Plasma Biomarkers Differentiate Cognitive Impairment in Postmenopausal Women with Insomnia Disorder
4 affiliations
- 1Department of Gynecology, Women's Hospital, School of Medicine, Zhejiang University, Hangzhou 310006, China
- 2Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
- 3School of Life Sciences, Zhejiang Chinese Medical University, Hangzhou, China
- 4Zhejiang Key Laboratory of Precision Psychiatry, Hangzhou, China
Abstract
Background: Sleep disorders are common in postmenopausal women and may contribute to cognitive decline. We investigated whether plasma biomarkers differentiate cognitive impairment (CI) in this population.
Methods: In this cross-sectional exploratory study, we recruited 105 outpatients with insomnia disorder (79 women and 26 men) aged 45-60 years with insomnia symptoms (PSQI > 5, ISI > 7). Cognition was assessed using the Chinese Brief Cognitive Test (CBCT) and Auditory Verbal Learning Test. Postmenopausal women were classified as CI or non-CI based on CBCT criteria. Plasma glial fibrillary acidic protein (GFAP), neurofilament light chain, orexin A, total tau, and phosphorylated tau-181 (p-Tau) were measured using enzyme-linked immunosorbent assay. Associations with cognition and exploratory classification performance were examined using correlation and receiver operating characteristic analyses.
Results: Postmenopausal women exhibited higher anxiety and poorer cognitive performance despite comparable insomnia severity. Among them (non-CI n=42; CI n=37), the CI group had higher plasma GFAP (14.82 vs. 12.42 ng/mL, P = .004) and p-Tau (1,002.18 vs. 918.27 pg/mL, P = .034). Biomarker-cognition correlations were weak. GFAP showed the highest apparent performance among individual biomarkers (area under the curve, AUC = 0.672). The clinical information-adjusted model incorporating orexin A, GFAP, and p-Tau showed the highest apparent AUC among biomarker combinations (AUC = 0.755), although internally validated performance was more modest.
Conclusions: Plasma GFAP and p-Tau, with potential incremental contribution from orexin A, may provide exploratory information for identifying cognitive vulnerability in postmenopausal women with insomnia disorder. These exploratory findings require validation in larger and independent cohorts.
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BibTeX
@article{wang2026plasma,
title = {{Plasma Biomarkers Differentiate Cognitive Impairment in Postmenopausal Women with Insomnia Disorder}},
author = {Danyun Wang and Bing Chen and Kangyu Jin and Shangping Cheng and Bin Qin and Yuting Tian and Jing Lu and Ketan Chu},
journal = {Psychiatry and clinical psychopharmacology},
year = {2026},
month = aug,
doi = {10.65801/pcp.3463},
url = {https://europepmc.org/article/PMC/PMC13720843},
note = {CC BY-NC},
}
RIS
TY - JOUR
TI - Plasma Biomarkers Differentiate Cognitive Impairment in Postmenopausal Women with Insomnia Disorder
AU - Danyun Wang
AU - Bing Chen
AU - Kangyu Jin
AU - Shangping Cheng
AU - Bin Qin
AU - Yuting Tian
AU - Jing Lu
AU - Ketan Chu
PY - 2026
DA - 2026/08/01
JO - Psychiatry and clinical psychopharmacology
DO - 10.65801/pcp.3463
UR - https://europepmc.org/article/PMC/PMC13720843
AB - Background: Sleep disorders are common in postmenopausal women and may contribute to cognitive decline. We investigated whether plasma biomarkers differentiate cognitive impairment (CI) in this population. Methods: In this cross-sectional exploratory study, we recruited 105 outpatients with insomnia disorder (79 women and 26 men) aged 45-60 years with insomnia symptoms (PSQI > 5, ISI > 7). Cognition was assessed using the Chinese Brief Cognitive Test (CBCT) and Auditory Verbal Learning Test. Postmenopausal women were classified as CI or non-CI based on CBCT criteria. Plasma glial fibrillary acidic protein (GFAP), neurofilament light chain, orexin A, total tau, and phosphorylated tau-181 (p-Tau) were measured using enzyme-linked immunosorbent assay. Associations with cognition and exploratory classification performance were examined using correlation and receiver operating characteristic analyses. Results: Postmenopausal women exhibited higher anxiety and poorer cognitive performance despite comparable insomnia severity. Among them (non-CI n=42; CI n=37), the CI group had higher plasma GFAP (14.82 vs. 12.42 ng/mL, P = .004) and p-Tau (1,002.18 vs. 918.27 pg/mL, P = .034). Biomarker-cognition correlations were weak. GFAP showed the highest apparent performance among individual biomarkers (area under the curve, AUC = 0.672). The clinical information-adjusted model incorporating orexin A, GFAP, and p-Tau showed the highest apparent AUC among biomarker combinations (AUC = 0.755), although internally validated performance was more modest. Conclusions: Plasma GFAP and p-Tau, with potential incremental contribution from orexin A, may provide exploratory information for identifying cognitive vulnerability in postmenopausal women with insomnia disorder. These exploratory findings require validation in larger and independent cohorts.
SN - 2475-0581
ER -