Researchers at the National University of Singapore (NUS) have identified four blood proteins associated with cerebrovascular disease, cognitive decline and serious cardiovascular outcomes.

The findings, published on November 10 in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, were based on an analysis of more than 1,400 proteins across two Singapore-based research cohorts.

The study examined 518 participants from a memory clinic cohort. Researchers analysed blood samples alongside brain MRI scans and cognitive assessments to identify protein patterns associated with damage to blood vessels in the brain.

The imaging assessments tracked conditions including white matter hyperintensities, lacunes, cerebral microbleeds and cortical infarcts. These abnormalities can indicate cerebrovascular damage and are associated with an increased risk of stroke, cognitive decline and dementia.

By comparing protein profiles with repeated brain imaging, the researchers identified signatures associated with existing cerebrovascular disease and its progression over time.

The findings were subsequently assessed in an independent Singaporean cohort. The identified proteins were also associated with mortality in this group.

The research was led by Professor Christopher Chen of NUS Medicine. Dr Sim Ming Ann, a researcher at the university’s Healthy Longevity Translational Research Programme and Memory Ageing and Cognition Centre, was the study’s first author.

The researchers said blood-based biomarkers could eventually complement existing clinical assessments and brain imaging. They may help identify individuals at higher risk and support earlier monitoring.

However, the findings require further validation before the proteins can be used in routine clinical practice. The team plans to investigate their biological roles and potential applications in future diagnostic tests and treatments.