Supplementary Material

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Background: Previous studies have shown that mitochondrial dysfunction (MtD) could be responsible for various age-related disorders, including cognitive decline. The main aim of the present study was to investigate possible link between serum levels of fibroblast growth factor 21 (FGF21, surrogate biomarker of MtD) and biomarkers of cognition in people over 60 years of age.

Methods: Eighty-seven adults aged 61 to 93 years (56 women) were enrolled in this cross-sectional study. Cognitive assessment included tests of global cognition, memory, and category fluency. Spearman's rank correlation was used to test an association between serum FGF21 and cognitive outcomes.

Results: Serum FGF21 levels are significantly higher in women compared to men (431.5 ± 268.8 vs. 274.0 ± 218.7 pg/ml; p < 0.01), with FGF21 positively correlated with global cognition (ρ = 0.35, p < 0.05), learning ability (ρ = 0.56, p < 0.01), immediate (ρ = 0.41, p <0.01) and delayed memory (ρ = 0.34, p < 0.05) in oldest participants (> 70 years).

Conclusion: A positive correlation between serum FGF21 and cognition are found in women and the oldest participants, suggesting modulation of mitochondrial function with age. Possible gender- and age-driven MtD in the elderly should be corroborated in further longitudinal studies.