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The disruption of key mechanisms involved in amyloid beta (Aβ) clearance during the early stages of dementia may contribute to the progression of cognitive decline toward irreversible brain damage. In this study, we investigated multiple immune-related pathways implicated in the management and clearance of Aβ within circulating extracellular vesicles (cEVs) and serum from individuals with subjective cognitive decline (SCD) who later progressed to mild cognitive impairment (MCI). A cytokine panel and the levels of Aβ In SCD patients, the concentrations of Aβ Our findings support the potential value of integrating serum M-CSF levels with RAVLT performance and cEVs Aβ Show less

Hispanic/Latino (H/L) adults are more likely than non-Hispanic White individuals to have Alzheimer's disease (AD), yet fewer than one in five H/L adults has apolipoprotein E ( Community-residing, Spanish-preferring Mexican/Mexican American adults ( Participants recognized AD as a memory disorder influenced by aging and genes but were largely unfamiliar with AD genetic testing. Testing was viewed as useful for diagnosis rather than future risk prediction, with limited perceived value for cognitively normal individuals without a family history. Despite this limited familiarity, participants expressed interest in AD research involving genetic testing. Findings suggested a perceived responsibility to use AD genetic testing despite limited awareness of its purposes, applications, and clinical implications. Participants' responses reflected a present-oriented health disposition: Genetic testing was viewed as appropriate once symptoms emerge rather than as a proactive tool for anticipating future decline, consistent with current clinical practice outside autosomal dominant AD. Educational materials co-created by community members and researchers may address these gaps by explaining both limitations of genetic testing in isolation and its potential future applications, including how genetic and multimodal biomarker data may inform risk estimation and prevention-focused decision-making. This approach may foster a future-oriented health disposition while remaining responsive to social and structural contexts. Future work is needed among other H/L heritage groups with differing social and structural experiences, migration histories, and language primacy. Show less

The choroid plexus (CP), known for producing cerebrospinal fluid, is increasingly implicated in the pathogenesis of Alzheimer's disease (AD). Neuroimaging studies document structural CP alterations in aging and AD. One such alteration, calcium deposition, increases with age and is typically considered benign, though the mechanism and clinical significance of CP calcification remain uncertain. Given established association between peripheral vascular calcification and cardiovascular risk, we hypothesized that the volume of calcium within CP would correlate with systemic cardiovascular health. Based on prior findings of APOEε4-specific associations between CP calcium and neurodegeneration, participants were stratified by APOEε4 status, a strong genetic risk factor for AD also implicated in cardiovascular disease. In this retrospective analysis of 105 adults (mean age 58.9 years; 39 APOEε4+), we examined whether CP calcium correlates with cardiovascular risk in cognitively normal adults. CP calcium was quantified using a previously validated MRI-CT method. Spearman correlations assessed the association of CP calcium and Framingham Cardiovascular Risk Score (FCRS), as well as individual cardiovascular risk factors. Overall, CP calcium was not associated with FCRS. Among APOEε4- subjects, CP calcium correlated positively with FCRS ( Show less

Resveratrol (Rsv) is a natural polyphenol with neuroprotective properties that modulates several pathways implicated in Alzheimer's disease (AD). Cholesterol homeostasis is disrupted in AD patients, and this imbalance plays a key role in amyloid precursor protein (APP) processing, β-amyloid aggregation and membrane stability. The effect of Rsv on the cerebellum, an emerging structure in cognitive networks and AD pathology due to its high connectivity with other brain regions, remains largely unexplored. This study aims to characterize the effects of Rsv on the cerebellum of SAMP8 mice, an animal model of AD, at different ages (5- and 7-month-old mice) and to investigate how it act as a neuroprotective polyphenol in this structure via modulation of cholesterol metabolism. Aging caused a significant increase in cerebellar membrane free cholesterol levels, which were reversed by Rsv treatment. HMG-CoA reductase levels were significantly reduced by Rsv treatment in 5-month-old mice, suggesting that this polyphenol modulates cholesterol synthesis. Parameters related to cholesterol trafficking were also modulated, with increased LDL receptor levels, but without affecting ApoE. Mitochondrial electron transport chain complexes were also upregulated by Rsv treatment in 5-month-old animals, without affecting mitochondrial dynamics. Collectively, these data demonstrate-for the first time-that Rsv modulates key aspects of cholesterol metabolism and mitochondrial function in the cerebella of SAMP8 mice. Show less

