Interpersonal emotion regulation during relationship conflict: Daily and longitudinal associations with couples' sexual well-being.

Relationship conflicts, which are common among committed couples, provoke negative emotions with implications for sexual well-being (i.e., satisfaction, desire, low distress). Couples might manage these emotions through extrinsic interpersonal emotion regulation (IER; attempting to influence the emotions of a romantic partner). In a preregistered dyadic, daily diary, and longitudinal study, we examined how four distinct IER strategies-responsiveness, cognitive support, physical presence, hostility-perceived by a romantic partner during relationship conflict related to both partners' sexual well-being. Over 28 days, community couples (N = 122; recruited between 2022 and 2023) completed brief measures of IER and sexual satisfaction, desire, and distress on days of relationship conflict and full versions of these measures 4 months later. Results may be generalizable to community couples in North America; however, improving the diversity of samples in future research would extend generalizability. Generally, greater perceived responsiveness, cognitive support, and physical presence IER on conflict days were each associated with higher daily sexual satisfaction and desire for couples, while greater perceived hostility was associated with lower daily satisfaction and desire. Greater perceived physical presence averaged across diaries was associated with one's own increased desire 4 months later. Most effects were similar for men and women; however, on days when women perceived greater responsiveness and cognitive support from partners, their partners reported more sexual distress, but there was no association between men's perceived IER and partners' distress. Findings expand models of IER to include sexual well-being and support IER as a target for interventions aimed at promoting sexual well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Trajectories of sexual well-being and links with grief after a recent pregnancy loss: a dyadic longitudinal study.

BACKGROUND: Pregnancy loss affects 1 in 4 women and is linked with poorer overall health and relationship outcomes. Despite sexual well-being's importance to health, how sexual well-being changes across time after a pregnancy loss and what might predict such changes, like perinatal grief, have never been examined, leaving practitioners and couples without knowledge of what to expect. AIM: We aimed to examine (1) how sexual satisfaction, sexual desire, sexual distress, and perinatal grief change from 10 to 25 weeks postloss for both couple members; and (2) if perinatal grief levels at 10 weeks postloss predict sexual well-being trajectories. METHODS: Women and gender-diverse individuals who were pregnant when a pregnancy loss occurred (within the last 4 months) and men, women, and gender-diverse partners who were not pregnant (N = 132 couples) independently completed 4 monthly assessments of sexual well-being and perinatal grief. OUTCOMES: Outcomes included sexual satisfaction (Global Measure of Sexual Satisfaction), sexual desire (Sexual Desire Inventory), sexual distress (Sexual Distress Scale-Short Form), perinatal grief (Perinatal Grief Scale). RESULTS: Dyadic growth curve modeling indicated that, from 10 to 25 weeks postloss, both couple members' sexual satisfaction increased, and their sexual desire remained stable; sexual distress decreased for partners but remained stable for individuals who were pregnant; and both couple members' perinatal grief decreased. Perinatal grief levels at 10 weeks postloss did not predict sexual well-being trajectories over time. CLINICAL IMPLICATIONS: Given sexual well-being's dynamic nature, clinicians should regularly discuss sexuality with both couple members after pregnancy loss. During such discussions, clinicians could reassure couples about their sexual relationship's recovery by sharing that, on average, sexual satisfaction, sexual desire, and sexual distress tend to improve or stay the same (rather than worsen) from 10 to 25 weeks postloss. They can also share that perinatal grief tends to decrease during this time and is unrelated to trajectories of sexual satisfaction, sexual desire, and sexual distress. STRENGTHS AND LIMITATIONS: This is the first study, to our knowledge, to examine how sexual well-being changes across time after a pregnancy loss and perinatal grief's role in such changes. The results may not generalize broadly, as most couples were in mixed-gender/sex relationships, identified as White, and were relatively affluent. CONCLUSION: From 10 to 25 weeks postloss, both couple members tend to experience improvements in their overall sexual well-being and declines in their perinatal grief. Early perinatal grief levels and subsequent sexual well-being trajectories are seemingly unrelated.

What Does a Pregnancy Loss Mean for Sex? Comparing Sexual Well-Being Between Couples With and Without a Recent Loss.

