Determinants of Midlife & Longitudinal Change in Cognitive Function: CARDIA Study

The identification of who is at risk for age-related cognitive decline remains one of the most important goals of our time. Not only does this have tremendous clinical value, but it may offer strategies for prevention and treatment and lead to fundamental discovery of mechanisms underlying etiology of dementia. Because the neuropathology associated with cognitive impairment/ dementia often develops over decades, determination of important risk effects over the life course, starting in early adulthood, could inform the design of more effective interventions for healthy cognitive aging. Yet, little is known about early adulthood risk factors, their cumulative exposure and effect on cognitive function later in life. We propose to address this gap by conducting an innovative ancillary study to the ongoing CARDIA study. CARDIA is a multisite prospective study of 5,115 adults, aged 18-30 years at baseline (1985-86), who recently completed their seventh (year 25) follow-up in which cognitive testing and brain MRIs were measured and who will be participating in a year 30 exam in 2015-16. We propose to repeat and augment the cognitive testing for the year 30 visit on an estimated 3100 participants. Since participants enrolled when they were young men and women and are now in mid- to early late-life, we have the unprecedented opportunity to investigate how important risk factors (focusing on cardiovascular and metabolic pathways as well as modifiable behavioral factors) may exert influence effects early in adulthood and if these demonstrate “critical windows” and 30-year cumulative effects on cognitive function and structural brain measures at mid-life. We will also have the cost-efficient opportunity to examine the complementary environmental and genetic determinants of 5-year change in cognitive function. In addition, as CARDIA has a biracial (black and white) composition, we will have the ability to explore if there are race and gender differences in rate of cognitive change in mid-life.