{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T03:42:19Z","timestamp":1791430939606,"version":"4.3.3"},"reference-count":55,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,2,9]],"date-time":"2022-02-09T00:00:00Z","timestamp":1644364800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>To examine longitudinal race and sex differences in mid\u2010life brain health and to evaluate whether cardiovascular health (CVH) or apolipoprotein E (<jats:italic>APOE<\/jats:italic>) \u03b54 explain differences.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The study included 478 Black and White participants (mean age: 50 years). Total (TBV), gray (GMV), white (WMV), and white matter hyperintensity (WMH) volumes and GM\u2013cerebral blood flow (CBF) were acquired with 3T\u2010magnetic resonance imaging at baseline and 5\u2010year follow\u2010up. Analyses were based on general linear models.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There were race x sex interactions for GMV (<jats:italic>P<\/jats:italic>\u2010interaction\u00a0=\u00a0.004) and CBF (<jats:italic>P<\/jats:italic>\u2010interaction\u00a0=\u00a0.01) such that men showed more decline than women, and this was most evident in Blacks. Blacks compared to Whites had a significantly greater increase in WMH (<jats:italic>P<\/jats:italic>\u00a0=\u00a0.002). All sex\u2013race differences in change were marginally attenuated by CVH and <jats:italic>APOE<\/jats:italic> \u03b54.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Race\u2013sex differences in brain health emerge by mid\u2010life. Identifying new environmental factors beyond CVH is needed to develop early interventions to maintain brain health.<\/jats:p><\/jats:sec>","DOI":"10.1002\/alz.12560","type":"journal-article","created":{"date-parts":[[2022,2,10]],"date-time":"2022-02-10T00:20:21Z","timestamp":1644452421000},"page":"2428-2437","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Race, sex, and mid\u2010life changes in brain health: Cardia MRI substudy"],"prefix":"10.1002","volume":"18","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8260-8762","authenticated-orcid":false,"given":"Justine E.F.","family":"Moonen","sequence":"first","affiliation":[{"name":"National Institute on Aging National Institute of Health LEPS\/IRP\/NIA\/NIH Laboratory of Epidemiology and Population Sciences  Baltimore Maryland USA"},{"name":"Department of Neurology Alzheimer center Amsterdam  De Boelelaan Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2346-7562","authenticated-orcid":false,"given":"Ilya M.","family":"Nasrallah","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Health System  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8115-6343","authenticated-orcid":false,"given":"John A.","family":"Detre","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Health System  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9035-3795","authenticated-orcid":false,"given":"Sudipto","family":"Dolui","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Health System  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6633-4861","authenticated-orcid":false,"given":"Guray","family":"Erus","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Pennsylvania Health System  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1025-8561","authenticated-orcid":false,"given":"Christos","family":"Davatzikos","sequence":"additional","affiliation":[{"name":"Center for Biomedical Image Computing and Analytics Perelman School for Advanced Medicine  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1124-5113","authenticated-orcid":false,"given":"Osorio","family":"Meirelles","sequence":"additional","affiliation":[{"name":"National Institute on Aging National Institute of Health LEPS\/IRP\/NIA\/NIH Laboratory of Epidemiology and Population Sciences  Baltimore Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2327-4579","authenticated-orcid":false,"given":"R. 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