It is unclear whether sexual well-being, which is an important part of individual and relational health, may be at risk for declines after a pregnancy loss given the limits of prior work. Accordingly, in a cross-sectional study, we used structural equation modeling to (1) compare sexual well-being levels-satisfaction, desire, function, distress, and frequency-of both partners in couples who had experienced a pregnancy loss in the past four months (N = 103 couples) to their counterparts in a control sample of couples with no history of pregnancy loss (N = 120 couples), and (2) compare sexual well-being levels of each member of a couple to one another. We found that gestational individuals and their partners in the pregnancy loss sample were less sexually satisfied than their control counterparts but did not differ in sexual desire, problems with sexual function, nor sexual frequency. Surprisingly, we found that partners of gestational individuals had less sexual distress than their control counterparts. In the pregnancy loss sample, gestational individuals had lower levels of sexual desire post-loss than their partners but did not differ in sexual satisfaction, problems with sexual function, nor sexual distress. Our results provide evidence that a recent pregnancy loss is associated with lower sexual satisfaction and greater differences between partners in sexual desire, which may be useful information for clinicians working with couples post-loss. Practitioners can share these findings with couples who may find it reassuring that we did not find many aspects of sexual well-being to be related to pregnancy loss at about three months post-loss.

Sexual growth and destiny beliefs: Longitudinal associations with dyadic coping among couples seeking medically assisted reproduction.

BACKGROUND: Medically assisted reproduction is a vulnerable time for couples' sexual health. Believing that sexual challenges can be worked through (i.e., sexual growth beliefs) or that these challenges indicate incompatibility (i.e., sexual destiny beliefs) may be related to dyadic coping-the strategies couples use to cope-with the physical and psychological stressors of medically assisted reproduction. AIM: In the current study we aimed to examine the longitudinal associations between typical (i.e., average) levels of sexual growth and destiny beliefs and positive and negative facets of dyadic coping and how greater than typical levels of these constructs predicted each other across time. METHODS: Couples (n = 219) seeking medically assisted reproduction were recruited for an online longitudinal, dyadic study. OUTCOMES: Couples completed online measures of sexual growth and destiny beliefs and positive and negative dyadic coping at baseline, 6-and 12-months. RESULTS: Random intercept cross-lagged panel models demonstrated that at the within-person level, reporting higher sexual growth beliefs at baseline, relative to their average across time points, was associated with lower negative dyadic coping at 6 months. Higher negative dyadic coping at 6 months, relative to their average, was linked to lower sexual growth beliefs at 12-months. When individuals reported higher sexual destiny beliefs at 6-months, relative to their average, they and their partners reported higher negative dyadic coping at 12 -months. At the between-person level, higher overall levels of sexual destiny beliefs were related to higher overall levels of negative dyadic coping. No associations with positive dyadic coping were identified. CLINICAL IMPLICATIONS: Couples may benefit from identifying and reducing unhelpful beliefs about sex and negative dyadic coping. STRENGTHS AND LIMITATIONS: Strengths of this study include our large, inclusive sample, engagement of community partners, and novel analytical approach to assess change over time. However, following couples in 6-month increments and not using questionnaires specific to medically assisted reproduction may have limited our ability to detect nuanced changes that couples experience during this time. CONCLUSION: Lower sexual growth and higher sexual destiny beliefs may promote couples' engagement in less adaptive coping behaviors as they seek medically assisted reproduction.

Perceived financial burden is indirectly linked to sexual well-being via quality of life among couples seeking medically assisted reproduction.

Introduction: Medically assisted reproduction is a difficult treatment process for couples both financially and sexually. Yet, these two domains have not been examined together among couples seeking treatment, leaving couples and practitioners without guidance on how to address these domains together. Methods: In line with Couples and Finance Theory, we tested the hypothesis that perceived financial burden and couple income would predict quality of life during medically assisted reproduction, which would then predict four domains of sexual well-being (i.e., sexual satisfaction, desire, distress, and frequency). We also examined if the results differed by treatment status-that is, between partners who were receiving treatment and those who were not. Cross-sectional data from 120 couples who had undergone medically assisted reproduction in the past six months were analyzed via structural equation modeling through an actor-partner interdependence mediation model. Results: An individual's greater perceived financial burden predicted their own lower quality of life during medically assisted reproduction, which in turn predicted their lower sexual satisfaction, desire and distress, as well as their partner's lower sexual satisfaction. Household income did not indirectly predict any sexual well-being domains, and results regarding treatment status were inconclusive. Discussion: Clinicians can discuss with couples how perceived financial strain of medically assisted reproduction affects their quality of life and what ramifications that may have for their sexual well-being.

