{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,25]],"date-time":"2026-04-25T10:50:59Z","timestamp":1777114259254,"version":"3.51.4"},"reference-count":8,"publisher":"S. Karger AG","issue":"3","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Neuroepidemiology"],"published-print":{"date-parts":[[2022]]},"abstract":"<b><i>Introduction:<\/i><\/b> This study aimed to characterize the association of cognitive decline starting in midlife with brain pathology in late life in the absence of dementia. <b><i>Methods:<\/i><\/b> Nondemented Atherosclerosis Risk in Communities participants with brain imaging, all cognitive factor scores (CFSs), and nonmissing covariates were included. CFSs were collected at three visits across 21 years (1990\u20132013) (short-term cognitive change [1990\u20131996], long-term cognitive change [1990\u20132013]), and brain magnetic resonance imaging and florbetapir positron emission tomography (PET) imaging were collected in 2011\u201313 (PET subset <i>n<\/i> = 327). Outcomes of interest were total and regional brain volumes (cm<sup>3<\/sup>), log<sub>2<\/sub> (white matter hyperintensity volume), white matter integrity (fractional anisotropy, mean diffusivity), \u22651 lacunar infarct (3\u201320 mm), and elevated brain \u03b2-amyloid (SUVR &#x3e;1.2). Multivariable linear\/logistic regression related outcomes to CFS slopes after adjusting for demographics and total intracranial volume. <b><i>Results:<\/i><\/b> At baseline, the 1,734 participants had a mean (SD) age of 55 (5.2) years, and were 60% female and 26% Black. After adjustment, a 1-SD larger long-term decline in CFS was associated with a smaller relative total brain volume by 1.2% (95% CI: 1.0, 1.5), a smaller relative temporal lobe meta region volume by 1.9% (1.5, 2.3), a 13% (9, 17) larger volume of white matter hyperintensities, a 1.3-fold (1.2, 1.4) higher odds of having \u22651 lacune, and 1.7-fold (1.3, 2.2) higher odds of elevated brain \u03b2-amyloid deposition and worse white matter integrity. Some long-term associations were also found for midlife short-term declines in CFS. <b><i>Conclusions:<\/i><\/b> This study provides evidence that starting in midlife, short-term and long-term declines in cognition are associated with multiple deleterious late-life differences in nondemented brains. <\/jats:p>","DOI":"10.1159\/000524731","type":"journal-article","created":{"date-parts":[[2022,5,2]],"date-time":"2022-05-02T21:02:13Z","timestamp":1651525333000},"page":"183-191","source":"Crossref","is-referenced-by-count":4,"title":["Brain Imaging Features Associated with 20-Year Cognitive Decline in a Community-Based Multiethnic Cohort without Dementia"],"prefix":"10.1159","volume":"56","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2900-3988","authenticated-orcid":false,"given":"Alessandro","family":"Orlando","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. Richey","family":"Sharrett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea L.C.","family":"Schneider","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rebecca F.","family":"Gottesman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David S.","family":"Knopman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreea","family":"Rawlings","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas H.","family":"Mosley","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7916-622X","authenticated-orcid":false,"given":"Clifford R.","family":"Jack","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9343-8367","authenticated-orcid":false,"given":"Dean","family":"Wong","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6858-620X","authenticated-orcid":false,"given":"James R.","family":"Pike","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4598-0669","authenticated-orcid":false,"given":"Josef","family":"Coresh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"127","published-online":{"date-parts":[[2022,5,2]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001774"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12009"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.21334"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1177\/1073858404263960"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.2008.167288"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c3666"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000000505"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.c3666"}],"container-title":["Neuroepidemiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/524731","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/524731","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T14:56:16Z","timestamp":1745420176000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000524731"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022]]},"references-count":8,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2022,8,2]]},"published-print":{"date-parts":[[2022,8,2]]}},"URL":"https:\/\/doi.org\/10.1159\/000524731","archive":["Portico"],"relation":{"is-supplemented-by":[{"id-type":"doi","id":"10.6084\/m9.figshare.19690624","asserted-by":"subject"}]},"ISSN":["0251-5350","1423-0208"],"issn-type":[{"value":"0251-5350","type":"print"},{"value":"1423-0208","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022]]}}}