{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T08:11:05Z","timestamp":1769069465625,"version":"3.49.0"},"posted":{"date-parts":[[2026,1,19]]},"group-title":"Epidemiology","reference-count":50,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T00:00:00Z","timestamp":1768780800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2026,1,19]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>While longitudinal studies aid in understanding and preventing long-latency disorders like dementia, evidence for cadmium\u2019s role in these conditions is still limited. We evaluated associations between cadmium exposure and incident Alzheimer\u2019s disease (AD) and all-cause dementia in US adults.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>National Health and Nutrition Examination Survey (NHANES) III (1988-1994) and continuous NHANES (1999-2016) data were linked with Medicare claims to identify incident AD and dementia cases through 2018. Urinary and\/or blood cadmium were measured during NHANES. We used covariate-adjusted, survey-weighted Cox proportional hazard models to evaluate the associations between cadmium exposure biomarkers and AD\/dementia over follow-up.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>In NHANES III (N=6,122), baseline age was 53.9\u00b10.5 years and urinary cadmium was 0.8\u00b10.02 ug\/L. Over a follow-up of 20.4\u00b10.3 years, 743 AD and 1,508 all-cause dementia cases occurred. Urinary cadmium was not associated with AD (HR: 1.01, 95% CI: 0.9-1.0) nor all-cause dementia incidence (HR: 1.02, 95% CI: 0.96-1.08). In continuous NHANES (urinary cadmium N=2,833; blood cadmium N=8,038), baseline age was 64.1\u00b10.2 years, urinary cadmium was 0.5\u00b10.03 ug\/L, and blood cadmium was 0.6\u00b10.01 ug\/L. Over 9.5\u00b10.1 years, 587 AD and 1,260 all-cause dementia cases occurred. Urinary and blood cadmium showed no associations with AD (HR [95% CI]: 1.09 [0.9, 1.4]; 1.06 [0.9, 1.2]) nor all-cause dementia (HR [95% CI]: 1.07 [0.9, 1.3]; 1.06 [0.95, 1.2]).<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>No association between cadmium exposure and dementia incidence was observed. Our null findings should be interpreted while considering potential methodological issues and verified by subsequent studies.<\/jats:p>\n                <\/jats:sec>","DOI":"10.64898\/2026.01.16.26344271","type":"posted-content","created":{"date-parts":[[2026,1,19]],"date-time":"2026-01-19T22:30:12Z","timestamp":1768861812000},"source":"Crossref","is-referenced-by-count":0,"title":["Cadmium Exposure and Incidence of All-Cause Dementia and Alzheimer\u2019s Disease in US Adults"],"prefix":"10.64898","author":[{"given":"Erika","family":"Walker","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanelli","family":"Rodr\u00edguez-Carmona","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhramar","family":"Mukherjee","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Yale School of Public Health, Yale University, New Haven, CT, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Laura","family":"Arboleda-Merino","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei","family":"Hao","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroko","family":"Dodge","sequence":"additional","affiliation":[{"name":"Massachusetts General Hospital, Harvard Medical School, Boston, MA, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Roger L.","family":"Albin","sequence":"additional","affiliation":[{"name":"Michigan Alzheimer\u2019s Disease Center, University of Michigan, Ann Arbor, MI, US"},{"name":"Department of Neurology, University of Michigan, Ann Arbor, MI, US"},{"name":"Neurology Service & GRECC, VAAAHS, Ann Arbor, MI, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Henry L.","family":"Paulson","sequence":"additional","affiliation":[{"name":"Michigan Alzheimer\u2019s Disease Center, University of Michigan, Ann Arbor, MI, US"},{"name":"Department of Neurology, University of Michigan, Ann Arbor, MI, US"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sung 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