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September 17, 2026European Heart Journal OpenOpen Access

Plasma Neurofilament Light Chain and Risk of Death and Stroke in Community-Dwelling Elderly Individuals

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Why the study?

Are baseline plasma NFL and GFAP concentrations associated with cardiovascular events and death in community-dwelling older adults?

Population

806 community-dwelling older adults aged 75 years from the Prospective Investigation of the Vasculature in…

Design

Cohort

Follow-up

median 10 years

Key result

Higher plasma neurofilament light chain was independently associated with an increased risk of all-cause death (adjusted HR per doubling 1.91; 95% CI 1.49-2.46) in community-dwelling older adults.

Authors

JAJulia AulinKSKarl SjölinEFErika Frank

Discussion

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Overview

Higher NFL levels were associated with mortality in older adults; extends AF findings but leaves open whether NFL marks frailty or warrants targeted intervention.

Key Points

  • To investigate the prospective associations of circulating neuroinjury biomarkers, neurofilament light chain (NFL) and glial fibrillary acidic protein (GFAP), with cardiovascular events and mortality in community-dwelling older adults.
  • Measured baseline plasma NFL and GFAP concentrations using high-sensitivity Simoa assays in 806 participants aged 75 years from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study.
  • Assessed incident ischemic stroke, myocardial infarction, cardiovascular death, all-cause death, and major adverse cardiovascular events (MACE) across a median 10-year follow-up using sequentially adjusted Cox regression models.
  • Higher NFL was independently associated with all-cause death (adjusted HR per doubling 1.91; 95% CI 1.49–2.46) and MACE (adjusted HR 1.53; 95% CI 1.21–1.93), improving discrimination for all-cause death beyond conventional risk factors.
  • NFL was not independently associated with ischemic stroke or myocardial infarction, and demonstrated no association with cardiovascular death after adjusting for NT-proBNP; GFAP showed no association with any clinical outcome.

Study Design

Type

Cohort (n=806)

Structured PICO

Are baseline plasma NFL and GFAP concentrations associated with cardiovascular events and death in community-dwelling older adults?

P
Population
806 community-dwelling adults aged 75 years, followed for a median of 10 years to assess the prognostic value of neuroinjury biomarkers.
E
Exposure
Baseline plasma neurofilament light chain (NFL) and glial fibrillary acidic protein (GFAP) concentrations
O
Outcome
Ischemic stroke, myocardial infarction, cardiovascular death, all-cause death, and major adverse cardiovascular events (MACE; stroke, myocardial infarction, and all-cause death)hard clinical

Main Result

Hazard Ratio: 1.91 (95% CI 1.49–2.46)

In community-dwelling elderly individuals, higher plasma NFL is associated with an increased risk of all-cause death and MACE, reflecting overall physiological vulnerability rather than discrete vascular risk.

Cite This Study

Aulin et al. (2026) conducted a cohort in Community-dwelling elderly individuals (n=806). Plasma neurofilament light chain (NFL) was evaluated on All-cause death (HR 1.91, 95% CI 1.49-2.46). Higher plasma neurofilament light chain was independently associated with an increased risk of all-cause death (adjusted HR per doubling 1.91; 95% CI 1.49-2.46) in community-dwelling older adults.

synapsesocial.com/papers/6aabb8135f706d05830e7a32https://doi.org/10.1093/ehjopen/oeag143
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