Air pollution particles exacerbate allergic asthma and can enhance inflammatory responses to allergen exposure, but the cellular mechanisms involved remain incompletely defined. We examined how diesel exhaust particles (DEP) enhance house-dust-mite (HDM) inflammatory responses within the lung and characterised potential mechanisms that may contribute to enhanced type 2 (T2) inflammatory responses. In mice subjected to repeated intranasal exposures, DEP alone had modest effects, whereas DEP + HDM markedly increased type-2 inflammatory indicators (Serum IgE; Airway Il13, Il4 & Tslp) and eosinophilia alongside expansion of Th2 cells. Bulk transcriptomics showed far stronger differential expression in luminal airway cells than tissue, with a DEP + HDM-specific signature enriched for mast cells, alternatively activated macrophages (AAM), and B-cells in the lumen. Combined single-cell proteomic and transcriptomic profiling identified an expanded Cd11c⁺, SiglecF⁻, Apoe⁺, Gpnmb⁺ monocyte-derived macrophage subset (RM.Gp2), which showed increased type 2 chemokines Ccl8 and Ccl24 with DEP + HDM compared to HDM alone. Trajectory analysis placed RM.Gp2 downstream of Ccr2⁺ monocyte derived population, and protein/mRNA data supported a Ccl2-Ccr2-dependent influx that enlarges the RM.Gp2 pool. High-content imaging confirmed increased RM.Mo and RM.Gp2 numbers and higher total luminal Ccl8/Ccl24. F4/80⁺ luminal airway macrophages isolated from DEP pre-treated mice, demonstrated enhanced upregulation of Ccl8 and Ccl24 mRNA in response to ex vivo Il-4/Il-13 treatment, compared to macrophages isolated from control mice. Examination of an additional particle type (CeO Our data suggests that pollutant particles such as DEP may contribute to enhanced HDM induced type 2 inflammation by expanding Ccr2-dependent monocyte-derived macrophages into the airway lumen and licensing a Th2-cytokine-responsive chemokine programme (Ccl8- Ccr8 to recruit Th2 cells; Ccl24-Ccr3 to recruit eosinophils). These findings identify luminal recruited macrophages as important targets in allergic inflammation within the lung, providing insight into potential mechanisms from which exposure and disease mitigation strategies may be developed. Show less

Dichlorodiphenyltrichloroethane (DDT), a persistent organochlorine pesticide, continues to be used for malaria control under the Stockholm Convention. We investigated associations between exposure to DDT and its metabolite dichlorodiphenyldichloroethylene (DDE) and midlife cognitive function and brain structure among primarily Mexican-born Latina women in an agricultural community in California, USA. In the CHAMACOS Maternal Cognition Study, a prospective cohort study, we assessed global and domain-specific cognitive performance in 472 women. A subset of 95 women underwent T1-weighted brain MRI to measure cortical thickness. We evaluated associations between serum p,p'-DDT and p,p'-DDE concentrations-measured 12 years earlier-and cognitive Z scores and cortical thickness using linear regression. Bayesian hierarchical models accounted for co-exposure to other organochlorine pesticides. Apolipoprotein E (APOE) genotype was assessed as a potential modifier. Higher p,p'-DDT and p,p'-DDE concentrations were significantly associated with lower executive function scores (p,p'-DDT β=-0·10 [95% CI -0·18 to -0·02]; p,p'-DDE β=-0·09 [-0·19 to 0·00]; SDs per ten-fold increase in serum concentration). No associations were observed with other cognitive domains. Results were robust to adjustment for APOE genotype and organochlorine co-exposures. No effect modification by APOE ε4 status was found. Both exposures were associated with greater frontal lobe cortical thickness, particularly in the medial orbitofrontal and pars orbitalis regions. p,p'-DDT and p,p'-DDE exposure was associated with reduced executive function more than a decade later, and with altered frontal brain structure. These findings suggest potential long-term neurodevelopmental effects of legacy organochlorine exposure and warrant further investigation. US National Institutes of Health and US Environmental Protection Agency. Show less

