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However, the association between Alzheimer disease (AD) and AUD is poorly characterized. To address this, we studied associations between AUD, cognition, and measures of AD neuropathology.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We measured a lifetime history of AUD, cognitive decline, and blood biomarkers for AD in middle\u2010aged and older participants (47\u201387\u2009years) from the St. Louis site of the Collaborative Study on the Genetics of Alcoholism (COGA) (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009392). Cognitive decline was measured using the Eight\u2010item Informant Interview to Differentiate Aging and Dementia (AD8) (\n                      <jats:italic>N<\/jats:italic>\n                      \u2009=\u2009366); 154 individuals had AD biomarkers derived from plasma measurements (Amyloid Probability Score 2, A\u03b242\/A\u03b240, and %p\u2010tau217). We used Poisson regression models to evaluate the relationship between AUD, age, and cognitive decline. AUD was categorized as no AUD, mild AUD, or moderate\u2010to\u2010severe AUD, and age was modeled as a piecewise linear variable segmented by decade. Linear regressions were used to assess the association between AD blood biomarkers and AUD.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Analyses revealed a significant association between moderate\u2010to\u2010severe AUD and increased cognitive decline in middle\u2010aged and older adults (RR\u2009=\u20091.4,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). While a greater proportion of participants with moderate\u2010to\u2010severe AUD met the A\u03b242\/A\u03b240 threshold for predicting elevated brain amyloid compared to those with mild or no AUD, consistent with our hypothesis, this trend did not achieve statistical significance.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>These results underscore the importance of addressing AUD as a potentially modifiable risk factor for cognitive decline in middle aged and older adults. Further study is needed to understand the link between AUD and AD biomarkers.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acer.70278","type":"journal-article","created":{"date-parts":[[2026,4,6]],"date-time":"2026-04-06T15:00:22Z","timestamp":1775487622000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The relationship between alcohol use disorder, measures of cognitive decline, and Alzheimer disease biomarkers in middle aged and older adults"],"prefix":"10.1111","volume":"50","author":[{"given":"Lisa A.","family":"Hayibor","sequence":"first","affiliation":[{"name":"School of Medicine Washington University  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrey","family":"Anokhin","sequence":"additional","affiliation":[{"name":"School of Medicine Washington University  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sherri L.","family":"Fisher","sequence":"additional","affiliation":[{"name":"School of Medicine Washington University  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alison","family":"Goate","sequence":"additional","affiliation":[{"name":"Icahn School of Medicine at Mount Sinai  New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tatiana M.","family":"Foroud","sequence":"additional","affiliation":[{"name":"School of Medicine Indiana University  Indianapolis Indiana USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Suzanne E.","family":"Schindler","sequence":"additional","affiliation":[{"name":"School of Medicine Washington University  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura J.","family":"Bierut","sequence":"additional","affiliation":[{"name":"School of Medicine Washington University  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sarah M.","family":"Hartz","sequence":"additional","affiliation":[{"name":"School of Medicine Washington University  St. Louis Missouri USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,4,6]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1002\/jnr.22091"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.14283\/jpad.2022.85"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/978-3-031-81908-7_10"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000543222"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1202753"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.15288\/jsa.1994.55.149"},{"key":"e_1_2_8_9_1","volume-title":"Facts about U.S. deaths from excessive alcohol use","author":"Centers for Disease Control and Prevention","year":"2024"},{"key":"e_1_2_8_10_1","unstructured":"COGA. 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