Publications by authors named "Yaffe K"

Study Objectives: Poor sleep may play a role in the risk of dementia. However, few studies have investigated the association between polysomnography (PSG)-derived sleep architecture and dementia incidence. We examined the relationship between sleep macro-architecture and dementia incidence across five US-based cohort studies from the Sleep and Dementia Consortium (SDC).

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Background: Black adults have higher dementia risk than White adults. Whether tighter population-level blood pressure (BP) control reduces this disparity is unknown.

Objective: Estimate the impact of optimal BP treatment intensity on racial disparities in dementia.

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Introduction: Poor cardiovascular health (CVH) is linked to Alzheimer's disease and dementia; however, its association with neurocognitive trajectories earlier in life remains underexplored.

Methods: We included 3224 participants with information on CVH at early midlife (mean age 45.0 ± standard deviation 3.

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Background: Addressing modifiable risk factors such as physical inactivity and social isolation could reduce risk of Alzheimer's disease and all-cause dementia, but little is known about which factors individuals are most willing to address or how they prefer to address them.

Objective: To examine and describe behavior change goals set by participants during the Systematic Multi-domain Alzheimer's Risk Reduction Trial (SMARRT).

Methods: In SMARRT, older adults worked with a health coach and nurse over 2 years to set incremental, personalized goals to reduce dementia risk.

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Background Racial and ethnic and sex differences in sleep may exist, but there are limited data directly comparing objective estimates of sleep-disordered breathing (SDB), particularly in rapid eye movement (REM) versus non-rapid eye movement (NREM) sleep, among Black, Mexican American (MA) and non-Hispanic White (NHW) men and women. Our goal is to investigate health disparities in SDB in a new, diverse cohort of older adults. Research Question Do SDB parameters during REM and NREM sleep differ by race and ethnicity or sex in community-dwelling older adults?.

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Article Synopsis
  • The study aimed to explore how sleep patterns in early midlife affect brain aging in late midlife using data from the CARDIA study.
  • Researchers analyzed sleep data, focusing on factors like sleep duration and quality, and later assessed brain age through MRIs taken 15 years later.
  • Results showed that individuals with more poor sleep characteristics had significantly older brain ages, emphasizing the need for sleep interventions to support brain health.*
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Background: Brain ageing is highly heterogeneous, as it is driven by a variety of normal and neuropathological processes. These processes may differentially affect structural and functional brain ageing across individuals, with more pronounced ageing (older brain age) during midlife being indicative of later development of dementia. Here, we examined whether brain-ageing heterogeneity in unimpaired older adults related to neurodegeneration, different cognitive trajectories, genetic and amyloid-beta (Aβ) profiles, and to predicted progression to Alzheimer's disease (AD).

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Article Synopsis
  • The study evaluates dementia risk scores developed primarily for non-Latinx White populations, focusing on their applicability in diverse racial and ethnic groups to tackle health disparities.* -
  • Results indicate that while higher CAIDE scores increase dementia risk among Asian, Latinx, and NLW participants, mCAIDE scores reveal an increased risk for Black participants, showcasing varying effects based on race/ethnicity.* -
  • The research emphasizes the necessity of validating dementia risk assessments across different populations to enhance personalized medicine and improve brain health outcomes.*
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Background: National guidelines recognize lifetime trauma as relevant to clinical care for adults nearing the end of life. We determined the prevalence of early life and cumulative trauma among persons at the end of life by gender and birth cohort, and the association of lifetime trauma with end-of-life physical, mental, and social well-being.

Methods: We used nationally representative Health and Retirement Study data (2006-2020), including adults age > 50 who died while enrolled (N = 6495).

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Article Synopsis
  • A study assessed the impact of 12 modifiable risk factors related to dementia across seven Latin American countries, revealing that about 54% of dementia cases could be attributed to these risks.
  • Data was collected from over 100,000 individuals in Argentina, Brazil, Bolivia, Chile, Honduras, Mexico, and Peru between 2015 and 2021, focusing on factors like education, hearing loss, and lifestyle choices.
  • The findings highlighted that obesity, physical inactivity, and depression were the leading contributors to dementia risk in these countries, indicating a higher population-attributable fraction compared to global estimates.
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Background: Life-space mobility captures the daily, enacted mobility of older adults. We determined cross-sectional associations between life-space mobility and cognitive impairment (CI) among community-dwelling women in the 9th and 10th decades of life.

Methods: A total of 1375 (mean age 88 years; 88% White) community-dwelling women enrolled in a prospective cohort of older women.

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Background: Sleep apnea (SA) has been linked to an increased risk of dementia in numerous observational studies; whether this is driven by neurodegenerative, vascular, or other mechanisms is not clear. We sought to examine the bidirectional causal relationships between SA, Alzheimer disease (AD), coronary artery disease (CAD), and ischemic stroke using Mendelian randomization.

Methods And Results: Using summary statistics from 4 recent, large genome-wide association studies of SA (n=523 366), AD (n=94 437), CAD (n=1 165 690), and stroke (n=1 308 460), we conducted bidirectional 2-sample Mendelian randomization analyses.

