6%] had depressive symptoms; 2648 [27.2%] had amyloid pathology), the presence of depressive symptoms was not associated with amyloid pathology (odds ratio [OR], 1.13; 95% CI, 0.90-1.40; P = .29). In individuals with MCI (mean [SD] age, 70.2 [8.7] years; 1481 [49.0%] female; 1046 [44.8%] APOE ε4 carriers; 824 [27.3%] had depressive symptoms; 1668 [55.8%] had amyloid pathology), the presence of depressive symptoms was associated with a lower likelihood of amyloid pathology (OR, 0.73; 95% CI 0.61-0.89; P = .001). When considering subgroup effects, in individuals with NC, the presence of depressive symptoms was associated with a higher frequency of amyloid pathology in APOE ε4 noncarriers (mean difference, 5.0%; 95% CI 1.0-9.0; P = .02) but not in APOE ε4 carriers. This was not the case in individuals with MCI.
Conclusions and Relevance Depressive symptoms were not consistently associated with a higher frequency of amyloid pathology in participants with NC and were associated with a lower likelihood of amyloid pathology in participants with MCI. These findings were not influenced by age, sex, or education level. Mechanisms other than amyloid accumulation may commonly underlie depressive symptoms in late life.
:
Conflict of Interest Disclosures: Dr Oomens reported grants from Biogen during the conduct of the study. Dr Engelborghs reported grants from Fonds voor Wetenschappelijk Onderzoek Vlaanderen and Geneeskundige Stichting Koningin Elisabeth/Fondation Médicale Reine Elisabeth during the conduct of the study and participating in consultancy or on advisory boards of Biogen, Danone, Eisai, Icometrix, Pfizer, Novartis, and Roche and receiving unrestricted research grants (paid to institution) from ADx Neurosciences and Janssen Pharmaceutica outside the submitted work. Dr von Arnim reported receiving honoraria from serving on the scientific advisory boards of Biogen, Roche, Novo Nordisk, Biontech, Eli Lilly, MindAhead, and Dr. Willmar Schwabe GmbH & Co KG; funding for travel and speaker honoraria from Biogen, Roche, Novartis, Medical Tribune Verlagsgesellschaft, Landesvereinigung für Gesundheit und Akademie für Sozialmedizin Niedersachsen, Forum für Medizinische Fortbildung, and Dr. Willmar Schwabe GmbH &Co. KG; and research support from Roche. Dr Boada reported funding from the Instituto de Salud Carlos III (ISCIII) Acción Estratégica en Salud, integrated in the Spanish National Investigación, Desarrollo e Innovación Plan and financed by ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional; consulting for Araclon, Avid, Grifols, Lilly, Nutricia, Roche, Eisai, Biogen, Merck, Zambon, Novo Nordisk, and Servier; receiving fees from lectures and funds for research from Araclon, Biogen, Grifols, Nutricia, Roche, Novo Nordisk, and Servier; receiving grants/research funding from AbbVie, Araclon, Biogen Research Limited, Bioiberica, Grifols, Lilly, SA Pharma, Merck Sharp & Dohme, Kyowa Hakko Kirin, Laboratorios Servier, Nutricia, Oryzon Genomics, Piramal Imaging Limited, Roche Pharma SA, and Schwabe Farma Iberica; and holding advisory board memberships with Grifols, Roche, Lilly, Araclon Biotech, Merck, Zambon, Biogen, Novo Nordisk, Bioiberica, Eisai, Servier, and Schwabe Pharma. Dr van der Flier reports research funding from ZonMW, Nederlandse Organisatie voor Wetenschappelijk Onderzoek, European Union Joint Programme–Neurodegenerative Disease Research, European Union Innovative Health Initiative, Alzheimer Nederland, Hersenstichting CardioVascular Onderzoek Nederland, Health~Holland, Topsector Life Sciences & Health, stichting Dioraphte, Gieskes-Strijbis fonds, stichting Equilibrio, Edwin Bouw fonds, Pasman stichting, stichting Alzheimer & Neuropsychiatrie Foundation, Philips, Biogen, Novartis-NL, Life- Molecular Imaging, Avid, Roche BV, Fujifilm, Eisai, and Combinostics; is consultant to Oxford Health Policy Forum, Roche, Biogen, and Eisai (all funding paid to institution); has participated in advisory boards of Biogen, Roche, and Eli Lilly; is member of the steering committee of EVOKE/EVOKE+ (Novo Nordisk) (all