Risk factors for Alzheimer’s disease and cognitive function before middle age in a U.S. representative population-based studyResearch in context

Summary: Background: Alzheimer’s disease is a major health concern in the U.S., but most research has focused on older populations. We examined whether established risk factors and blood biomarkers are associated with cognition before midlife. Methods: Data from the National Longitudinal Study of A...

Full description

Saved in:
Bibliographic Details
Main Authors: Allison E. Aiello, Jennifer Momkus, Rebecca C. Stebbins, Yuan S. Zhang, Chantel L. Martin, Y. Claire Yang, Lauren Gaydosh, Taylor Hargrove, Adina Zeki Al Hazzouri, Kathleen Mullan Harris
Format: Article
Language:English
Published: Elsevier 2025-05-01
Series:The Lancet Regional Health. Americas
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2667193X25000973
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849728790627876864
author Allison E. Aiello
Jennifer Momkus
Rebecca C. Stebbins
Yuan S. Zhang
Chantel L. Martin
Y. Claire Yang
Lauren Gaydosh
Taylor Hargrove
Adina Zeki Al Hazzouri
Kathleen Mullan Harris
author_facet Allison E. Aiello
Jennifer Momkus
Rebecca C. Stebbins
Yuan S. Zhang
Chantel L. Martin
Y. Claire Yang
Lauren Gaydosh
Taylor Hargrove
Adina Zeki Al Hazzouri
Kathleen Mullan Harris
author_sort Allison E. Aiello
collection DOAJ
description Summary: Background: Alzheimer’s disease is a major health concern in the U.S., but most research has focused on older populations. We examined whether established risk factors and blood biomarkers are associated with cognition before midlife. Methods: Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) were analyzed. Participants were enrolled in 1994–95 (grades 7–12) and followed through 2018. We cross-sectionally analyzed weighted survey and biomarker data from Waves IV and V. We measured the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score comprised of age, education, sex, systolic blood pressure, body mass index, cholesteroal, and physical activity and apolipoprotein E ε4 allele (APOE ε4) status. We also measured total Tau and Neurofilament light (NfL), high sensitivity C-reactive protein (hsCRP), Interleukin (IL)-1β, IL-6, IL-8, IL-10, and Tumor necrosis factor alpha (TNF-α). Outcomes included immediate word recall, delayed word recall, and backward digit span. Findings: Analytic sample sizes ranged from 4507 to 11,449 participants in Wave IV and from 529 to 1121 participants in Wave V. The survey-weighted median (IQR) age was 28 (26–29) years in Wave IV and 38 (36–29) years in Wave V. About half of the survey-weighted Wave IV participants were female (48.4–52.1% across analytic samples), 71.4–72.5% were White, 12.5–14.9% were Black, and 9.3–10.2% were Hispanic. In Wave V, 43.6–46.8% were female, 68.7–69.3% were White, 17.1%–20.0% were Black, and 7.3%–9.6% were Hispanic. The CAIDE score was associated with all cognition measures in Wave IV. For example, among adults aged 24–34, each 1-point increase in CAIDE was associated with a 0.03 standard deviation lower backward digit span score (95% CI: −0.04, −0.02). Total Tau was associated with immediate word recall in Wave V (β = −0.13, 95% CI: −0.23, −0.04). Wave IV hsCRP and IL-10 and Wave V IL-6, IL-1β, and IL-8 were also associated with lower cognitive scores. Interpretation: Key risk factors for Alzheimer’s Disease are linked to cognitive function as early as ages 24–44, highlighting the need for early prevention in the US. Funding: NIH P01HD31921, U01AG071448, U01AG071450, R01AG057800, P30AG066615, T32HD091058, P2CHD050924.
format Article
id doaj-art-c75c2c6bf0fb476cad235407f5c53b2b
institution DOAJ
issn 2667-193X
language English
publishDate 2025-05-01
publisher Elsevier
record_format Article
series The Lancet Regional Health. Americas
spelling doaj-art-c75c2c6bf0fb476cad235407f5c53b2b2025-08-20T03:09:27ZengElsevierThe Lancet Regional Health. Americas2667-193X2025-05-014510108710.1016/j.lana.2025.101087Risk factors for Alzheimer’s disease and cognitive function before middle age in a U.S. representative population-based studyResearch in contextAllison E. Aiello0Jennifer Momkus1Rebecca C. Stebbins2Yuan S. Zhang3Chantel L. Martin4Y. Claire Yang5Lauren Gaydosh6Taylor Hargrove7Adina Zeki Al Hazzouri8Kathleen Mullan Harris9Robert N. Butler Columbia Aging Center, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA; Corresponding author. Department of Epidemiology, Robert N Butler Columbia Aging Center, Mailman School of Public Health, Columbia University, USA.Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USARobert N. Butler Columbia Aging Center, Columbia University, New York, NY, USARobert N. Butler Columbia Aging Center, Columbia University, New York, NY, USA; Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USACarolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USACarolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USACarolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USACarolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USARobert N. Butler Columbia Aging Center, Columbia University, New York, NY, USA; Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USACarolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Department of Sociology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USASummary: Background: Alzheimer’s disease is a major health concern