Methylprednisolone (mPSL) pulse therapy is an essential treatment for systemic lupus erythematosus (SLE); however, it carries a risk of osteonecrosis of the femoral head (ONFH). The pathogenesis of ONFH involves neutrophil extracellular trap (NET)-mediated microcirculation disorders. In BALB/c mice with imiquimod (IMQ)-induced lupus, mPSL pulse elevated serum levels of prenylcysteine oxidase 1 (PCYOX1), an enzyme that produces NET inducers hydrogen peroxide and farnesal, resulting in increased NETs in vivo. Although ischemia was observed in the femoral head, IMQ + mPSL-treated BALB/c mice did not develop ONFH. PCYOX1 is abundant in very-low-density lipoproteins. This study aimed to demonstrate that hyperlipidemia exacerbates NET-mediated microcirculation disorders and leads to ONFH development following mPSL pulse in lupus mice. To address this, ApoE mutant hyperlipidemic and BALB/c mice with IMQ-induced lupus received mPSL pulse. NET-forming neutrophils in peripheral blood were detected by flow cytometry. ONFH was assessed microscopically. As a result, IMQ + mPSL-treated ApoE mutant but not BALB/c mice developed ONFH, exhibiting higher levels of PCYOX1 and NET-forming neutrophils in circulation. In addition, NET-forming neutrophils accumulated in the vessels surrounding the femoral head, accompanied by osteocyte necrosis. This study demonstrated that mPSL pulse in lupus mice with hyperlipidemia enhanced PCYOX1 levels and NET formation, resulting in ONFH development, suggesting that hyperlipidemia may be a risk factor for ONFH following mPSL pulse therapy in SLE. Show less

An accurate understanding of prognosis in Parkinson's disease (PD) is important for patient information provision, personalized treatment, and clinical trial design, but most previous research has been biased towards younger, healthier patients. To describe key clinical outcomes longitudinally and identify baseline prognostic factors (predictors) for these outcomes using population-representative PD cohorts. We meta-analyzed individual patient data from six incidence cohorts in Western Europe (Norway, Sweden, and UK). Each cohort aimed to recruit and follow up all newly diagnosed cases in defined population/incidence periods (between 2000 and 2011). We described postural instability (Hoehn & Yahr Stage 3), functional dependency (needing help with daily activities), dementia, and death with up to 12 years' follow-up and investigated clinical and genetic predictors using frailty Cox models. In 883 population-based incident patients, median age at motor symptom onset was 69.2 years. Median time to postural instability and functional dependency was 7.4 years. Dementia affected 49.6% by 10 years and 54.7% had died by 12 years (median survival 9.4 years). Older age, higher Movement Disorder Society-Unified Parkinson's Disease Rating Scale-Part III (MDS-UPDRS-III) score, and lower Mini-Mental State Examination (MMSE) were significantly associated with all outcomes; cognitive symptoms and GBA polymorphisms with each outcome except mortality; and APOE ε4 with increased mortality and dementia. This first individual patient data meta-analysis of population-based incidence cohorts provides robust prognostic data, with fewer selection biases than previous PD studies, for informing people with PD about prognosis. In incidence cohorts, overall PD prognosis is worse than previously suggested, with key outcomes often occurring early. Further work should develop validated prognostic models for objective stratification of prognostic risk and for personalized medicine. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society. Show less

Cholesterol efflux capacity (CEC) is robust biomarker for atherosclerotic cardiovascular disease (ASCVD). However, cell-based CEC assays require complex procedures that limit clinical use. The immobilized liposome-bound gel beads (ILG) method, a newly developed cell-free CEC assay, demonstrates sufficient performance for clinical application. This study investigated the clinical significance of CEC measured by the ILG method in relation to HDL subclasses and coronary artery plaque characteristics. We analyzed CEC and HDL parameters, including the ratio of apolipoprotein E (apoE)-HDL-C to HDL-C (%apoE) and HDL CEC correlated positively with HDL-C and %apoE. Among the patients, 26 (42.6%) exhibited large lipid-rich plaques on OCT. Univariable analysis showed that CEC was significantly lower in patients with large lipid-rich plaques compared to those without. While this association did not reach statistical significance after multivariable adjustment (p = 0.109), the addition of CEC to traditional risk factors improved the model's explanatory power (Nagelkerke R CEC measured using the ILG method reflects HDL subclass features and is associated with the burden of lipid-rich coronary artery plaques. These findings suggest the significance of CEC evaluated using the ILG method, supporting its potential for enhanced ASCVD risk assessment and further clinical applications. Show less

