Public Health.

Background: Adverse social exposome (indexed by national Area Deprivation Index [ADI] 80-100 or 'high ADI') is linked to structural inequities and increased risk of Alzheimer's disease neuropathology. Twenty percent of the US population resides within high ADI areas, predominantly in inner cities, tribal reservations and rural areas. The percentage of brain donors from high ADI areas within the Alzheimer's Disease Research Center (ADRC) brain bank system is unknown.

Public Health.

Background: Weakened white matter (WM) integrity is highly associated with dementia risk. Still, not everyone with WM changes develops dementia, suggesting the important role modifiable lifestyle factors may have in reducing dementia risk. We investigated how social relationships in mid-life may modify the association between WM integrity and incident dementia risk within race and sex subgroups.

Public Health.

Background: Midlife vascular risk factors are associated with an increased risk of dementia. However, the overall contribution of modifiable vascular risk factors in midlife and late-life to dementia remains unclear. In this study, we quantified population attributable fractions, which account for risk factor prevalence and strength of relative risks, of incident dementia from vascular risk factors measured in midlife and early late-life.

Public Health.

Background: Little is known about how education in later life is related to cognitive function in older adults. This study assessed whether participating in later-life education was associated with better cognitive function over time and whether the benefits differed by sex, race/ethnicity, and prior education level in a nationally-representative sample of U.S.

Public Health.

Background: Alzheimer's Disease and Related Dementias (ADRDs) patients have a well-established increase in comorbid disorders compared to non-cognitively impaired aged-matched controls. Since ADRDs are considered age-related disorders, it was hypothesized that younger ADRD patients should have a lower incidence of comorbid disorders than older ADRD patients.

Method: Four patient cohorts were defined in the TriNetX Analytics Network database (comprised of anonymized healthcare records from >150 million patients who have received care at 80+ health care organizations in the United States).

Public Health.

Background: Socioeconomic disadvantage at different life-course stages has been associated with later life cognitive impairment. However, its association with changes in cognitive function needs to be further elucidated. We assessed the association between socioeconomic position (SEP) throughout the life-course and cognitive function change in middle-aged and older Hispanic/Latino adults.

Public Health.

Background: Multidomain lifestyle interventions have shown promise to slow cognitive decline and possibly prevent dementia. However, challenges arise in analyzing and interpreting treatment response when participants vary in their adherence to intervention components. The U.

Public Health.

Background: Many studies have demonstrated an association between sleep and cognition in older adults. The Long Life Family Study (LLFS) has followed families enriched with longevity since 2006 and has shown that this cohort has slower rates of cognitive decline than their spouse controls and the general public. Understanding how sleep and cognition are related in this population can improve our understanding of the key to long life.

Public Health.

Background: Vascular disorders are proposed as modifiable risk factors for dementia; yet, physiologic mechanisms connecting vascular disorders to cognitive impairment remain unknown. We examined subclinical cardiovascular measures to determine which predict global cognitive decline and domain specific cognitive impairment and point to potential pathways linking subclinical vascular disease and dementia.

Methods: MESA includes a diverse cohort of 6,814 participants free from clinical cardiovascular disease with follow-up over 6 clinical examinations and annual follow-up calls.

Public Health.

Background: Qualitative patient interviews are increasingly conducted alongside clinical trials; interviews administered early in drug development can yield insight into the patient journey. Examination among patient subgroups may identify factors that influence the patient experience, including trial participation. As part of the INTERCEPT-AD phase 1 study evaluating the safety and tolerability of the Aβ oligomer-targeting monoclonal antibody ACU193, we conducted semi-structured qualitative interviews among a subset of participants with mild cognitive impairment (MCI) or mild dementia due to Alzheimer's disease (AD) and their study partners to obtain feedback on their trial experience and the decision-making process preceding trial enrollment; results were compared between study participant genders.

Public Health.

Background: The Mediterranean-Dash Intervention for Neurodegenerative Delay (MIND) diet, featuring emphasis on green leafy and other colorful vegetables, berries, unsaturated fats, fish, and whole grains is a major component of the U.S. POINTER multi-domain lifestyle intervention.

Public Health.

Background: Social support has been associated with a reduced risk of heart disease and stroke, higher cognitive function, less cognitive decline, and resilience to stress. Notably, social support differs by gender and race/ethnicity. However, it is not clear whether these factors modify the relationship between social support and cognition.

Public Health.

Background: Alzheimer's Disease (AD) is a common form of dementia among the elderly with a large percentage of estimated heritability. Conventional polygenic risk analysis only accounts for the linearly combined genomic effects of single nucleotide polymorphisms (SNPs). On the other hand, a deep-learning-based approach is able to uncover nonlinearly associated effects from data with high-dimensional features such as genomics.

Public Health.

Background: Vascular risk factors captured in midlife represent modifiable features of cardiovascular disease (CVD), stroke, dementia, and dementia-related neuropathology. Subclinical measures of CVD may help identify specific structural and function aspects underlying vascular contributions to cognitive impairment and dementia over and above conventional dementia risk scores.