funding paid to institution); is a member of the steering committee of PAVE and Think Brain Health (no financial compensation); was associate editor of Alzheimer, Research & Therapy in 2020 and 2021; is associate editor at Brain (no financial compensation); holds the Pasman chair; is a recipient of ABOARD (A Personalized Medicine Approach for Alzheimer’s Disease), which is a public-private partnership receiving funding from ZonMW and Health~Holland; and has been an invited speaker at Biogen, Danone, Eisai, WebMD Neurology (Medscape), Novo Nordisk, Springer Healthcare, and European Brain Council. Dr Fröhlich reported personal fees from Biogen, Eisai, Grifols, Hummingbird, Janssen Cilag, Eli Lilly, Lundbeck, Neurimmune, Noselab, Novo Nordisk, Hoffmann La Roche, Dr. Willmar Schwabe, Otsuka/Avanir, Pharmatropix, Neuroscios, Vivoryon, and FZ Jülich outside the submitted work. Dr Grimmer reported consulting fees from AbbVie, Alector, Anavex, Biogen, Bristol Myers Squibb, Cogthera, Eli Lilly, Functional Neuromodulation, Grifols, Iqvia, Janssen, Noselab, Novo Nordisk, NuiCare, Orphanzyme, Roche Diagnostics, Roche Pharma, Union Chimique Belge, Advantage Therapeutics, and Vivoryon; lecture fees from Biogen, Eisai, Grifols, Medical Tribune, Novo Nordisk, Roche Pharma, Schwabe, and Synlab; and has received grants (paid to institution) from Biogen, Eisai, and Roche. Dr Hort has consulted for Eisai, Biogen, Eli Lilly, Roche, and Neurona and holds stock options in Alzheon. Dr Lee reported grants from the Korean and US governments during the conduct of the study. Dr Lléo reported consulting fees from Eisai, Eli Lilly, Novo Nordisk, Biogen, and Grifols outside the submitted work. Dr Martinez-Lage reported grants from the Basque government Department of Health and the government of Spain, Ministry of Health during the conduct of the study as well as personal fees from Eisai, Eli Lilly, Roche, Nutricia, and Esteve outside the submitted work. Dr Meyer reported sponsorships from Siemens, GE Healthcare, Mediso Eli Lilly, Rotop, and Life Molecular Imaging (all paid to institution) outside the submitted work. Dr Popp reported receiving consultation and speaker honoraria from Nestle Institute of Health Sciences, Innovation Campus, École Polytechnique Fédérale de Lausanne, Ono Pharma, OM Pharma Suisse, and Fujirebio Europe and grants from the Swiss National Research Foundation and the European Medical Information Network (to institution) during the conduct of the study. Dr Rami reported funding from the Instituto de Salud Carlos III (ISCIII) Acción Estratégica en Salud, integrated in the Spanish National Investigación, Desarrollo e Innovación Plan and financed by ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (Una manera de hacer Europa). Dr Reiman is cofounder of and advisor for ALZPath. Dr Rinne reported grants from Sigrid Juselius Foundation and the Finnish government outside the submitted work. Dr Sarazin reported grants from French Ministry of Health, Fondation pour la recherche sur Alzheimer, Institut de Recherches Internationales Servier, and France-Alzheimer during the conduct of the study as well as grants from Institut Roche de Recherche et Medecine Translationelle outside the submitted work. Dr Scarmeas reported being a local recruiting site principal investigator for Novo Nordisk–funded multinational, multicenter industry sponsored phase III treatment trial for Alzheimer disease (to institution) outside the submitted work. Dr Snyder reported being a consultant to Alzheon, AlzeCure Pharma, and ALZPath outside the submitted work. Dr Sperling reported receiving honorarium for consulting from AbbVie, AC Immune, Acumen, Alector, Alnylam, Biohaven, Bristol Myers Squibb, Cytox, Genentech, Ionis, Janssen, Japanese Organisation for Medical Device Development, Oligomerix, Neuraly, Neurocentria, Nervgen, Renew, Roche, Prothena, Shionogi, Vaxxinity, and Vigil Neuroscience; research funding from the National Institute on Aging, Alzheimer’s Association, Eisai, Eli Lilly, and Janssen; and spousal financial relationships (Keith