Associations between New Mothers' Partner-Oriented Sexual Values and Sexual Distress in the Transition to Parenthood.

Women commonly experience heightened sexual distress in pregnancy and postpartum, and there is limited knowledge of protective factors. Women report declines in the importance of sexuality during this time, suggesting that valuing sexuality could be a relevant individual difference factor. It may be particularly protective for women to feel successful in living in line with their sexual values. In a longitudinal study, we examined associations between the extent to which women valued their role as a sexual partner, and their success living in line with this partner-oriented sexual value, with their sexual distress. Women (N = 367) reported the importance of their role as a sexual partner, success living according to this value, and sexual distress during pregnancy (18-20 weeks) and at 3, 6, 12 and 24-months postpartum. More strongly valuing one's role as a sexual partner was associated with more sexual distress, both between-person (i.e., across women) and within-person (i.e., variation within women over time). Above and beyond these effects, greater success at living in line with one's partner-oriented sexual value was associated with less sexual distress. Finding ways to live in line with one's sexual values may protect against sexual distress for new mothers in the transition to parenthood.

Oxidative Stress, Cytotoxic and Inflammatory Effects of Urban Ultrafine Road-Deposited Dust from the UK and Mexico in Human Epithelial Lung (Calu-3) Cells.

Road-deposited dust (RD) is a pervasive form of particulate pollution identified (typically via epidemiological or mathematical modelling) as hazardous to human health. Finer RD particle sizes, the most abundant (by number, not mass), may pose greater risk as they can access all major organs. Here, the first in vitro exposure of human lung epithelial (Calu-3) cells to 0−300 µg/mL of the ultrafine (<220 nm) fraction of road dust (UF-RDPs) from three contrasting cities (Lancaster and Birmingham, UK, and Mexico City, Mexico) resulted in differential oxidative, cytotoxic, and inflammatory responses. Except for Cd, Na, and Pb, analysed metals were most abundant in Mexico City UF-RDPs, which were most cytotoxic. Birmingham UF-RDPs provoked greatest ROS release (only at 300 µg/mL) and greatest increase in pro-inflammatory cytokine release. Lancaster UF-RDPs increased cell viability. All three UF-RDP samples stimulated ROS production and pro-inflammatory cytokine release. Mass-based PM limits seem inappropriate given the location-specific PM compositions and health impacts evidenced here. A combination of new, biologically relevant metrics and localised regulations appears critical to mitigating the global pandemic of health impacts of particulate air pollution and road-deposited dust.

Alzheimer's disease diagnosis by blood plasma molecular fluorescence spectroscopy (EEM).

Despite tremendous research advances in detecting Alzheimer's disease (AD), traditional diagnostic tests remain expensive, time-consuming or invasive. The search for a low-cost, rapid, and minimally invasive test has marked a new era of research and technological developments toward establishing blood-based AD biomarkers. The current study has employed excitation-emission matrices (EEM) of fluorescence spectroscopy combined with machine learning to diagnose AD using blood plasma samples from 230 individuals (83 AD patients from 147 healthy controls). To evaluate the performance of the classification algorithms, we calculated the commonly used figures of merit (accuracy, sensitivity and specificity) and figures of merit that take into account the samples unbalance and the discrimination power of the models, as F2-score (F2), Matthews correlation coefficient (MCC) and test effectiveness ([Formula: see text]). The classification models achieved satisfactory results: Parallel Factor Analysis with Quadratic Discriminant Analysis (PARAFAC-QDA) with 83.33% sensitivity, 100% specificity, 86.21% F2; and Tucker3-QDA with 91.67% sensitivity, 95.45% specificity and 91.67% F2. In addition, the classifiers show high overall performance with 94.12% accuracy and 0.87 MCC. Regarding the discrimination power between healthy and AD patients, the classification algorithms showed high effectiveness with the mean scores separated by three or more standard deviations. The PARAFAC's spectral profiles and the wavelength values from both models loading profiles can be used in future research to relate this information to plasma AD biomarkers. Our results point to a rapid, low-cost and minimally invasive blood-based method for AD diagnosis.

