Plasma metabolomic signatures of dual decline in memory and gait in older adults

Abstract

Older adults experiencing dual decline in memory and gait have greater dementia risk than those with memory or gait decline only, but mechanisms are unknown. Dual decline may indicate specific pathophysiological pathways to dementia which can be reflected by circulating metabolites. We compared longitudinal changes in plasma metabolite biomarkers of older adults with and without dual decline in the Baltimore Longitudinal Study of Aging (BLSA). Participants were grouped into 4 phenotypes based on annual rates of decline in verbal memory and gait speed: no decline in memory or gait, memory decline only, gait decline only, and dual decline. Repeated measures of plasma metabolomics were measured by biocrates p500 kit during the same time of memory and gait assessments. In BLSA, 18 metabolites differed across groups (q-value < 0.05). Metabolites differentially abundant were enriched for lysophosphatidylcholines (lysoPC C18:0,C16:0,C17:0,C18:1,C18:2), ceramides (d18:2/24:0,d16:1/24:0,d16:1/23:0), and amino acids (glycine) classes. Compared to no decline, the dual decline group showed greater declines in lysoPC C18:0, homoarginine synthesis, and the metabolite module containing mostly triglycerides, and showed a greater increase in indoleamine 2,3-dioxygenase (IDO) activity. Metabolites distinguishing dual decline and no decline groups were implicated in metabolic pathways of the aminoacyl-tRNA biosynthesis, valine, leucine and isoleucine biosynthesis, histidine metabolism, and sphingolipid metabolism. Older adults with dual decline exhibit the most extensive alterations in metabolic profiling of lysoPCs, ceramides, IDO activity, and homoarginine synthesis. Alterations in these metabolites may indicate mitochondrial dysfunction, compromised immunity, and elevated burden of cardiovascular and kidney pathology.

Keywords: Dementia risk; Dual decline; Gait decline; Memory decline; Metabolomics.

Fig. 1

Trajectories of top significant metabolites from the lysophosphatidylcholines (A) and ceramides classes (B). Legend: p-values indicate the significance for group differences, including both cross-sectional and longitudinal comparisons

Fig. 2

Trajectories of IDO activity and homoarginine synthesis by groups. Legend: p-values indicate the significance for group differences, including both cross-sectional and longitudinal comparisons. The dual decline group had a significant increase in IDO activity and a significant decrease in homoarginine synthesis compared to no decline (p = 2.72E-05, and p = 0.012, respectively)

Fig. 3

Pathway enrichment analysis for metabolites different between dual decline and no decline groups in the BLSA