A. Johnson): Cerveau, Janssen, AC Immune, and Novartis outside the submitted work. Dr Wiltfang reported personal fees from Abbott, Biogen, Boehringer Ingelheim, Immungenetics, Janssen, Lilly, Merck Sharp & Dohme, Noselab, Pfizer, Roche, Roboscreen, and Beejing Yibai Science and Technology outside the submitted work; in addition, Dr Wiltfang had a patent for PCT/EP 2011 001724 issued and a patent for PCT/EP 2015 052945 issued. Dr Zetterberg reported having served at scientific advisory boards or as a consultant for AbbVie, Acumen, Alector, Alzinova, ALZPath, Amylyx, Annexon, Apellis, Artery Therapeutics, AZTherapies, Cognito Therapeutics, CogRx, Denali, Eisai, Merry Life, Nervgen, Novo Nordisk, Optoceutics, Passage Bio, Pinteon Therapeutics, Prothena, Red Abbey Labs, reMYND, Roche, Samumed, Siemens Healthineers, Triplet Therapeutics, and Wave; having given lectures in symposia sponsored by Alzecure, Biogen, Cellectricon, Fujirebio, Eli Lilly, Novo Nordisk, and Roche; and being a cofounder of Brain Biomarker Solutions in Gothenburg, which is a part of the GU Ventures Incubator Program, outside the submitted work. Dr Ossenkoppele has received research funding (paid to institution) from European Research Council, ZonMw, Nederlandse Organisatie voor Wetenschappelijk Onderzoek, National Institute of Health, Alzheimer’s Association, Alzheimer Nederland, Stichting Dioraphte, Cure Alzheimer’s fund, Health Holland, ERA PerMed, Alzheimerfonden, Hjarnfonden, Avid Radiopharmaceuticals, Janssen Research & Development, Roche, Quanterix and Optina Diagnostics; has given lectures in symposia sponsored by GE Healthcare; is an advisory board member for Asceneuron and Bristol Myers Squibb, a steering committee member for Biogen and Bristol Myers Squibb, and an editorial board member of Alzheimer’s Research & Therapy and the European Journal of Nuclear Medicine and Molecular Imaging. Dr Vos reported grants from the Innovative Medicines Initiative of the European Platform for Neurodegenerative Diseases, Stichting Adriana van Rinsum-Ponsen, and Alzheimer Nederland outside the submitted work. Dr Jansen reported research support from Biogen and grants from ZonMw, St. Rinsum-Ponsen and Alzheimer Nederland during the conduct of the study. Dr Alcolea reported participating in advisory boards from Fujirebio-Europe and Roche Diagnostics; receiving speaker honoraria from Fujirebio-Europe, Roche Diagnostics, Nutricia, Krka Farmacéutica SL, Zambon SAU, and Esteve Pharmaceuticals SA and personal fees from Grifols SA and Eli Lilly; filing a patent application (WO2019175379 A1 Markers of Synaptopathy in Neurodegenerative Disease); and holds a patent for EPI8382175.0 licensed to ADx. Dr Altomare received funding from the Fondation Recherche Alzheimer and the Swiss National Science Foundation. Dr Bateman has equity ownership interest in and receives advisory board compensation from C2N Diagnostics; may receive income based on technology (methods to detect microtubule-binding region tau isoforms and use thereof) licensed by Washington University to C2N Diagnostics; has received honoraria as a speaker, consultant, or advisory board member from Amgen and Roche; and reports grants from the National Institute on Aging and Alzheimer’s Association during the conduct of the study; in addition, Dr Bateman has served as consortium member for Amgen, Hoffman-La Roche, AstraZeneca, Forum, Mithridion, Pfizer, Sanofi, United Neuroscience, Biogen, AbbVie, Bristol Myers Squibb, Eisai, Eli Lilly, Ionis, Janssen, Prothena, Roche/Genentech, and Novartis; has received grants from the National Institute on Aging, Centene Corporation, Rainwater Foundation, the Association for Frontotemporal Degeneration, Biogen, BrightFocus Foundation, Cure Alzheimer’s Fund, Coins for Alzheimer’s Research Trust, Alzheimer’s Association, Eisai, The Foundation for Barnes–Jewish Hospital, Target ALS, and Good Ventures Foundation; has received nonfinancial support from Fondazione Prada, NAPA Advisory Council on Alzheimer’s Research, Clinical Trials on Alzheimer’s Disease, Fralin Biomedical