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The LIBRA index was not associated with biomarker trajectories or the primary cognitive composite outcome trajectory. There were inconsistent effects on secondary domain\u2010specific cognitive trajectories. In contrast, tau and neurodegeneration were strongly associated with cognitive trajectories.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>In the age\u2010range and disease\u2010range studied, lifestyle did not exhibit a meaningful effect on Alzheimer's disease or vascular biomarker accumulation and was not consistently associated with cognitive trajectories.<\/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>In this age\u2010range, the LIfestyle for BRAin Health (LIBRA) index was not associated with biomarker trajectories.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The LIBRA index was not consistently associated with cognitive trajectories.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Effects of lifestyle, if any, may take more time to manifest.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dad2.70101","type":"journal-article","created":{"date-parts":[[2025,4,16]],"date-time":"2025-04-16T00:57:05Z","timestamp":1744765025000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Late\u2010midlife lifestyle and brain and cognitive changes in individuals on the AD versus non\u2010AD continuum"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5201-8080","authenticated-orcid":false,"given":"Julie E.","family":"Oomens","sequence":"first","affiliation":[{"name":"Department of Psychiatry and Neuropsychology School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University  Maastricht The Netherlands"},{"name":"Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karly A.","family":"Cody","sequence":"additional","affiliation":[{"name":"Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"Stanford University  Stanford California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianlian","family":"Du","sequence":"additional","affiliation":[{"name":"Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"Wisconsin Alzheimer's Institute School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"Rush Alzheimer's Disease Center Rush University Medical Center  Chicago Illinois USA"},{"name":"Department of Neurological Sciences Rush Medical College  Chicago Illinois USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Erin M.","family":"Jonaitis","sequence":"additional","affiliation":[{"name":"Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"},{"name":"Wisconsin Alzheimer's Institute School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rachel L.","family":"Studer","sequence":"additional","affiliation":[{"name":"Wisconsin Alzheimer's Institute School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nathaniel A.","family":"Chin","sequence":"additional","affiliation":[{"name":"Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health University of Wisconsin\u2010Madison  Madison Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"K\u00f6hler","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neuropsychology School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University  Maastricht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pieter Jelle","family":"Visser","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neuropsychology School for Mental Health and Neuroscience, Alzheimer Centrum Limburg, Maastricht University  Maastricht The Netherlands"},{"name":"Department of Neurology Alzheimer Center VU University Medical Center  Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie J. 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