Chronological age is the strongest risk factor for neurodegenerative disease, yet biological age is heterogeneous and poorly understood. Although almost all (>95%) aged brains go to autopsy with significant pathology, a minority of older adults develop dementia. Further, an estimated 40% of dementia cases are attributable to modifiable risk factors. There is an urgent need to identify the multimodal pathways that protect against cognitive change with age in order to identify biologically informed, precise primary and secondary dementia prevention points. In this symposium, we will highlight how modifiable lifestyle behaviors and systemic interventions help shape age-related brain health and explore what these findings teach us about transdiagnostic biological targets for the aging brain. First, Dr. Rowan Saloner leveraged latent profile analyses to capture the multimodal lifestyle patterns that associate with slowed cognitive aging in community dwelling adults, and will highlight the high relevance of person-specific risk management even in the context of neuropathology accumulation. Dr. Iris Strangmann will next discuss how literacy and multilingualism may protect cognitive aging outcomes in a diverse cohort of older adults in India. Her data highlight the critical role of both premorbid educational experiences and lifelong cognitively stimulating activities in shaping cognitive health in late life. Next, Dr. Adam Brickman will report on the latest findings from the largest, randomized controlled trial of multivitamin and flavanol diet supplementation for cognitive health in older adults. His work underscores both the causally related role of systemic nutrients on brain aging and importance of biomarker informed intervention design. Dr. Judy Pa will then discuss a role for the glymphatics system as a biological mechanism underlying the well-established neuroprotective role of sleep. Her cutting-edge work leverages the latest technologies in objective sleep quantification and MRI analytics to characterize CSF flow as a systems level mechanism supporting age-related cognition. Finally, Dr. Casaletto will present data translating several mechanistically identified circulating factors that have demonstrated brain rejuvenation effects in animal models for the first time in adults with genetic frontotemporal dementia and Alzheimer’s disease. Her work highlights how disentangling biological aging can support identification of transdiagnostic targets for dementia prevention. Together, these presentations highlight state of the science knowledge on modifiable risk and common biological targets for transdiagnostic Alzheimer's and related dementias (ADRD) prevention.
Rowan Saloner, UCSF, San Francisco, United States Emily Paolillo, UCSF, San Francisco, United States Anna VandeBunte, UCSF, San Francisco, United States Shannon Lee, University of Florida, Gainesville, United States David Bennett, Rush University, Chicago, United States Kaitlin Casaletto, UCSF, San Francisco, United States
Kaitlin Casaletto, UCSF, San Francisco, United States Rowan Saloner, UCSF, San Francisco, United States John Kornak, UCSF, San Francisco, United States Emily Paolillo, UCSF, San Francisco, United States Anna VandeBunte, UCSF, San Francisco, United States Hilary Heuer, UCSF, San Francisco, United States Adam Staffaroni, UCSF, San Francisco, United States Joel Kramer, UCSF, San Francisco, United States Brad Boeve, Mayo Clinic, Rochester, United States Howie Rosen, UCSF, San Francisco, United States Julio Rojas, UCSF, San Francisco, United States Adam Boxer, UCSF, San Francisco, United States
Adam Brickman, Columbia University, New York, United States Lok-Kin Yeung, Columbia University, New York, United States Melanie Wall, Columbia University, New York, United States Howard Sesso, Harvard University, Boston, United States JoAnn Manson, Harvard University, Boston, United States Scott Small, Columbia University, New York, United States
Judy Pa, UCSD, San Diego, United States Yilei Dong, UCSD, San Diego, United States Laura Fenton, USC, Los Angeles, United States Vahan Aslanyan, USC, Los Angeles, United States Joy Stradford, USC, Los Angeles, United States Teresa Monreal, USC, Los Angeles, United States Ashwin Sakhare, USC, Los Angeles, United States Lisette Isenberg, USC, Los Angeles, United States
Iris Strangmann, Columbia University, New York, United States Sarah Petrosyan, USC, Los Angeles, United States Emily Brinceno, University of Michigan, Ann Arbor, United States Emma Nichols, USC, Los Angeles, United States Lindsay Kobayashi, University of Michigan, Ann Arbor, United States Jinkook Lee, University of Michigan, Ann Arbor, United States Miguel Arce Renteria, Columbia University, New York, United States