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Bringing together the genetic risk factor of a family history of FXTAS and the environmental protective factor of higher education, the goal of the study was to determine how these factors potentially interact to predict self\u2010reported FXTAS\u2010type symptoms in women carrying the\n                    <jats:italic>FMR1<\/jats:italic>\n                    premutation. We investigated age\u2010related changes in symptoms, measured prospectively over a decade. Using an accelerated longitudinal design approach, we estimated trajectories of change extending from early midlife (starting at age 39) into older age (up to age 80) in a community\u2010based cohort. Results indicated that women with the\n                    <jats:italic>FMR1<\/jats:italic>\n                    premutation who have a family history of FXTAS are at greater risk for experiencing symptoms during late midlife and older age than those who do not have such a family history. Consistent with research on other neurodegenerative diseases, this family history risk may be moderated by completing a college education, suggesting that cognitive enrichment during a period of neuroplasticity might provide protection from the neurodegenerative symptoms that are experienced by some women with the premutation as they age.\n                  <\/jats:p>","DOI":"10.1002\/ajmg.b.70022","type":"journal-article","created":{"date-parts":[[2026,5,22]],"date-time":"2026-05-22T01:24:41Z","timestamp":1779413081000},"page":"451-463","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Interaction of\n                    <scp>FXTAS<\/scp>\n                    Family History and College Degree Attainment Predicts Trajectories of Cognitive and Motor Symptoms in\n                    <scp>\n                      <i>FMR1<\/i>\n                    <\/scp>\n                    Premutation Carrier Women"],"prefix":"10.1002","volume":"201","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6789-2571","authenticated-orcid":false,"given":"Jinkuk","family":"Hong","sequence":"first","affiliation":[{"name":"Waisman Center University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0376-4095","authenticated-orcid":false,"given":"Leann Smith","family":"DaWalt","sequence":"additional","affiliation":[{"name":"Waisman Center University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2818-0344","authenticated-orcid":false,"given":"Jessica","family":"Klusek","sequence":"additional","affiliation":[{"name":"University of South Carolina  Columbia South Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth 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