Introduction: Cerebrospinal fluid (CSF) glial fibrillary acidic protein (GFAP) is a neuroinflammatory marker reflecting reactive astrogliosis and is measured regularly in clinical practice. However, its diagnostic utility in differentiating dementia subtypes remains unclear. This study aimed to evaluate differences in CSF GFAP concentrations and its associations with markers of disease severity and amyloid pathology. Methods: We conducted a retrospective cohort study using three datasets encompassing a broad range of dementia diagnoses. Included variables were CSF GFAP, β-amyloid 42 (Aβ42), the Aβ42/Aβ40 ratio, mini-mental state exam (MMSE) scores, and time from sampling to death. Results: A total of 1345 individuals were included. In Parkinson’s disease dementia (PDD) and Lewy body dementia (LBD), GFAP levels were similar (p>.05). Lower levels were observed in PDD compared to early-onset Alzheimer’s disease (AD), late-onset AD (LAD), and vascular dementia (VaD) (all p.05). Conclusion: CSF GFAP did not exhibit clinically relevant diagnostic or prognostic value in dementia. Further studies are needed to clarify its role in PDD.
Erickson et al. (Tue,) studied this question.