Research Institute, Beeson, Adler Symposium Hotel and transfers reimbursed, University of Pennsylvania, Yale University, Eisai, Janssen, Hoffman La Roche, CogState, Hoffman La Roche, Alzheimer’s Association, Duke Margolis Alzheimer’s Roundtable, BrightFocus Foundation, the Tau Consortium, and Signant; has received personal fees from Korean Dementia Association, American Neurological Association, Fondazione Prada, Weill Cornell Medical College, Harvard University, University of Pennsylvania; has served (unpaid) on advisory boards for Hoffman La Roche/Genentech, Biogen, UK Dementia Research Institute at University College London, and Stanford University outside the submitted work; in addition, Dr Bateman had a patent for Methods for Measuring the Metabolism of Central Nervous System–Derived Biomolecules In Vivo, a patent for Methods for Measuring the Metabolism of Neurally-Derived Biomolecules In Vivo, a patent for Plasma-Based Methods for Detecting Central Nervous System Amyloid Disposition, a patent for Plasma-Based Methods for Determining A-Beta Amyloidosis, a patent for Methods of Treating Based on Site-Specific Tau Phosphorylation, and a patent for Tau Kinetic Measurements; Dr Bateman also reports equity ownership interest in C2N Diagnostics and received royalty income based on technology (methods of diagnosing AD with phosphorylation changes, stable isotope labeling kinetics, and blood plasma assay) licensed by Washington University to C2N Diagnostics and receives income from C2N Diagnostics for serving on the scientific advisory board. Dr Blennow has served as a consultant and at advisory boards for AbbVie, AC Immune, ALZPath, AriBio, BioArctic, Biogen, Eisai, Eli Lilly, Moleac Pte Ltd, Neurimmune, Novartis, Ono Pharma, Prothena, Roche Diagnostics, and Siemens Healthineers; has served on data monitoring committees for Julius Clinical and Novartis; has given lectures, produced educational materials, and participated in educational programs for AC Immune, Biogen, Celdara Medical, Eisai, and Roche Diagnostics; and is a cofounder of Brain Biomarker Solutions in Gothenburg AB, which is a part of the GU Ventures Incubator Program, outside the present work. Dr Chen reported grants from the National Institutes of Health and the state of Arizona outside the submitted work. Dr Day reports no competing interests directly relevant to this work; his research is supported by the National Institutes of Health; he also serves as a consultant for Parabon Nanolabs and as a topic editor (dementia) for DynaMed. He is the co–project principal investigator for a clinical trial in anti–N-Methyl-D-aspartate receptor encephalitis, which receives support from the National Institute of Neurological Disorders and Stroke and Amgen Pharmaceuticals, and a consultant for Arialys Therapeutics; he has developed educational materials for Continuing Education Inc and Ionis Pharmaceuticals; he owns stock in ANI Pharmaceuticals; Dr Day’s institution has received support from Eli Lilly for development of and participation in an educational event promoting early diagnosis of symptomatic Alzheimer disease and in-kind contributions of radiotracer precursors for tau positron emission tomography neuroimaging in studies of memory and aging (via Avid Radiopharmaceuticals, a wholly owned subsidiary of Eli Lilly). Dr Drzezga reported grants from EU Amypad and Deutsche Forschungsgemeinschaft; nonfinancial support from Siemens Healthineers, Life Molecular Imaging, GE Healthcare, Avid Radiopharmaceuticals, Sofie, Eisai, Novartis, and Ariceum Therapeutics; personal fees from Siemens Healthineers, Sanofi, GE Healthcare, Biogen, Novo Nordisk, Invicro, Novartis, Bayer Vital, Eli Lilly, Peer View Institute for Medical Education, International Atomic Energy Agency; and stock in Siemens Healthineers, Lantheus Holding, Structured Therapeutics, and Eli Lilly outside the submitted work. Dr Eckerström reported employment as an independent reviewer at WCG Clinical Services outside the submitted work. Dr Ekblad reported personal fees from Finnish Governmental