Clinical Manifestations.

Background: Menopause is a time of accelerated loss of physical function, illustrated by challenges to mobility, speed, strength, and performance of activities of daily living. Physical function is associated with cognitive function, but there are limited data exploring this association among older women. In a cohort of older adult women, we hypothesize better performance on measures of physical function will be associated with better cognitive performance.

Clinical Manifestations.

Background: Ecological momentary assessments (EMA) are increasingly used to monitor self-perceived memory and cognitive difficulties. We investigate how traditional self-reported, recall based assessments of cognitive difficulties correlate with EMA measures. We identify factors explaining shared variance between measures from the 40-item version of the Cognitive Change Index (CCI) and from EMA daily diaries, and factors explaining unique variance in each assessment.

Clinical Manifestations.

Background: Sex hormones are frequently implicated in the development of cerebral small vessel disease among midlife women. However, few studies directly measure endogenous sex hormones and consider them in relation to white matter hyperintensities (WMH), indicators of cerebral small vessel disease. Further, existing work on hormones, menopause, and the brain typically focuses on ovarian estradiol (E2), with limited consideration of estrone (E1), the primary postmenopausal estrogen, or follicle stimulating hormone (FSH), an indicator of ovarian age.

Exposure to air pollution is associated with adipokines in midlife women: The Study of Women's Health Across the Nation.

This study examined the associations between ambient air pollution exposure, including fine particulate matter (PM), nitrogen dioxide (NO), and ozone (O), with serum levels of high molecular weight (HMW) adiponectin, leptin, and soluble leptin receptors (sOB-R) in midlife women. The analysis included 1551 participants from the Study of Women's Health Across the Nation (median age = 52.3 years) with adipokine data from 2002 to 2003.

Associations of endogenous estrogens, plasma Alzheimer's disease biomarkers, and carrier status on regional brain volumes in postmenopausal women.

Background: Women carrying the allele are at greater risk of developing Alzheimer's disease (AD) from ages 65-75 years compared to men. To better understand the elevated risk conferred by carrier status among midlife women, we investigated the separate and interactive associations of endogenous estrogens, plasma AD biomarkers, and carrier status on regional brain volumes in a sample of late midlife postmenopausal women.

Methods: Participants were enrolled in MsBrain, a cohort study of postmenopausal women ( = 171, mean age = 59.

Endogenous estrogens and brain activation during verbal memory encoding and recognition in the postmenopause.

Objective: Determine associations of endogenous estrogens with memory systems in the postmenopausal brain and evaluate clinical significance.

Study Design: In the MsBrain cohort (n=199, mean age 59.3+3.

Reproductive hormones in relation to white matter hyperintensity volumes among midlife women.

Introduction: Although reproductive hormones are implicated in cerebral small vessel disease in women, few studies consider measured hormones in relation to white matter hyperintensity volume (WMHV), a key indicator of cerebral small vessel disease. Even fewer studies consider estrone (E1), the primary postmenopausal estrogen, or follicle-stimulating hormone (FSH), an indicator of ovarian age. We tested associations of estradiol (E2), E1, and FSH to WMHV among women.

Perceived but not objective measures of neighborhood safety and food environments are associated with longitudinal changes in processing speed among urban older adults.

Background: Although a growing body of literature documents the importance of neighborhood effects on late-life cognition, little is known about the relative strength of objective and subjective neighborhood measures on late-life cognitive changes. This study examined effects of objective and subjective neighborhood measures in three neighborhood domains (neighborhood safety, physical disorder, food environments) on longitudinal changes in processing speed, an early marker of cognitive aging and impairment.

Methods: The analysis sample included 306 community-dwelling older adults enrolled in the Einstein Aging Study (mean age = 77, age range = 70 to 91; female = 67.

Neighborhood physical environments and change in cardiometabolic risk factors over 14 years in the study of Women's health across the nation.

Background: Neighborhood physical environments may influence cardiometabolic health, but prior studies have been inconsistent, and few included long follow-up periods.

Methods: Changes in cardiometabolic risk factors were measured for up to 14 years in 2830 midlife women in the Study of Women's Health Across the Nation, a multi-ethnic/racial cohort of women from seven U.S.

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Introduction: The LIfestyle for BRAin Health (LIBRA) index yields a dementia risk score based on modifiable lifestyle factors and is validated in Western samples. We investigated whether the association between LIBRA scores and incident dementia is moderated by geographical location or sociodemographic characteristics.

Methods: We combined data from 21 prospective cohorts across six continents (N = 31,680) and conducted cohort-specific Cox proportional hazard regression analyses in a two-step individual participant data meta-analysis.

Elevated Blood Homocysteine Increases the Risk of Incident Motoric Cognitive Risk Syndrome: A Two-Cohort Study.