Change in 21 Sexual Concerns of New Parents From Three to Twelve Months Postpartum: Similarities and Differences between Mothers and Partners.

BACKGROUND: Postpartum sexual concerns are associated with depressive symptoms, distress, and lower relationship satisfaction, and are commonly reported by both mothers and their partners. Previous studies have examined changes in postpartum sexual concern using aggregate scores and have not examined patterns of change for unique concerns, thus ignoring that the initial levels and trajectories of a variety of distinct, postpartum sexual concerns may differ from one another and may differ between mothers and partners. AIMS: The aims of the current study were to (i) examine how a variety of postpartum sexual concerns change from 3 to 12 months postpartum for mothers and their partners using a sample of first-time parents, and (ii) examine how mothers and their partners may differ in their initial levels and subsequent changes in postpartum sexual concerns. METHODS: First-time mothers and their partners (N = 203 couples) independently completed a measure of 21 postpartum sexual concerns at 3, 6, 9, and 12 months postpartum. OUTCOMES: Postpartum Sexual Concerns Questionnaire RESULTS: Growth modeling indicated that twelve of mothers' and 6 of partners' postpartum sexual concerns declined over time from 3 to 12 months postpartum, only one concern of mothers' and none of partners' concerns increased over time, and the remaining 8 and 15 concerns were stable for mothers and partners, respectively. At 3 months postpartum, mothers had higher levels of 11 postpartum sexual concerns than partners, while partners had higher levels than mothers on 4 concerns. Compared to partners, from 3 to 12 months postpartum, mothers showed both steeper decreases in concern about body image changes and steeper increases in concern about returning to work. CLINICAL IMPLICATIONS: Various postpartum sexual concerns do not all follow the same pattern of change over time, and mothers and their partners share similarities and differences in these patterns. Clinicians should use a checklist to discuss a range of postpartum sexual concerns with both new mothers and their partners. STRENGTHS AND LIMITATIONS: This is the first study, to our knowledge, to examine how a variety of postpartum sexual concerns change over time and how mothers and partners both differ and are similar in their experiences. Most couples were in mixed-sex relationships, identified as White, and were relatively affluent; results may not generalize. CONCLUSION: A variety of postpartum sexual concerns follow different patterns of change from 3 to 12 months postpartum, and mothers and partners share similarities and differences in these patterns. Allsop DB, Impett EA, Vannier SA, et al. Change in 21 Sexual Concerns of New Parents From Three to Twelve Months Postpartum: Similarities and Differences between Mothers and Partners. J Sex Med 2022;19:1366-1377.

Variable Sexual Satisfaction in Pregnancy: A Latent Profile Analysis of Pregnant Wives and Their Husbands.

Although not all couples achieve high levels of sexual satisfaction during pregnancy, evidence of variability in couple sexual satisfaction during pregnancy indicates that sexual dissatisfaction in pregnancy does not apply to all. Subsequently, the current study examined whether a nationally representative U.S. sample of wives and husbands (N = 523 couples) fell into subgroups in terms of their sexual satisfaction during pregnancy and to what degree biopsychosocial factors distinguish potential subgroups. Latent profile analyses, adjusted for pregnancy-related biological factors, indicated that couples could be classified into two subsets - a larger subset of couples where wives and husbands were satisfied with sex overall (79%) and a smaller subset where wives and husbands were neutral about satisfaction with sex (21%). Lower depressive symptoms among wives was associated with a greater likelihood of being in the more satisfied subset over the less satisfied subset - the only significant group membership predictor among a variety of other factors. Implications include notions that couples and practitioners should consider women's depressive symptoms throughout pregnancy in addition to the perinatal period, and that most U.S. newly married pregnant couples do well navigating sexual satisfaction challenges during pregnancy.

Amyotrophic lateral sclerosis: Correlations between fluid biomarkers of NfL, TDP-43, and tau, and clinical characteristics.