Research Funding during the conduct of the study. Dr Epelbaum reports research support from Fondation Recherche Alzheimer, consulting fees from Biogen and Roche, honoraria from Eisai, and travel support from Edimark. Dr Fortea reported grants from Fondo de Investigaciones Sanitario, Instituto de Salud Carlos III, National Institutes of Health, Generalitat de Catalunya, Fundació Tatiana Pérez de Guzmán el Bueno, Alzheimer’s Association, Brightfocus, and Horizon 2020 (European Commission) during the conduct of the study as well as personal fees from Lundbeck, Roche, AC Immune, Esteve, Biogen, Laboratorios Carnot, Adamed, Life Molecular Imaging, Eli Lilly, Alzheon, Eisai, Zambón, Ionis, and Perha outside the submitted work; in addition, Dr Fortea had a patent for WO2019175379 A1 Markers of Synaptopathy in Neurodegenerative Disease issued. Dr Guedj reported having a scientific collaboration on amyloid positron emission tomography imaging with Life Molecular Imaging before 2018 and receiving honoraria from GE Healthcare and Life Molecular Imaging for expertise and training in the last 3 years. Dr Jiménez-Bonilla reported funding from Instituto de Investigación Sanitaria Valdecilla. Dr Paraskevas reported research funding from Novo Nordisk and consulting fees from Biogen and ITF Hellas outside the submitted work. Dr Kern reported consulting, speaking, or advisory board fees or honoraria from Geras Solutions, Biogen, Bioarctic, Roche, Eli Lilly, Geras Solutions, and Optoceutics. Dr Kirsebom reported grants from Helse Nord during the conduct of the study and personal fees from Eisai (medical advisory board) and Roche (lecture) outside the submitted work. Dr Landau reported grants from the National Institutes of Health during the conduct of the study as well as grants from the National Institute on Aging; speaking fees from IMPACT-AD and Eisai; consulting fees from Banner Health; and data safety monitoring board participation at KeifeRx and the National Institutes of Health outside the submitted work. Dr Nobili reported receiving fees for teaching courses from GE Healthcare and Biogen, board participation at Roche and Biogen, and consultation with Bial. Dr Landau reported grants from the National Institutes of Health during the conduct of the study as well as grants from the National Institute on Aging; speaking fees from IMPACT-AD and Eisai; consulting fees from Banner Health; and data safety monitoring board participation at KeifeRx and the National Institutes of Health outside the submitted work. Dr Maserejian is an employee and shareholder at Biogen. Dr Marquié reported funding from the Instituto de Salud Carlos III Acción Estratégica en Salud, integrated in the Spanish National Investigación, Desarrollo e Innovación Plan and financed by ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional; consulting for F. Hoffmann-La Roche; and participating in advisory boards at Araclon Biotech-Grifols. Dr Mroczko has received consulting and/or lecture honoraria from Abbott, Wiener, Roche, Cormay, Biameditek, and TK Biotech companies. Dr Perrin reported receiving research support from the National Institute on Aging; his laboratory receives cost recovery funding from Biogen for tissue procurement and processing services related to amyotrophic lateral sclerosis clinical trials outside the scope of this submitted work; neither he nor his family owns stock or has equity interest (outside of mutual funds or other externally directed accounts) in any pharmaceutical or biotechnology company. Dr Peters reported grants from Roche, Biogen, Eisai, Noselab, Alector, and Predemtec and personal fees from Grifols, Novo Nordisk, Proinnovation, Eli Lilly, and Neurotransdata outside the submitted work; she is editor in chief of Alzheimer Research and Therapy; serves on editorial boards of Molecular Neurodegeneration, Neurology: Neuroimmunology & Neuroinflammation, Medidact Neurologie/Springer; and serves on a committee to define guidelines for cognitive disturbances and another committee for acute neurology in the Netherlands. She had