In a previous study, we showed that oral supplementation with lysophosphatidylcholine (LPC)-bound omega-3 fatty acids (n-3) increases cortical eicosapentaenoic acid (EPA, C20:5n-3) but not docosahexaenoic acid (DHA, C22:6n-3) in an apolipoprotein E (APOE)- and duration-dependent manner. This may reflect DHA retention in blood-brain interfaces, such as microvessels (MV) and choroid plexus (ChP). To assess whether LPC n-3 intake over two or four months modulates the lipid composition of MV and ChP in APOE3 and APOE4 mice. APOE3 and APOE4 mice received daily gavage of LPC-bound EPA (21.5 mg/day) and DHA (10.4 mg/day) or sunflower oil (control) for two or four months (n=5-8 mice per genotype and treatment). Lipids from plasma, frontal cortex (FCx), ChP, and MV were analyzed by liquid chromatography-tandem mass spectrometry. Principal component analysis indicated that phospholipid levels in plasma, ChP, MV and FCx were modulated more by the type of oil administered by gavage (LPC n-3-enriched oil vs. sunflower oil) than by APOE genotype or gavage duration. The ChP was the most responsive tissue to n-3 supplementation. Total DHA increased in the FCx of APOE3 mice receiving LPC n-3, but not in APOE4 mice. In contrast, EPA levels were significantly higher across genotypes and biological compartments in n-3-supplemented mice. This study reports higher DHA and EPA concentrations in the brain of APOE3 mice supplemented with LPC n‑3 and reinforces evidence of lower DHA accretion in APOE4 mice. It also identifies the ChP as a major site of n‑3 response. Show less

Macrophages play central roles in the initiation and growth of atherosclerosis (AS). This study aimed to investigate the role of ENC1 in macrophage oxidative stress during AS and its mechanism. An animal model of AS was constructed by feeding ApoE KO mice with a high-cholesterol diet, and an in vitro AS model was induced on mouse macrophages RAW 264.7 using oxLDL. Macrophage-specific adeno-associated viruses containing the F4/80 promoter were used to interfere with RBM47 and ENC1 expression in vivo, and lentiviral infection of RAW 264.7 was applied in vitro. RBM47 improved the stability of ENC1 by binding to the AU-rich elements, which curbed NRF2 synthesis and nuclear translocation. Exogenous inhibition of ENC1 or RBM47 suppressed aortic oxidative stress in mice with AS, reduced lipid and cholesterol uptake, and strengthened cellular scavenging activity against oxidative stress in RAW 264.7 cells. The NRF2 inhibitor ML385 reversed the above benefits from the knockdown of ENC1 in RAW 264.7 cells, and combined overexpression of ENC1 reversed these benefits from the knockdown of RBM47 in vitro and in vivo. This study provides new evidence that ENC1 is a contributor to AS progression, and targeting ENC1 in macrophages may serve as a potential therapy. Show less

Posttraumatic stress disorder (PTSD) has been associated with accelerated cognitive aging and increased risk for Alzheimer's disease (AD) and related dementias (ADRD), yet the neural substrates linking trauma-related psychiatric illness to late-life neurodegenerative vulnerability remain poorly defined. The amygdala plays a central role in threat processing and emotional memory and exhibits persistent hyperactivity in PTSD, but its molecular and pathological state in aging individuals with PTSD has not been systematically examined. Postmortem amygdala tissue from older adult donors (≥ 70 years) with lifetime PTSD (n = 5) and age-matched controls (n = 5) was obtained from the National PTSD Brain Bank. A multimodal analysis was performed integrating immunohistochemical quantification of β-amyloid and phosphorylated tau pathology, targeted transcriptional profiling of AD-related genes, gene network analysis, and protein quantification of pathological, inflammatory, and synaptic markers. PTSD cases showed enrichment of combined tau-amyloid pathology within the amygdala and significantly greater β-amyloid burden. Targeted transcriptomic profiling identified coordinated upregulation of AD-related genes involved in amyloid processing, lipid metabolism, proteostasis, and inflammatory signaling. Network analysis revealed an APP-centered molecular architecture with APOE, MAPT, and CLU functioning as highly connected secondary hubs. Protein analyses demonstrated increased amyloid-β and pTau231 abundance, selective markers of gliosis, and synaptic alterations characterized by elevated excitatory receptor expression and reduced inhibitory GABABR1a. Older adults with PTSD exhibit convergent evidence of AD-relevant molecular and pathological remodeling in the amygdala. These findings suggest that chronic trauma-related circuit dysregulation may intersect with aging-associated inflammatory and synaptic processes, creating a biological environment permissive for neurodegenerative vulnerability in emotionally salient brain circuits. Show less

