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medRxiv PreprintsInternational6 October 2026

Blood Biomarkers of Alzheimer's Disease Neuropathology, Cognition, and Response to a Multidomain Lifestyle Intervention: Secondary analysis of the FINGER Randomized Controlled Dementia Risk Reduction Trial

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Interventions targeting lifestyle and health behaviors support cognition in older adults at risk of dementia. It remains unclear if the cognitive benefit of such interventions is modified by Alzheimer's disease (AD)-related neuropathology, and if lifestyle interventions lead to changes in blood AD biomarkers. Here, we analyzed core AD plasma biomarkers (A{beta}, p-tau181, p-tau217, p-tau231, NFL, GFAP) in the two-year FINGER randomized controlled multidomain lifestyle trial, which demonstrated cognitive efficacy in an at-risk older general population (N=1260). We found that 85% of participants
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