OBJECTIVES: We previously reported the diagnostic and prognostic performance of neurofilament light chain (NfL), TAR DNA-binding protein 43 (TDP-43), and total tau (t-tau) in cerebrospinal fluid (CSF) and plasma as amyotrophic lateral sclerosis (ALS) biomarkers. The present study aimed to elucidate associations between clinical characteristics and the markers as well as mutual associations of the markers in ALS patients using the same dataset. METHODS: NfL, TDP-43, and t-tau levels in CSF and plasma in 75 ALS patients were analyzed. The associations between those markers and clinical details were investigated by uni- and multivariate analyses. Correlations between the markers were analyzed univariately. RESULTS: In multivariate analysis of CSF proteins, the disease progression rate (DPR) was positively correlated with NfL (ß: 0.51, p = 0.007) and t-tau (ß: 0.37, p = 0.03). Plasma NfL was correlated with age (ß: 0.53, p = 0.005) and diagnostic grade (ß: -0.42, p = 0.02) in multivariate analysis. Plasma TDP-43 was correlated negatively with split hand index (ß: -0.48, p = 0.04) and positively with % vital capacity (ß: 0.64, p = 0.03) in multivariate analysis. Regarding mutual biomarker analysis, a negative correlation between CSF-NfL and TDP-43 was identified (r: -0.36, p = 0.002). CONCLUSIONS: Elevated NfL and t-tau levels in CSF may be biomarkers to predict rapid DPR from onset to sample collection. The negative relationship between CSF NfL and TDP-43 suggests that elevation of CSF TDP-43 in ALS is not a simple consequence of its release into CSF during neurodegeneration. The negative correlation between plasma TDP-43 and split hand index may support the pathophysiological association between plasma TDP-43 and ALS.

Mindfulness and Sexual Mindfulness as Moderators Between Conflict Resolution and Sexual and Relationship Satisfaction.

Mindfulness has shown positive links with conflict resolution. Additionally, couples skilled in conflict resolution report greater sexual and relationship satisfaction. However, no research has examined the moderating effect of mindfulness, specifically sexual mindfulness, between conflict resolution and sexual and relationship satisfaction. We used 1,627 couples from wave III of the Couple Relationships and Transition Experiences (CREATE) study. Sexual mindfulness moderated the association between conflict resolution and sexual satisfaction, even after controlling for attachment. Wives higher in sexual mindful awareness may rely less on conflict resolution for their sexual satisfaction. Karremans and colleagues' (2017) model of mindfulness and romantic relationships provides a framework for testing whether, when, and how mindfulness increases positive romantic relationship processes and outcomes. Under this framework, mindfulness may provide a mechanism to help couples achieve sexual and relationship satisfaction. Mindfulness and sexual mindfulness may provide a useful mechanism for therapists, educators, social workers, and couples to enhance satisfaction within the romantic and sexual relationship even without partner buy-in.

Variation in the concentration and regional distribution of magnetic nanoparticles in human brains, with and without Alzheimer's disease, from the UK.

The presence of magnetic nanoparticles (MNPs) in the human brain was attributed until recently to endogenous formation; associated with a putative navigational sense, or with pathological mishandling of brain iron within senile plaques. Conversely, an exogenous, high-temperature source of brain MNPs has been newly identified, based on their variable sizes/concentrations, rounded shapes/surface crystallites, and co-association with non-physiological metals (e.g., platinum, cobalt). Here, we examined the concentration and regional distribution of brain magnetite/maghemite, by magnetic remanence measurements of 147 samples of fresh/frozen tissues, from Alzheimer's disease (AD) and pathologically-unremarkable brains (80-98 years at death) from the Manchester Brain Bank (MBB), UK. The magnetite/maghemite concentrations varied between individual cases, and different brain regions, with no significant difference between the AD and non-AD cases. Similarly, all the elderly MBB brains contain varying concentrations of non-physiological metals (e.g. lead, cerium), suggesting universal incursion of environmentally-sourced particles, likely across the geriatric blood-brain barrier (BBB). Cerebellar Manchester samples contained significantly lower (~ 9×) ferrimagnetic content compared with those from a young (29 years ave.), neurologically-damaged Mexico City cohort. Investigation of younger, variably-exposed cohorts, prior to loss of BBB integrity, seems essential to understand early brain impacts of exposure to exogenous magnetite/maghemite and other metal-rich pollution particles.

How Empathy Moderates Associations Between Sexual and Relational Satisfaction.