consultancy/speaker contracts for Aribio, Biogen, Beckman-Coulter, Cognition Therapeutics, Eli Lilly, Merck, Novo Nordisk, Olink, Roche, and Veravas. Dr Ruiz reported receiving support from Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Instituto de Salud Carlos III (ISCIII); the European Union/European Federation of Pharmaceutical Industries and Associations Innovative Medicines Initiative Joint Undertaking; grants from the Exosomes Isolation Tool with Nanofluidic Concentration Device project, European Union Euronanomed3 Program, PREADAPT project (identification of personalized inflammatory profiles of aging and senescence which are modified specifically by risk factors of dementia modulating the preclinical speed of dementia progression), and the Joint Program for Neurodegenerative Diseases; and research funding from ISCIII Acción Estratégica en Salud, which was integrated in the Spanish National Investigación, Desarrollo e Innovación Plan and financed by a grant from ISCIII-Subdirección General de Evaluación and the Fondo Europeo de Desarrollo Regional (Una manera de hacer Europa) by Fundación Bancaria La Caixa and Grífols SA); in addition, Dr Ruiz reported personal fees from Landsteiner Genmed (scientific advisory board), nonfinancial support from Grifols (traveling), and grants from ISCIII, European Union Joint Programme–Neurodegenerative Disease Research, Vlaams Agentschap Innoveren & Ondernemen–Flanders innovation & entrepreneurship, Alzheimer Association, and Janssen during the conduct of the study. Dr Soininen reported consulting fees from AC Immune and Novo Nordisk outside the submitted work. Dr Teunissen is supported by the European Commission (Marie Curie International Training Network) and Targeting Aging with Metformin, Innovative Medicines Initiatives 3TR (Horizon 2020) European Platform for Neurodegenerative Diseases (Innovative Medicines Initiatives 2 Joint Undertaking) and European Union Joint Programme–Neurodegenerative Disease Research (Blood Proteins for Early Discrimination of Dementias; Deciphering the Chemoproteomics and Chemo Transcriptomics of Anti-Alzheimer Drugs for Novel Druggable Target Identification and Biomarkers Development), European Partnership on Metrology, cofinanced from the European Union’s Horizon Europe Research and Innovation Programme and by the Participating States (22HLT07 NEuroBioStand), Clinical Implementation of Amyloid Neurodegeneration and Tau Testing (CANTATE) project funded by the Alzheimer Drug Discovery Foundation, Alzheimer Association, Michael J. Fox Foundation, Health Holland, the Dutch Research Council, Alzheimer Drug Discovery Foundation, The Selfridges Group Foundation, Alzheimer Netherlands; in addition, Dr Teunissen is a recipient of ABOARD (A Personalized Medicine Approach for Alzheimer’s Disease), which is a public-private partnership receiving funding from ZonMW and Health~Holland, Topsector Life Sciences & Health; Dr Teunissen is also a recipient of Timely, Accurate and Personalized Diagnosis of Dementia (TAP-dementia), a ZonMw-funded project in the context of the Dutch National Dementia Strategy. Dr Teunissen reports having a collaboration contract with ADx Neurosciences, Quanterix, and Eli Lilly; performing contract research or receiving grants from AC Immune, Axon Neurosciences, Biogen, Brainstorm Therapeutics, Celgene, EIP Pharma, Eisai, PeopleBio, Roche, Toyama, and Vivoryon; serving on editorial boards of Medidact Neurologie/Springer, Alzheimer Research and Therapy, and Neurology: Neuroimmunology & Neuroinflammation; and being editor of a neuromethods book from Springer. Dr Teunissen also reported research contracts with Acumen, ADx Neurosciences, AC Immune, Alamar, Aribio, Axon Neurosciences, Beckman-Coulter, BioConnect, Bioorchestra, Brainstorm Therapeutics, Celgene, Cognition Therapeutics, EIP Pharma, Eisai, Eli Lilly, Fujirebio, Instant Nano Biosensors, Novo Nordisk, Olink, PeopleBio, Quanterix, Roche, Toyama, and Vivoryon. Dr A. Wallin reported receiving gratuity for lectures from Lundbeck. No other disclosures were reported.