An annual blood test with analysis of methylation sites from key epigenetic aging clocks (e.g. Horvath). Epigenetic aging clocks have already been shown to reliably predict age, time-to-death, all cause mortality, cog. function, immune function, CV disease, cancer, and more. They may also become a key tool to demonstrate the reversibility of disease risk through dietary and therapeutic regimens, as epigenetic states are... more »

These are frequent antecedents in neurodegenerative disease. They may, in themselves, be early biomarkers and or demarcate a peripheral origin for the disease. However their onset is not well understood and they are not specific to neurodegenerative diseases. Understanding their natural history, and co-association with other midlife/old age symptoms coupled with omic data may help understand the role of these symptoms... more »

The consequences of concussion on cognition, especially repeated concussion, is a major concern in the US. The ABCD research program is assessing the effects of concussion on behavioral health in children but there are no other population studies of concussion effects. Obtaining information about index events and incorporating it into follow-up assessments of cognition and diagnosis of dementia would be extremely valuable... more »

Cardio- and cerebrovascular disease are linked to poor brain health outcomes, including dementia. To increase public health impact of this knowledge, better train care providers to identify and counter vascular risk and disease (e.g. hypertension, clots, diabetes, metabolic syndrome) in everyday care settings, and better educate patients on the importance of vascular health and related lifestyle decisions for brain health.... more »

Recent findings from 15,744 black and white adults in the ARIC Cohort Study found that several cardiovascular (CV) risk factors in middle age (smoking, diabetes, prehypertension & hypertension) are linked to higher risk of dementia later in life, and that blacks have higher rates of dementia v. whites. AoU offers ability to evaluate differential associations of specific CV risk factors, & their interactions with other... more »

REM sleep behaviour (RBD) can precede subsequent Lewy body disease by many years/decades. Thus RBD could be a potent prodromal biomarker of future disease and allow for identification of an ideal target population for disease modifying treatment. In depth assessment of sleep behaviours in midlife as measured using participant survey complimented by wearable devices technology could provide unparalleled information in... more »

The structure and scope of All of Us is such that it would be well positioned to address the following goals and approaches:
-Measure the benefit or detriment of identification of cognitive impairment on the family and health care provider decision making
-Can a baseline healthy cognitive assessment serve as a baseline for future determination of meaningful change?
-Determine how to overcome financial, technical, and... more »

Longitudinal study with cases identified in childhood (typically, before 5-6 years of age) with the presence of febrile seizures, followed over time for the diagnosis of dementia (including mild cognitive impairment). Genetic data and viral serolgies also should be collected to identify causal/association data.
Justification: febrile seizures occur in 3-5% of the US population (i.e., most common type of seizure). Changes... more »

Initial data (e.g., demographic) and data that are noted routinely as a part of healthcare maintenance (e.g., anthropomorphic factors, blood pressure, cholesterol, serum creatinine, etc.) could be collected longitudinally and then evaluated in terms of onset of epilepsy later in life.
Justification: as the US population ages, the incidence and prevalence of epilepsy is expected to increase, given the association of epilepsy... more »

Blood pressure and anti-hypertensive medication use will be collected at baseline through physical examination and medical history taking as well as from the EHR. Track blood pressure and changes in medication to examine different regimens and degrees of blood pressure control as predictors of vascular complications, while using continuing medical care to understand the role of potential co-morbidities and medication... more »

A retrospective analysis of longitudinal health data from the EHR and self reports of patients who are chronic users of antidepressants. Both antidepressants and cognitive decline are associated with falls and repeated falls, a major source of morbidity/mortality. Antidepressants are poorly studied in patients experiencing cognitive decline. The study would test for a synergistic interaction between the drug class... more »

Exercise, socialization, cognitive training, education, dietary habits and environmental exposures interacting with genetic profiles are suggested to raise the risk of Alzheimer’s dementia. Less is known about environmental, genetic and epigenetic contributors to raising the risk of dementia with Lewy bodies. Large scale data sets would allow first-of-its-kind enhanced profiling in multi-path analyses key midlife factors... more »