Those with low sexual satisfaction tend to have low relational satisfaction. However, literature provides examples of those who maintain satisfying relationships despite low sexual satisfaction yet provides few clues as to what factors protect these individuals. Using U.S. nationally representative data from 1569 newlywed couples, we investigated if empathy for one's partner buffers individuals and couples from low relational satisfaction due to low sexual satisfaction. The positive connection between sexual satisfaction and relational satisfaction was weak for those reporting high empathy but was strong for those reporting low empathy. Empathy may protect against poor relational satisfaction when sexual satisfaction is low.

Perspectives from Highly Religious Families on Boundaries and Rules About Sex.

We investigated the intersection of religion and boundaries placed around sex using qualitative data from 198 highly religious Muslim, Christian, and Jewish families. Coding performed by two researchers resulted in six core themes that provide insight into the connection between these two domains. Frequency counts of the core themes, participant quotes, and implications are presented-including the benefits of practitioners inquiring into how clients' faith affects sexual behavior and scripts, how fidelity and vows might serve a protective function for the relationships of highly religious couples, and how religion may empower women in terms of sexual boundary setting.

How Gender Differences in Emotional Cutoff and Reactivity Influence Couple's Sexual and Relational Outcomes.

We evaluated gender differences in differentiation of self, specifically addressing aspects of emotional cutoff (EC) and emotional reactivity (ER), and their association with relational and sexual satisfaction and sexual desire. Midlife U.S. men and women (N = 334 married heterosexual couples; 50% female; 85% Caucasian, mean age 47.4 years) completed online surveys. Men reported higher levels of EC compared to women after accounting for control variables-a medium effect (Cohen's d = .48) which negatively predicted their own relationship and sexual satisfaction as well as partner relationship satisfaction. Women's EC was also negatively associated with their own relationship satisfaction. Women reported higher levels of ER compared to men after accounting for control variables-a small effect (Cohen's d = .18). No associations with ER and outcome variables were found and no other partner effects were found. For couples in which the woman was higher on ER, the association between women's T1 emotional reactivity and men's T2 sexual desire was positive and significant (B = .31, p < .05). These findings underscore the influence of emotional cutoff on relationship satisfaction and sexual desire and the importance of staying engaged even through relational conflict.

Forgiveness and Gratitude: Links Between Couples' Mindfulness and Sexual and Relational Satisfaction in New Cisgender Heterosexual Marriages.

The association of mindfulness with couples' relational and sexual satisfaction may be mediated by forgiveness and gratitude. Although forgiveness and gratitude have individually been shown to play a role in couples' relational and sexual satisfaction, we use an integrated model. This study included 1,360 couples recruited through a nationwide two-stage cluster stratification. Using an actor-partner interdependence model, we found significant indirect effects (ß = 0.01, 0.08, p < .01), indicating that forgiveness and gratitude mediated many of the associations between couples' mindfulness and their sexual and relational satisfaction. This may provide useful information for clinicians and therapists when addressing marital issues.

Diagnostic Biomarkers for Alzheimer's Disease Using Non-Invasive Specimens.

Studies in the field of Alzheimer's disease (AD) have shown the emergence of biomarkers in biologic fluids that hold great promise for the diagnosis of the disease. A diagnosis of AD at a presymptomatic or early stage may be the key for a successful treatment, with clinical trials currently investigating this. It is anticipated that preventative and therapeutic strategies may be stage-dependent, which means that they have a better chance of success at a very early stage-before critical neurons are lost. Several studies have been investigating the use of cerebrospinal fluid (CSF) and blood as clinical samples for the detection of AD with a number of established core markers, such as amyloid beta (Aß), total tau (T-tau) and phosphorylated tau (P-tau), being at the center of clinical research interest. The use of oral samples-including saliva and buccal mucosal cells-falls under one of the least-investigated areas in AD diagnosis. Such samples have great potential to provide a completely non-invasive alternative to current CSF and blood sampling procedures. The present work is a thorough review of the results and analytical approaches, including proteomics, metabolomics, spectroscopy and microbiome analyses that have been used for the study and detection of AD using salivary samples and buccal cells. With a few exceptions, most of the studies utilizing oral samples were performed in small cohorts, which in combination with the existence of contradictory results render it difficult to come to a definitive conclusion on the value of oral markers. Proteins such as Aß, T-tau and P-tau, as well as small metabolites, were detected in saliva and have shown some potential as future AD diagnostics. Future large-cohort studies and standardization of sample preparation and (pre-)analytical factors are necessary to determine the use of these non-invasive samples as a diagnostic tool for AD.