in the U.S., but most research has focused on older populations. We examined whether established risk factors and blood biomarkers are associated with cognition before midlife. Methods: Data from the National Longitudinal Study of Adolescent to Adult Health (Add Health) were analyzed. Participants were enrolled in 1994–95 (grades 7–12) and followed through 2018. We cross-sectionally analyzed weighted survey and biomarker data from Waves IV and V. We measured the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) score comprised of age, education, sex, systolic blood pressure, body mass index, cholesteroal, and physical activity and apolipoprotein E ε4 allele (APOE ε4) status. We also measured total Tau and Neurofilament light (NfL), high sensitivity C-reactive protein (hsCRP), Interleukin (IL)-1β, IL-6, IL-8, IL-10, and Tumor necrosis factor alpha (TNF-α). Outcomes included immediate word recall, delayed word recall, and backward digit span. Findings: Analytic sample sizes ranged from 4507 to 11,449 participants in Wave IV and from 529 to 1121 participants in Wave V. The survey-weighted median (IQR) age was 28 (26–29) years in Wave IV and 38 (36–29) years in Wave V. About half of the survey-weighted Wave IV participants were female (48.4–52.1% across analytic samples), 71.4–72.5% were White, 12.5–14.9% were Black, and 9.3–10.2% were Hispanic. In Wave V, 43.6–46.8% were female, 68.7–69.3% were White, 17.1%–20.0% were Black, and 7.3%–9.6% were Hispanic. The CAIDE score was associated with all cognition measures in Wave IV. For example, among adults aged 24–34, each 1-point increase in CAIDE was associated with a 0.03 standard deviation lower backward digit span score (95% CI: −0.04, −0.02). Total Tau was associated with immediate word recall in Wave V (β = −0.13, 95% CI: −0.23, −0.04). Wave IV hsCRP and IL-10 and Wave V IL-6, IL-1β, and IL-8 were also associated with lower cognitive scores. Interpretation: Key risk factors for Alzheimer’s Disease are linked to cognitive function as early as ages 24–44, highlighting the need for early prevention in the US. Funding: NIH P01HD31921, U01AG071448, U01AG071450, R01AG057800, P30AG066615, T32HD091058, P2CHD050924.http://www.sciencedirect.com/science/article/pii/S2667193X25000973Alzheimer’s diseaseDementia risk factorsCAIDE risk scoreDementia risk scoreAPOENeurofilament light chain
spellingShingle Allison E. Aiello
Jennifer Momkus
Rebecca C. Stebbins
Yuan S. Zhang
Chantel L. Martin
Y. Claire Yang
Lauren Gaydosh
Taylor Hargrove
Adina Zeki Al Hazzouri
Kathleen Mullan Harris
Risk factors for Alzheimer’s disease and cognitive function before middle age in a U.S. representative population-based studyResearch in context
The Lancet Regional Health. Americas
Alzheimer’s disease
Dementia risk factors
CAIDE risk score
Dementia risk score
APOE
Neurofilament light chain
title Risk factors for Alzheimer’s disease and cognitive function before middle age in a U.S. representative population-based studyResearch in context
title_full Risk factors for Alzheimer’s disease and cognitive function before middle age in a U.S. representative population-based studyResearch in context
title_fullStr Risk factors for Alzheimer’s disease and cognitive function before middle age in a U.S. representative population-based studyResearch in context
title_full_unstemmed Risk factors for Alzheimer’s disease and cognitive function before middle age in a U.S. representative population-based studyResearch in context
title_short Risk factors for Alzheimer’s disease and cognitive function before middle age in a U.S. representative population-based studyResearch in context
title_sort risk factors for alzheimer s disease and cognitive function before middle age in a u s representative population based studyresearch in context
topic Alzheimer’s disease
Dementia risk factors
CAIDE risk score
Dementia risk score
APOE
Neurofilament light chain
url http://www.sciencedirect.com/science/article/pii/S2667193X25000973
work_keys_str_mv AT allisoneaiello riskfactorsforalzheimersdiseaseandcognitivefunctionbeforemiddleageinausrepresentativepopulationbasedstudyresearchincontext
AT jennifermomkus riskfactorsforalzheimersdiseaseandcognitivefunctionbeforemiddleageinausrepresentativepopulationbasedstudyresearchincontext
AT rebeccacstebbins riskfactorsforalzheimersdiseaseandcognitivefunctionbeforemiddleageinausrepresentativepopulationbasedstudyresearchincontext
AT yuanszhang riskfactorsforalzheimersdiseaseandcognitivefunctionbeforemiddleageinausrepresentativepopulationbasedstudyresearchincontext
AT chantellmartin riskfactorsforalzheimersdiseaseandcognitivefunctionbeforemiddleageinausrepresentativepopulationbasedstudyresearchincontext
AT yclaireyang riskfactorsforalzheimersdiseaseandcognitivefunctionbeforemiddleageinausrepresentativepopulationbasedstudyresearchincontext
AT laurengaydosh riskfactorsforalzheimersdiseaseandcognitivefunctionbeforemiddleageinausrepresentativepopulationbasedstudyresearchincontext
AT taylorhargrove riskfactorsforalzheimersdiseaseandcognitivefunctionbeforemiddleageinausrepresentativepopulationbasedstudyresearchincontext
AT adinazekialhazzouri riskfactorsforalzheimersdiseaseandcognitivefunctionbeforemiddleageinausrepresentativepopulationbasedstudyresearchincontext
AT kathleenmullanharris riskfactorsforalzheimersdiseaseandcognitivefunctionbeforemiddleageinausrepresentativepopulationbasedstudyresearchincontext