Background: Motoric Cognitive Risk (MCR) syndrome, a predementia syndrome characterized by cognitive complaints and slow gait, may have an underlying vascular etiology. Elevated blood levels of homocysteine, a known vascular risk factor, have been linked to physical and cognitive decline in older adults, though the relationship with MCR is unknown. We aimed to identify the association between homocysteine and MCR risk.

Cardiovascular Health, Race, and Decline in Cognitive Function in Midlife Women: The Study of Women's Health Across the Nation.

Background: Cognitive decline may progress for decades before dementia onset. Better cardiovascular health (CVH) has been related to less cognitive decline, but it is unclear whether this begins early, for all racial subgroups, and all domains of cognitive function. The purpose of this study was to determine the impact of CVH on decline in the 2 domains of cognition that decline first in White and Black women at midlife.

Does the Cognitive Change Index Predict Future Cognitive and Clinical Decline? Longitudinal Analysis in a Demographically Diverse Cohort.

Background: The Cognitive Change Index (CCI) is a widely-used measure of self-perceived cognitive ability and change. Unfortunately, it is unclear if the CCI predicts future cognitive and clinical decline.

Objective: We evaluated baseline CCI to predict transition from normal cognition to cognitive impairment in nondemented older adults and in predementia groups including, subjective cognitive decline, motoric cognitive risk syndrome, and mild cognitive impairment.

Trajectories of Sleep Over Midlife and Incident Cardiovascular Disease Events in the Study of Women's Health Across the Nation.

Background: Up to 50% of women report sleep problems in midlife, and cardiovascular disease (CVD) is the leading cause of death in women. How chronic poor sleep exposure over decades of midlife is related to CVD risk in women is poorly understood. We tested whether trajectories of insomnia symptoms or sleep duration over midlife were related to subsequent CVD events among SWAN (Study of Women's Health Across the Nation) participants, whose sleep was assessed up to 16 times over 22 years.

Associations between exposure to air pollution and sex hormones during the menopausal transition.

Menopause is a significant milestone in a woman's life, characterized by decreasing estradiol (E2) and increasing follicle-stimulating hormone (FSH) levels. Growing evidence suggests that air pollution may affect reproductive health and disrupt hormone profiles, yet the associations in women undergoing menopausal transition (MT) remains underexplored. We examined the associations between annual air pollutant exposures and repeated measures of E2 and FSH in 1365 women with known final menstrual period (FMP) date from the Study of Women's Health Across the Nation.

Menopausal vasomotor symptoms and plasma Alzheimer disease biomarkers.

Background: Identifying risk factors for Alzheimer disease in women is important as women compose two-thirds of individuals with Alzheimer disease. Previous work links vasomotor symptoms, the cardinal menopausal symptom, with poor memory performance and alterations in brain structure, function, and connectivity. These associations are evident when vasomotor symptoms are monitored objectively with ambulatory skin conductance monitors.

Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life: An Individual Participant Data Meta-Analysis.

Importance: The utility of antihypertensives and ideal blood pressure (BP) for dementia prevention in late life remains unclear and highly contested.

Objectives: To assess the associations of hypertension history, antihypertensive use, and baseline measured BP in late life (age >60 years) with dementia and the moderating factors of age, sex, and racial group.

Data Source And Study Selection: Longitudinal, population-based studies of aging participating in the Cohort Studies of Memory in an International Consortium (COSMIC) group were included.

Six multidimensional sleep health facets in older adults identified with factor analysis of actigraphy: Results from the Einstein Aging Study.

Objectives: The concept of multi-dimensional sleep health, originally based on self-report, was recently extended to actigraphy in older adults, yielding five components, but without a hypothesized rhythmicity factor. The current study extends prior work using a sample of older adults with a longer period of actigraphy follow-up, which may facilitate observation of the rhythmicity factor.

Methods: Wrist actigraphy measures of participants (N = 289, M = 77.

The quantity and quality of cardiovascular fat at mid-life and future cognitive performance among women: The SWAN cardiovascular fat ancillary study.

Introduction: Cardiovascular fat is a novel risk factor that may link to dementia. Fat volume and radiodensity are measurements of fat quantity and quality, respectively. Importantly, high fat radiodensity could indicate healthy or adverse metabolic processes.

Availability of healthy foods, fruit and vegetable consumption, and cognition among urban older adults.

Background: . Although prior studies have examined the associations between neighborhood characteristics and cognitive health, little is known about whether local food environments, which are critical for individuals' daily living, are associated with late-life cognition. Further, little is known about how local environments may shape individuals' health-related behaviors and impact cognitive health.

Carotid intima media thickness and white matter hyperintensity volume among midlife women.

Introduction: Carotid atherosclerosis may be associated with brain white matter hyperintensities (WMH). Few studies consider women at midlife, a critical time for women's cardiovascular and brain health. We tested the hypothesis that higher carotid intima media thickness (IMT) would be associated with greater WMH volume (WMHV) among midlife women.