Understanding the time course of Alzheimer's disease biomarkers of amyloid and tau pathology and their temporal relation to clinical symptoms is key to identifying optimal windows for disease intervention and planning future drug trials. The goal of this work was to determine the extent to which Sampled Iterative Local Approximation (SILA), an algorithm extensively validated for amyloid PET, is capable of modeling longitudinal tau (T) PET trajectories and estimating person-level tau positivity onset ages in two commonly analyzed brain regions and two tracers from two different cohorts. 385 participants from the Alzheimer's Disease Neuroimaging Initiative (ADNI; mean (SD) age = 73.4 (7.3) years) with longitudinal flortaucipir tau PET and 288 participants from the Wisconsin Registry for Alzheimer's Prevention and Wisconsin Alzheimer's Disease Research Center (collectively referred to as WISC; mean (SD) age = 67.4 (6.7) years) with longitudinal MK-6240 tau PET were included in the study. Standard uptake value ratios (SUVRs) in the entorhinal cortex and a meta-temporal ROI were modeled with SILA separately, for each cohort and region. Forward and backward SUVR and T+/- prediction were characterized with ten-fold cross-validation and in-sample validation techniques. Accuracy of estimated T+ onset ages (ETOA) was characterized in T- to T+ converters. Differences in ETOA were tested between SILA was able to accurately estimate retrospective change in tau SUVR in the meta-temporal region regardless of age, sex, Our results suggest SILA can be used to accurately model longitudinal tau PET trajectories and retrospectively estimate individual T+ onset ages in the meta-temporal region. The accuracy of SILA time estimates in entorhinal cortex worsened amongst those with dementia in ADNI suggesting entorhinal cortex may only be suitable for studying the temporal progression of tau during the preclinical time frame. Show less

This review comprehensively summarizes the interaction mechanisms between Megalin and several key ligands, including calcium ions, gentamicin, ApoE, ANKRA2, FVIII, TTR, STC1, RAP, and MMP-9, focusing on the specific amino acid binding sites involved. The analysis highlights the structural basis of these interactions and their clinical relevance, particularly concerning diseases such as nephrotoxicity, Alzheimer's disease, metabolic disorders, and renal pathologies. This review comprehensively summarizes the specific binding sites of Megalin with its ligands and explores the mechanisms, including protein reabsorption, blood coagulation, and neuroprotection, by integrating the results of animal studies and human clinical studies. This review proposes a theoretical framework for designing therapeutic strategies that target the binding sites of Megalin with its ligands. Gene editing technology and monoclonal antibody therapy aim to regulate Megalin receptor-ligand interactions to achieve therapeutic effects on related diseases. Show less

Intermittent hypoxia and hypercapnia (IHC), a hallmark of obstructive sleep apnea (OSA), accelerates atherosclerosis, yet the underlying mechanisms remain unclear. The gut microbiota and metabolites, specifically bile acids, change with IHC and thus the bile acid receptor farnesoid X receptor (FXR) might mediate IHC-induced atherosclerosis. In this study, Show less

Disruption of brain glucose and lipid metabolism contributes to Alzheimer's disease (AD) and often emerges before clinical symptoms. Women are at elevated AD risk due to menopause-associated estrogen decline, which impairs mitochondrial function and glucose metabolism. Women's risk of AD is further elevated by the APOE4 allele, the strongest genetic risk factor for late-onset AD. To investigate the impact of APOE3/3 mice exhibited dynamic regulation of brain metabolic systems that supported postmenopausal bioenergetic demand. In contrast, APOE3/4 and APOE4/4 mice displayed accelerated and altered metabolic shifts, resulting in postmenopausal amino acid depletion, reduced tricarboxylic acid (TCA) cycle intermediates, lipid accumulation, and alterations in brain lipid composition. A single APOE4 allele was sufficient to impair metabolic adaptation, while APOE4 homozygosity resulted in greater severity of deficits. Outcomes of these analyses revealed that APOE4 accelerated menopause-related metabolic decline and compromised bioenergetic adaptation, providing a mechanistic basis for increased AD susceptibility and earlier onset in APOE4-positive women. Show less

