Fig. 4: Differential biomarker–behavior correlations in SCD and NC.

The biomarker–mental health correlation analysis comparing individuals with SCD and NC revealed a negative correlation between anxiety and plasma p-Tau181 in NC but not in those with SCD (group difference p = 0.044; A). In biomarker–cognition correlation studies, a trend of higher plasma Tau being associated with superior semantic fluency (CF-animal and fruit) in NC had the opposite direction among those with SCD; however, the correlations for those with SCD were not statistically significant (group differences all p < 0.05; B). Moreover, the negative correlation of plasma Aβ40 and the positive correlation of Aβ42/Aβ40 ratio with semantic fluency (CF-animal and color) and working memory (DST-f) were present in the NC group but not in the SCD group (group differences all p < 0.05; C). Additionally, no differences were observed between the SCD and NC groups in terms of correlations between physical biomarkers and fatigability (all group differences p > 0.05).