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Article Synopsis
  • - Cardiovascular health, evaluated through Life's Simple 7 (LS7), is linked to slower cognitive decline and better brain integrity in patients with autosomal dominant frontotemporal lobar degeneration (FTLD).
  • - A study involving 247 FTLD genetic variant carriers and 189 non-carrier controls found that those with better cardiovascular health had slower memory and language declines, as well as less accumulation of frontal white matter hyperintensities (WMHs).
  • - Maintaining good cardiovascular health could be a key modifiable strategy to improve cognitive outcomes and brain health in individuals at risk for genetic forms of dementia.
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Importance: Sleep health comprises several dimensions such as duration and fragmentation of sleep, circadian activity, and daytime behavior. Yet, most research has focused on individual sleep characteristics. Studies are needed to identify sleep profiles incorporating multiple dimensions and to assess how different profiles may be linked to adverse health outcomes.

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Introduction: Sleep disruptions are associated with cognitive aging in older adults. However, it is unclear whether longitudinal changes in 24-hour multidimensional sleep-wake activity are linked to cognitive impairment in the oldest old.

Methods: We studied 733 cognitively unimpaired women (mean age=82.

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Background: To understand the role of hypertensive disorders of pregnancy (HDP), including preeclampsia and gestational hypertension (GH), in brain health earlier in life, we investigated the association of HDP with midlife cognition and brain health.

Methods: We studied a prospective cohort of women, baseline age 18 to 30 years, who were assessed at study years 25 and 30 with a cognitive battery and a subset with brain magnetic resonance imaging. A history of HDP was defined based on self-report.

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Background: Hospitalizations are frequently disruptive for persons with dementia (PWD) in part due to the use of potentially problematic medications for complications such as delirium, pain, and insomnia. We sought to determine the impact of hospitalizations on problematic medication prescribing in the months following hospitalization.

Methods: We included community-dwelling PWD in the Health and Retirement Study aged ≥66 with a hospitalization from 2008 to 2018.

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Article Synopsis
  • - The aging process of the brain is affected by lifestyle, environmental, genetic factors, and age-related diseases, with advanced imaging and AI techniques helping to reveal the complexities of neuroanatomical changes.
  • - A study involving nearly 50,000 participants identified five major patterns of brain atrophy, which are quantified using R-indices to analyze their connections to various biomedical, lifestyle, and genetic factors.
  • - These R-indices not only predict disease progression and mortality but also offer a new, nuanced framework for understanding brain aging, which may enhance personalized diagnostics and improve clinical trial strategies.
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Introduction: Clonal hematopoiesis of indeterminate potential (CHIP) and dementia disproportionately burden patients with chronic kidney disease (CKD). The association between CHIP and cognitive impairment in CKD patients is unknown.

Methods: We conducted time-to-event analyses in up to 1452 older adults with CKD from the Chronic Renal Insufficiency Cohort who underwent CHIP gene sequencing.

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Importance: Vision and eye conditions are associated with increased risk for Alzheimer disease and related dementias (ADRDs), but the nature of the association and the underlying biological pathways remain unclear. If causal, vision would be an important modifiable risk factor with viable population-level interventions.

Objective: To evaluate potentially causal associations between visual acuity, eye conditions (specifically cataracts and myopia), neuroimaging outcomes, and ADRDs.

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Article Synopsis
  • Over one-fourth of older adults with cognitive impairment (CI) live alone, facing challenges in medication management and a higher risk for adverse drug events.
  • A study analyzed data from 1569 older adults, finding that those living alone, averaging 79.9 years of age, often manage their medications independently and frequently use high-risk medications, such as anticholinergics and opioids.
  • Compared to their counterparts living with others, those living alone were more likely to take high-risk medications and lack assistance with medication management, indicating potential safety issues.
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Background: Vascular risk factors, particularly hypertension, are important contributors to accelerated brain aging. We sought to quantify vascular risk factor risks over adulthood and assess the empirical evidence for risk thresholds.

Methods: We used SBP (systolic blood pressure) and diastolic blood pressure, total cholesterol, fasting blood glucose, and body mass index measurements collected from participants in the CARDIA study (Coronary Artery Risk Development in Young Adults) at 2- to 5-year intervals through year 30.

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Introduction: People with university degrees have a lower incidence of Alzheimer's Disease (AD). However, the relationship between education and AD could be due to selection, collider, and ascertainment biases, such as lower familiarity with cognitive testing or the fact that those with degrees are more likely to participate in research. Here, we use two-sample Mendelian randomization (MR) to investigate the causal relationships between education, participation, and AD.

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Article Synopsis
  • Black and Hispanic older adults have a higher risk of developing Alzheimer's disease and dementia compared to White adults, but the reasons behind these disparities are not fully understood.
  • A study involving over 1.5 million older Veterans found that Black Veterans had a 65% higher risk and Hispanic Veterans had a 50% higher risk of developing dementia compared to White Veterans, even after adjusting for age and sex.
  • The research concluded that social determinants of health and cardiovascular disease are significant factors contributing to these disparities, suggesting they could be potential targets for interventions to help reduce the risk of dementia in these populations.
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