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Peripheral immunosenescence biomarkers and longitudinal cognitive decline: a large population-based study.

Source: PubMed, NCBI / U.S. National Library of Medicine

npj agingHua Rong, Yang Aimin, Lam Chun Sing, et al.Published 6/2/2026Last synced 6/3/2026Status: syncedPMID: 42230607DOI: 10.1038/s41514-026-00423-4

Peripheral immunosenescence has been increasingly implicated in dementia pathogenesis. However, the contributions of specific lymphocyte subsets to cognitive outcomes remain poorly defined, and evidence from large-scale longitudinal studies is scarce. We leveraged data from the US Health and Retirement Study (n&#x2009;=&#x2009;7444; mean age: 67.7&#x2009;&#xb1;&#x2009;9.7 years). Our primary analysis calculated three ratio metrics to quantify T-cell immunosenescence: the CD4:CD8 ratio, CD4&#x2009;+&#x2009;EMRA: Na&#xef;ve and CD8&#x2009;+&#x2009;EMRA: Na&#xef;ve ratios. Their longitudinal associations with 6-year cognitive decline were evaluated by linear mixed model adjusted for multiple covariates. We found that a higher CD8&#x2009;+&#x2009;EMRA: Na&#xef;ve ratio was significantly associated with accelerated cognitive decline (-0.050 point/year per SD; 95% CI: -0.066 to -0.033, P&#x2009;<&#x2009;0.001). A nonlinear association was observed for the CD4:CD8 ratio (P for nonlinearity&#x2009;=&#x2009;0.033), with only an intermediate level (the third quartile) associated with a slower cognitive decline. No significant association was found for the CD4&#x2009;+&#x2009;EMRA: Na&#xef;ve ratio. This study reveals a compartmentalized pattern in the associations of immunosenescent metrics with cognitive aging. The findings indicate a specific detrimental pathway characterized by an elevated CD8&#x2009;+&#x2009;EMRA:Na&#xef;ve ratio, whereas balanced CD4:CD8 homeostasis may play a ben

Abstract

Peripheral immunosenescence has been increasingly implicated in dementia pathogenesis. However, the contributions of specific lymphocyte subsets to cognitive outcomes remain poorly defined, and evidence from large-scale longitudinal studies is scarce. We leveraged data from the US Health and Retirement Study (n&#x2009;=&#x2009;7444; mean age: 67.7&#x2009;&#xb1;&#x2009;9.7 years). Our primary analysis calculated three ratio metrics to quantify T-cell immunosenescence: the CD4:CD8 ratio, CD4&#x2009;+&#x2009;EMRA: Na&#xef;ve and CD8&#x2009;+&#x2009;EMRA: Na&#xef;ve ratios. Their longitudinal associations with 6-year cognitive decline were evaluated by linear mixed model adjusted for multiple covariates. We found that a higher CD8&#x2009;+&#x2009;EMRA: Na&#xef;ve ratio was significantly associated with accelerated cognitive decline (-0.050 point/year per SD; 95% CI: -0.066 to -0.033, P&#x2009;<&#x2009;0.001). A nonlinear association was observed for the CD4:CD8 ratio (P for nonlinearity&#x2009;=&#x2009;0.033), with only an intermediate level (the third quartile) associated with a slower cognitive decline. No significant association was found for the CD4&#x2009;+&#x2009;EMRA: Na&#xef;ve ratio. This study reveals a compartmentalized pattern in the associations of immunosenescent metrics with cognitive aging. The findings indicate a specific detrimental pathway characterized by an elevated CD8&#x2009;+&#x2009;EMRA:Na&#xef;ve ratio, whereas balanced CD4:CD8 homeostasis may play a beneficial role.

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