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Serum alkaline phosphatase is elevated and inversely correlated with cognitive functions in subjective cognitive decline: results from the ReGAl 2.0 project

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Abstract

Background

Alkaline phosphatase has been found on neuronal membranes and plasma alkaline phosphatase (ALP) activity increases during brain injury and cerebrovascular diseases, suggesting that its levels may reflect the neuronal loss. It is known that ALP is higher in subjects affected by Alzheimer’s dementia and inversely correlated with cognitive functions. No study has investigated the relationship between ALP and cognitive functions in old-age subject with pre-clinical cognitive impairment.

Methods

This is a cross-sectional study with data gathered from the ReGAl 2.0 project (Rete Geriatrica Alzheimer-Geriatric Network on Alzheimer’s disease), a large Italian multicentric clinical-based study. A cohort of 209 old-age subjects healthy controls (HC), Subjective cognitive decline (SCD), and Mild Cognitive Impairment (MCI) was included in the study. Cognitive performances were assessed with a large neuropsychological battery. The same day, serum alkaline phosphatase activity was measured in all subjects.

Results

We found that the SCD group had significantly higher ALP levels as compared with HC (p = 0.001). Among all neuropsychological tests, in all population ALP levels negatively correlated with scores at attentional matrices (r =  − 0.243, p = 0.002), Digit Span Forward (r =  − 0.241, p = 0.003) and Letter Fluency Test (r =  − 0.196, p = 0.044). Attentional Matrices (r =  − 0.208, p = 0.014) and Letter Fluency Test (r =  − 0.229, p = 0.019) remained significantly correlated with ALP even after controlling for gender. In the SCD group, only the Attentional Matrices significantly and negatively correlated with ALP (r =  − 0.344 p = 0.035), while no significant correlations were found in HC or MCI.

Conclusions

Results indicate that serum alkaline phosphatase activity is increased in SCD and inversely correlates with cognitive functions. Further studies are needed to investigate the role of ALP in the progression to AD.

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Acknowledgements

ReGAl 2.0 study group: Carlo Alberto Defanti, Cosimo Dentizzi, Antonio Gambardella, Daniela Mari, Fiammetta Monacelli, Fabio Monzani, Enrico Mossello, Graziano Onder, Giovanni Scala. Coordinating center: Institute of Gerontology and Geriatrics, Santa Maria della Misericordia Hospital, Department of Medicine, University of Perugia, Italy (Patrizia Mecocci, Virginia Boccardi). Collecting centers: Carlo Alberto Defanti (Fondazione Europea Ricerca Biomedica FERB, Centro Alzheimer, Ospedale Briolini, Gazzaniga, Bergamo, Italy); Cosimo Dentizzi (Centro Diurno Alzheimer, Centro Alzheimer ASREM Campobasso, Italy); Antonio Gambardella (Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Campania "Luigi Vanvitelli", Napoli, Italy); Daniela Mari (Geriatric Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy); Fiammetta Monacelli (Geriatrics Clinic, Department of Internal Medicine and Medical Specialties DIMI, University of Genova, Genova, Italy); Fabio Monzani (Geriatrics Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy); Enrico Mossello (Department of Experimental and Clinical Medicine, Research Unit of Medicine of Aging, University of Firenze, Firenze Italy); Graziano Onder (Centro di Medicina dell'Invecchiamento, Department of Geriatrics, Università Cattolica del Sacro Cuore di Roma and IRCCS Fondazione Policlinico "A. Gemelli", Roma, Italy); Giovanni Scala (Poliambulatorio ASL Roma 2, Roma, Italy). Webmaster: Arcangelo Biancardi.

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Authors and Affiliations

  1. Institute of Gerontology and Geriatrics, Department of Medicine, University of Perugia, Snta Maria Della Misericordia Hospital, Piazzale Gambuli 1, 06132, Perugia, Italy

    Virginia Boccardi, Valentina Bubba, Ilenia Murasecco, Martina Pigliautile, Roberta Cecchetti, Michela Scamosci, Patrizia Bastiani & Patrizia Mecocci

  2. Department of Biomedicine, Neuroscience and Advanced Diagnostics, University of Palermo, Palermo, Italy

    Roberto Monastero

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  1. Virginia Boccardi
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ReGAL 2.0 study group

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Correspondence to Virginia Boccardi.

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The study is carried in accordance with the 1964 Helsinki Declaration and its later amendments and with the ethical standards of the institutional ethics committee, and was approved by the ethics committee of the University of Perugia, Perugia, Italy.

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Boccardi, V., Bubba, V., Murasecco, I. et al. Serum alkaline phosphatase is elevated and inversely correlated with cognitive functions in subjective cognitive decline: results from the ReGAl 2.0 project. Aging Clin Exp Res 33, 603–609 (2021). https://doi.org/10.1007/s40520-020-01572-6

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