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The cohort was prospectively split into low\u2010, medium\u2010, and high\u2010risk groups based on the presence of known risk factors (apolipoprotein E [<jats:italic>APOE<\/jats:italic>] \u03b54 genotype and family history of dementia [FH]). We used ordinal logistic regression to test for cross\u2010sectional associations between choroidal measurements and AD risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>Choroidal vasculature was progressively larger between ordinal risk groups, and significantly associated with risk group prediction. <jats:italic>APOE<\/jats:italic> \u03b54 carriers had thicker choroids and larger vascularity compared to non\u2010carriers. Similar trends were observed for those with a FH.<\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSIONS<\/jats:title><jats:p>Our results suggest a potential link between the choroidal vasculature and AD risk. However, these exploratory findings should be replicated in a larger sample.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Ocular choroidal microvasculature is of interest in relation to neurodegeneration due to its autonomic response to systemic, pathophysiological change.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Choroidal changes in the prodromal stage of Alzheimer's disease (AD) are unexplored.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>The PREVENT Dementia cohort offers a unique, non\u2010invasive study of the microvasculature in mid\u2010life individuals at increased risk for developing AD.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Significantly increased ocular choroidal vasculature was associated with increased risk (apolipoprotein E carrier and\/or family history of dementia) for AD.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>These exploratory results suggest a potential association between the ocular choroidal vasculature and AD risk. However, findings should be replicated in a larger sample.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/dad2.70075","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T07:44:11Z","timestamp":1737013451000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Association between choroidal microvasculature in the eye and Alzheimer's disease risk in cognitively healthy mid\u2010life adults: A pilot study"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8001-6819","authenticated-orcid":false,"given":"Jamie","family":"Burke","sequence":"first","affiliation":[{"name":"Robert O Curle Ophthalmology Suite Institute for Regeneration and Repair University of Edinburgh  Edinburgh UK"},{"name":"School of Mathematics, University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel","family":"Gibbon","sequence":"additional","affiliation":[{"name":"Robert O Curle Ophthalmology Suite Institute for Regeneration and Repair University of Edinburgh  Edinburgh UK"},{"name":"Centre for Clinical Brain Sciences Chancellor's Building  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Low","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlene","family":"Hamid","sequence":"additional","affiliation":[{"name":"Edinburgh Imaging, The Queen's Medical Research Institute, University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megan","family":"Reid\u2010Schachter","sequence":"additional","affiliation":[{"name":"Edinburgh Imaging, The Queen's Medical Research Institute, University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graciela","family":"Muniz\u2010Terrera","sequence":"additional","affiliation":[{"name":"Heritage College of Osteopathic Medicine Ohio University  Athens Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Craig W.","family":"Ritchie","sequence":"additional","affiliation":[{"name":"Centre for Clinical Brain Sciences Chancellor's Building  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baljean","family":"Dhillon","sequence":"additional","affiliation":[{"name":"Robert O Curle Ophthalmology Suite Institute for Regeneration and Repair University of Edinburgh  Edinburgh UK"},{"name":"Centre for Clinical Brain Sciences Chancellor's Building  Edinburgh UK"},{"name":"Princess Alexandra Eye Pavilion Chalmers Centre  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John T.","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Department of Psychiatry University of Cambridge  Cambridge UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stuart","family":"King","sequence":"additional","affiliation":[{"name":"School of Mathematics, University of Edinburgh  Edinburgh UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ian J. 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