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Multivariate linear regression models and multivariate linear mixed models adjusted for age, sex, education, and race.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      MtDNA heteroplasmy burden and count were not associated with cognitive performance. However, mtHgs in macro\u2010mtHg L were linked to poorer cognitive outcomes, particularly in processing speed and global cognition in cross\u2010sectional and longitudinal analyses. Associations remained significant after adjusting for social determinants of health (SDOH) or\n                      <jats:italic>APOE \u03b54<\/jats:italic>\n                      , comorbidities, and lifestyle variables.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>The mtDNA variation, especially mtHgs, may play a role in influencing cognitive trajectories, warranting further research on its role in cognitive aging.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Heteroplasmy burden was not associated with cognitive performance at midlife.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Haplogroups were associated with cognitive outcomes at midlife.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Longitudinal analysis revealed that haplogroups are associated with cognitive trajectories.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70839","type":"journal-article","created":{"date-parts":[[2025,10,29]],"date-time":"2025-10-29T03:28:14Z","timestamp":1761708494000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Mitochondrial haplogroups, but not heteroplasmy, are associated with midlife cognitive 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Center at Houston University of Texas  Houston Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristine","family":"Yaffe","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Biostatistics University of California  San Francisco California USA"},{"name":"Department of Psychiatry and Behavioral Sciences University of California  San Francisco California USA"},{"name":"Department of Neurology University of California  San Francisco California 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