Method: The MESA study followed a diverse cohort of 6,814 adults aged 45-84 years over 6 clinical examinations and annual follow-up calls since baseline, 2000-2002.

Public Health.

Background: People living with dementia (PWD) often have inactivity-induced muscle atrophy, increased sedentary behavior, and circadian rhythm disorders. Exercise may improve physical activity, sedentary behavior, and sleep in PWD, but further research is needed. The purpose of this pilot randomized controlled trial (RCT) was to examine whether a structured exercise program improves physical activity, sedentary behavior, and sleep in PWD.

Public Health.

Background: Hypertension is an important modifiable risk factor for dementia, but the role of blood pressure (BP) in the development of dementia is not fully understood. Emerging data links increased BP variability and abnormal BP dynamics to dementia risk, but the relationship between baroreflex sensitivity (BRS), a fundamental physiological mechanism for maintaining stable BP, and dementia risk is unknown.

Methods: We investigated the association of BRS with the risk of dementia in community-based older adults from the Rotterdam Study in the Netherlands.

Public Health.

Background: Environmental pollutants, called perfluoroalkyl substances (PFAS) have been linked to adverse cardiometabolic outcomes, immune dysfunction and cancer risk, but their associations with adult cognition are unknown. Nearly everyone in the United States has detectable levels of PFAS in their blood, but our prior work found that Asian Americans have the highest exposure burden. As Asian Americans fastest growing segment of older adults, examination of relationships between serum PFAS concentrations and cognition in Asian Americans urgently needed.

Public Health.

Background: Behavioral interventions designed to promote healthy lifestyles have the potential to slow biological aging and increase health span. Multidomain interventions that simultaneously target multiple lifestyle behaviors may particularly be promising by increasing the number of interrelated processes that might be benefited. Deficit accumulation frailty indices (FIs) are increasingly used as measures of aging and health status in clinical trials and cohort studies.

Public Health.

Background: Pesticide exposure may contribute to cognitive decline, but empirical evidence is limited. We examined high pesticide exposure events (HPEE) in relation to subjective cognitive decline among farmers in the Pesticide and Sense of Smell Study (PASS), a sub-cohort of the Agricultural Health Study (AHS).

Method: This analysis included 2365 predominantly white male farmers from Iowa and North Carolina (aged 70±10 years) who enrolled in AHS from 1993-1997 and participated in PASS in 2020-2021.

Public Health.

Background: Subclinical cardiovascular disease (CVD), assessed by high-sensitivity cardiac troponin T (hs-cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP), is linked to cognitive decline, but the associations in hypertensive adults and the underlying brain pathologies remain unclear. It is also undetermined whether an intensive blood pressure treatment compared to a standard treatment may slow down cognitive decline associated with subclinical CVD.

Method: We conducted a post hoc analysis of the Systolic Blood Pressure Intervention Trial, where older adults with hypertension were randomized to an intensive treatment (systolic blood pressure (SBP) target of < 120 mm Hg) or standard treatment (< 140 mm Hg).

Public Health.

Background: Healthy lifestyle behaviors can help prevent or delay cognitive impairment in older adults, including increasing moderate-vigorous physical activity (MVPA). However, across studies examining effects of MVPA on cognitive function, findings are mixed. This may be partially explained by higher levels of sedentary behavior (SB) that may offset some benefit of MVPA.

Public Health.

Background: Recent cross-sectional and longitudinal studies have shown that higher activity diversity - defined as richness and evenness of daily activities are beneficial to older adults' cognitive performance. This benefit is independent of frequency or level of cognitive challenge or physical activity.

Method: A total of 1688 participants from the U.

Public Health.

Background: Estimating the incidence and prevalence of dementia is challenging. Cohort and brain banking studies can provide very precise estimates of incidence and prevalence in specific populations, but it is not clear how generalizable those estimates are to other populations. Furthermore, diagnoses of dementia made in clinical practice may differ from gold-standard neuropathological diagnoses.

Public Health.

Background: Matrescence, like adolescence, is a critical period for neurodevelopment characterized by hormonal changes that reshape the brain in preparation for new experiences and subsequent learning. Women exhibit greater age-matched Alzheimer's disease (AD) risk than men, yet little is known about long-term neurological health consequences of reproduction (Buckley, 2019), the defining biological difference between the sexes. We tested the hypothesis that greater number of months pregnant would be positively associated with cortical thickness (CT), particularly in regions within the default mode network (DMN).

Public Health.

Background: It is not well understood how incidence patterns of subtypes of Alzheimer's disease and related dementias (ADRD) have evolved in real-world practice. While cohort and brain bank studies provide precise biological definition of ADRD subtypes, these populations may not be representative and may not reflect how dementia is coded and diagnosed in routine clinical practice. Therefore, we sought to perform a nationally representative study of medical claims data to understand trends in diagnosis of dementia by dementia subtypes in routine clinical practice.