While the apolipoprotein E (APOE) ε4 allele is a major risk factor for Alzheimer's disease (AD), the role of translocase of outer mitochondrial membrane 40 (TOMM40)-an adjacent gene involved in mitochondrial protein import-is not known. Human brain tissue, human induced pluripotent stem cell-derived neurons (iNeurons), and mice were used for study of gene expression, cholesterol metabolism, mitochondrial function, and animal cognition. Human brain transcriptomics showed reduced TOMM40 expression that correlated with cholesterol regulatory gene expression, amyloid burden, and clinical AD diagnosis. In human iNeurons, TOMM40 knockdown (KD) disrupted mitochondria-endoplasmic reticulum contact sites (MERCs), causing mitochondrial dysfunction and promoting reactive oxygen species that led to activation of liver X receptor beta (NR1H2), upregulation of APOE and low-density lipoprotein receptor (LDLR), and increased cellular cholesterol and amyloid beta (Aβ)42 independent of APOE ε4. Consistently, Tomm40 KD in mice induced increased brain cholesterol, Aβ42 content, and impaired memory. TOMM40 is a novel mediator of AD pathology through dual effects on MERCs that regulate cholesterol homeostasis and mitochondrial function. Show less

Late-onset Alzheimer's disease (LOAD) is the most common form of dementia in the elderly, yet no curative treatments are available. Although genome-wide association studies (GWASs) have identified numerous genetic risk factors, these factors often differ among ethnic groups, and the mechanisms driving LOAD onset remain poorly understood. Most GWASs of LOAD have been conducted in European populations; the expansion of future studies to non-European populations should uncover novel genetic factors underlying LOAD pathogenesis. To identify novel LOAD-susceptible genes, we conducted whole-genome sequencing data analysis on 1928 Japanese individuals including 325 patients with LOAD and 1603 cognitively normal elderly controls. A GWAS for common variants identified a statistically significant association signal in rs429358, within the apolipoprotein E gene (APOE), which defines the APOE Show less

Plant-based diets have been linked to slower cognitive decline, but data on long-term dietary changes and from diverse populations are limited. The primary aim of this study was to examine plant-based dietary patterns and their change over time in relation to Alzheimer disease and related dementias (ADRDs). This prospective longitudinal analysis of the Multiethnic Cohort Study, based in Hawaii and California (primarily Los Angeles County), included data on African American, Japanese American, Latino, Native Hawaiian, and White participants who completed food frequency questionnaires at baseline (1993-1996; age 45-75 years) and at 10-year follow-up (2003-2008) and whose Medicare claims were linked to identify incident ADRDs. A priori indices for the overall plant-based diet index (PDI), the healthful plant-based diet index (hPDI), and the unhealthful plant-based diet index (uPDI) were analyzed in Cox regression models for ADRD. The analysis included 92,849 participants (mean age 59.2 years, 55.1% female, 21,478 with ADRDs) for the baseline diet and 45,065 participants (8,360 with ADRDs) for the 10-year dietary change. For the baseline diet, comparing the highest vs lowest quintile, PDI and hPDI were associated with 12% (hazard ratio [HR] 0.88; 95% CI 0.85-0.92) and 7% (HR 0.93; 95% CI 0.89-0.97) lower risks of ADRD, respectively, whereas uPDI was related to a 6% higher risk (HR 1.06; 95% CI 1.01-1.10). For the dietary change over time, the strongest association with ADRD was observed for uPDI rather than for PDI or hPDI. Compared with those with a stable score (<0.5 SD change), participants with a large increase in uPDI (≥1 SD) showed a 25% higher risk (HR 1.25; 95% CI 1.15-1.36) and those with a large decrease in uPDI showed an 11% lower risk (HR 0.89; 95% CI 0.84-0.94). The associations between the plant-based diet indices and ADRD were generally similar by age group (<60 vs ≥60 years at baseline), race and ethnicity, or These findings suggest that adopting plant-based diets, specifically refraining from low-quality plant-based diets, even at an older age, is associated with a lower risk of ADRDs. Show less

Anti-amyloid-β (Aβ) therapies are reshaping Alzheimer's disease (AD) management. Understanding changes in real-world patterns of diagnostic testing and infusion chair usage is essential for optimizing access to care. Retrospective analysis of Mayo Clinic enterprise electronic health records (Jan 2019-Mar 2025) assessed trends in AD-relevant brain imaging, fluid biomarkers, apolipoprotein E (APOE) testing, and lecanemab infusions. Rates of amyloid-beta (Aβ) positivity by sex and age, APOE genotype frequencies, and lecanemab treatment initiation and discontinuation were evaluated. Following national insurance coverage changes, lecanemab infusions grew by 110 infusions per quarter to 605 in Q1 2025. Aβ positron emission tomography scans increased (+22/quarter), cerebrospinal fluid biomarker orders declined (-25/quarter), and plasma p-tau The adoption of anti-Aβ therapies coincided with a rapid shift in diagnostic workflows. Show less

Effective real-time monitoring and tracking of lipid droplets (LDs) are essential for the precise diagnosis of atherosclerotic plaques and the assessment of pathological progression. However, viable strategies for Show less

Vascular remodeling involves structural and functional vascular changes in response to injury, aging, and disease. A key pathological feature is vascular smooth muscle cells (VSMCs) phenotypic switching, which is accompanied by mitochondrial dysregulation. Metabolic reprogramming resembling the Warburg effect alongside mitochondrial oxidative damage collectively drive this pathological VSMC transdifferentiation. We hypothesized that targeting mitochondrial ROS could restore mitochondrial integrity and enhance oxidative phosphorylation (OXPHOS) to counteract both oxidative damage and metabolic reprogramming in cardiovascular diseases associated with vascular remodeling. We proposed that the uncharacterized membrane-associated protein FAM177A1 drives VSMC mitochondrial oxidative impairment and metabolic reprogramming, thereby promoting VSMC phenotypic switching and vascular dysfunction. We modeled vascular remodeling using global We identify FAM177A1 as a key mitochondrial regulator that drives VSMC switching through SIRT3-SOD2 axis disruption. Targeting FAM177A1 restores redox-metabolic homeostasis through scavenging ROS and improving OXPHOS, establishing it as a novel therapeutic target against vascular remodeling. Show less

Mild cognitive impairment (MCI) is an intermediate stage between normal and pathological brain aging, with 30% to 50% progressing to dementia within 3 to 5 years. Early identification of individuals at high risk of progression is crucial for public health strategies. The INTERCEPTOR project included 398 MCI individuals. Baseline assessment included harmonized procedures for sociodemographic, clinical, neuropsychological, genetic (apolipoprotein E), cerebrospinal fluid (amyloid beta tau), electroencephalogram (brain connectivity), magnetic resonance imaging (hippocampal volumetry), and fluorodeoxyglucose positron emission tomography. The baseline and follow-up were completed by 351 individuals with MCI with neuropsychological tests every 6 months for 3 years. Dementia developed in 104 individuals (29.6%), including 85 (22.4%) who met core clinical criteria for probable and possible Alzheimer's disease dementia. A Cox model combining clinical and sociodemographic data achieved a concordance index of 72%, which increased to 82% when neuropsychology and biomarkers were added. The INTERCEPTOR nomogram represents a tool for predicting dementia progression risk, supporting public health strategies, including screening for risk assessment and risk/benefit ratio in innovative treatments. Show less

Alzheimer's disease (AD) heterogeneity complicates early detection and trial design. Scalable predictors may aid risk stratification. We assessed whether scalable baseline plasma biomarkers and neuropsychological measures predict 5‑year cognitive and functional decline in cognitively unimpaired older adults. We analyzed 866 amyloid-positive participants from the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) trial and 343 amyloid-negative individuals from the Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) study. Decline was defined as a ≥0.5 increase in Clinical Dementia Rating-Global Score over 240 weeks. The separate and joint value of demographics, apolipoprotein E ( The p-tau217 and PACC significantly improved prediction. Full models achieved areas under the curve (AUCs) of 0.78-0.80 across cohorts. Additional plasma biomarkers offered modest AUC gains (1%-3%). The p-tau217 and PACC enhanced prediction of preclinical decline, supporting their utility in early identification and trial enrichment in AD. Show less

Glioma presents significant therapeutic challenges due to its marked heterogeneity and resistance to conventional treatments. Apolipoprotein E (APOE), a glycoprotein involved in lipid metabolism, has been reported to be dysregulated in glioma; however, its functional role in glioma progression remains poorly understood. APOE expression in glioma was analyzed using publicly available transcriptomic datasets from The Cancer Genome Atlas (TCGA) and Chinese Glioma Genome Atlas (CGGA). Functional studies were performed in U251MG and U87MG glioma cells with APOE overexpression or knockout. Cell proliferation, migration, and invasion were evaluated using CCK-8, Edu, Transwell, and wound-healing assay. Mechanistic analyses included RNA sequencing, immunofluorescence, nucleocytoplasmic fractionation, Western blotting and immunoprecipitation. A nude mouse xenograft model was used to assess tumor growth in vivo. APOE expression was elevated in glioma datasets. Functional assays demonstrated that APOE promotes glioma cell proliferation, migration, and invasion. Notably, APOE was detected in the nucleus, where it exhibited transcriptional regulatory activity. Mechanistically, APOE overexpression significantly activated the PI3K/AKT signaling pathway, and this effect was effectively reversed by the PI3K inhibitor LY294002. Consistently, APOE overexpression enhanced tumor growth in vivo. These findings indicate that APOE promotes glioma progression through nuclear activity and activation of the PI3K/AKT signaling pathway, highlighting APOE-related signaling as a potential therapeutic target in glioma. Show less

Arterial stiffness is a contributor to cognitive decline. Pressure time constants (PTCs: PTC1, PTC2) are new measures of arterial compliance (inverse of stiffness) which are based on a Windkessel model of arterial pulse pressure waveforms. The methodology for PTCs is open-source and scalable. We evaluated the cross-sectional association between PTCs from radial artery pressure waveforms and cognitive performance: Global cognitive function (Cognitive Abilities Screening Instrument, CASI; score range 0-100); processing speed (Digit Symbol Coding, DSC; 0-133); and working memory (Digit Span, DS; 0-30). Among 3134 adults from 6 U.S. communities in 2010-2012 (aged 54-94 years; 47% male; 41% White, 25% Black, 23% Hispanic/Latino, 12% Chinese), the mean ± SD was 283 ± 127 ms for PTC1, 85 ± 31 ms for PTC2, 89 ± 8 for CASI, 51 ± 18 for DSC, and 15 ± 4 for DS. In the entire sample (after adjustment for community, race/ethnicity, and variables in the dementia score called "Cardiovascular Risk Factors, Aging, and Incidence of Dementia"), neither PTC1 nor PTC2 was associated with CASI, DSC, or DS. In exploratory analyses, after adjustment, one SD higher PTC2 was associated with a 1.4 (95% confidence interval: 0.4, 2.5; p = 0.004) higher mean DSC score among the subset with at least one APOE-ε4 allele (N = 828) and a 0.8 (0.1, 1.5; p = 0.03) higher mean DSC score among those 65 years and older (N = 2020). Higher radial artery PTC2 (lower arterial stiffness) was associated with faster processing speed among carriers of APOE-ε4 and older adults. Future work should investigate the association of PTCs with other indicators of brain health. Show less

This study aimed to investigate the anti-atherosclerotic properties of tirzepatide, a dual glucose-dependent insulinotropic polypeptide (GIP)/glucagon-like peptide-1 (GLP-1) receptor agonist, in comparison with semaglutide, a selective GLP-1 receptor agonist. ApoE knockout mice were divided into early diabetes (dosed from 10 to 22 weeks of age), late diabetes (dosed from 18 to 30 weeks of age), and non-diabetic groups after streptozotocin treatment, and each group received semaglutide, tirzepatide, or saline for 12 weeks. In the early diabetes group, both agents significantly suppressed aortic plaque formation compared with control, while modestly improving glycemia and lipid levels. No significant vascular effects were observed in late diabetes or non-diabetic groups. Tirzepatide markedly reduced inflammatory mediators, including Mcp-1, Il-6, I-cam, and Cd68, whereas semaglutide showed partial overlap. Notably, these anti-inflammatory effects were also detected in non-diabetic mice, suggesting vascular protection may involve arterial actions independently of metabolic control. Taken together, our findings demonstrate that tirzepatide exerts anti-atherosclerotic effects comparable to semaglutide, supporting the concept that GIP and GLP-1 signaling can confer vascular benefits. These results highlight the potential clinical relevance of dual incretin receptor agonism for cardiovascular risk reduction, although further studies are required to clarify the specific role of GIP signaling. Show less

The olfactory system is an early target in Alzheimer's disease (AD), yet regional glial pathology interactions remain poorly defined. We examined how glial activation and pathological burden differ between the olfactory cortex (OC) and olfactory bulb (OB) across disease stages. Post mortem OC and OB samples from cognitively normal (CN), mild cognitive impairment, and AD cases were analyzed using immunohistochemistry and immunofluorescence for amyloid beta (Aβ), phosphorylated tau (pTau), Iba1 (microglia), GFAP (astrocyte), and apolipoprotein E (apoE). Both regions showed stage-dependent increases in Aβ and pTau, with regionally distinct glial responses. ApoE signal varied with clinical stage rather than genotype. Co-expression analyses revealed astrocyte-linked networks in the OC and microglia-linked relationships in the OB. Findings demonstrate spatially heterogenous glial pathology architectures in the human olfactory system, supporting its role as an early and regionally diverse site of AD vulnerability. Show less