Selected social and lifestyle correlates of brain health markers: the Cross-Cohort Collaboration Consortium

Leslie Grasset; Joshua C Bis; Stefan Frenzel; Daniel Kojis; Jeannette Simino; Amber Yaqub; Alexa Beiser; Claudine Berr; Jan Bressler; Robin Bülow; Charles S DeCarli; Alison E Fohner; Laura B Harrington; Catherine Helmer; M Arfan Ikram; Rozenn N Lemaitre; Oscar L Lopez; W T Longstreth Jr; Julia Neitzel; Michelle C Odden; Priya Palta; Carsten O Schmidt; Rajesh Talluri; Meike W Vernooij; Henry Völzke; Trudy Voortman; Quest Whalen; Katharina Wittfeld; Hans J Grabe; Thomas H Mosley Jr; Bruce M Psaty; Frank J Wolters; Sudha Seshadri; Carole Dufouil

doi:10.1002/alz.70148

Selected social and lifestyle correlates of brain health markers: the Cross-Cohort Collaboration Consortium

Alzheimers Dement. 2025 Apr;21(4):e70148. doi: 10.1002/alz.70148.

Authors

Leslie Grasset¹, Joshua C Bis², Stefan Frenzel³, Daniel Kojis^{4

5}, Jeannette Simino^{6

7}, Amber Yaqub⁸, Alexa Beiser^{4

9

10}, Claudine Berr¹¹, Jan Bressler¹², Robin Bülow¹³, Charles S DeCarli^{14

15}, Alison E Fohner^{16

17}, Laura B Harrington^{18

19

20}, Catherine Helmer¹, M Arfan Ikram⁸, Rozenn N Lemaitre²¹, Oscar L Lopez²², W T Longstreth Jr²³, Julia Neitzel^{8

24

25}, Michelle C Odden²⁶, Priya Palta²⁷, Carsten O Schmidt²⁸, Rajesh Talluri⁶, Meike W Vernooij^{8

24}, Henry Völzke²⁸, Trudy Voortman^{8

29}, Quest Whalen⁶, Katharina Wittfeld³, Hans J Grabe^{3

30}, Thomas H Mosley Jr^{7

31}, Bruce M Psaty³², Frank J Wolters^{8

24}, Sudha Seshadri^{4

10

33

34}, Carole Dufouil^{1

35}

Affiliations

¹ University Bordeaux, Inserm, Bordeaux Population Health Research Center, Bordeaux, France.
² Cardiovascular Health Research Unit, Department of Radiology & Nuclear Medicine, Erasmus University of Washington, Seattle, Washington, USA.
³ Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany.
⁴ The Framingham Heart Study, Framingham, Massachusetts, USA.
⁵ Boston University School of Public Health, Boston, Massachusetts, USA.
⁶ Department of Data Science, John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, Mississippi, USA.
⁷ Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, Mississippi, USA.
⁸ Department of Epidemiology, Erasmus University Medical Center, Rotterdam, the Netherlands.
⁹ Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA.
¹⁰ Department of Neurology, Boston School of Medicine, Boston, Massachusetts, USA.
¹¹ INM, Univ Montpellier, INSERM, Montpellier, France.
¹² Human Genetics Center, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA.
¹³ Institute of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, Greifswald, Germany.
¹⁴ Department of Neurology and Center for Neuroscience, University of California at Davis, Sacramento, California, USA.
¹⁵ Imaging of Dementia and Aging (IDeA) Laboratory, Department of Neurology, University of California-Davis, Davis, California, USA.
¹⁶ Department of Epidemiology, University of Washington, Seattle, Washington, USA.
¹⁷ Cardiovascular Health Research Unit, University of Washington, Seattle, Washington, USA.
¹⁸ Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, Washington, USA.
¹⁹ Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA.
²⁰ Department of Health Systems Science, Kaiser Permanente Bernard J. Tyson School of Medicine, Pasadena, California, USA.
²¹ Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, Washington, USA.
²² Department of Neurology and psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
²³ Departments of Neurology and Epidemiology, University of Washington, Seattle, Washington, USA.
²⁴ Department of Radiology and Nuclear Medicine, Erasmus University Medical Center, Rotterdam, the Netherlands.
²⁵ Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA.
²⁶ Department of Epidemiology and Population Health, Stanford University School of Medicine, Palo Alto, California, USA.
²⁷ Department of Neurology, University of North Carolina, Chapel Hill, North Carolina, USA.
²⁸ Institute for Community Medicine, University Medicine of Greifswald, Greifswald, Germany.
²⁹ Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, California, USA.
³⁰ German Center for Neurodegenerative Disease (DZNE), partner site Rostock/Greifswald, Greisfswald, Germany.
³¹ Department of Medicine (Geriatrics) and Neurology, University of Mississippi Medical Center, Jackson, Mississippi, USA.
³² Cardiovascular Health Research Unit, Departments of Medicine, Epidemiology, and Health Systems and Population Health, University of Washington, Seattle, Washington, USA.
³³ Glenn Biggs Institute for Alzheimer and Neurodegenerative Diseases, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
³⁴ Department of Neurology, The University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA.
³⁵ Pole de santé publique, Centre Hospitalier Universitaire (CHU) de Bordeaux, Bordeaux, France.

Abstract

Introduction: To investigate the associations of education level, marital status, and physical activity with dementia risk and brain MRI markers.

Methods: Data from six community-based samples from the Cross-Cohort Collaboration Consortium were analyzed. Self-reported education level, marital status, and physical activity at age 60 to 75 years were harmonized. Subsamples of participants with brain MRI markers at time of exposure were selected. Associations with dementia risk and cross-sectional MRI markers were meta-analyzed.

Results: Higher education level was associated with lower dementia risk (hazard ratio [HR] = 0.65, 95% confidence interval [CI] = 0.59; 0.72 vs low level) but not significantly with brain MRI markers. Compared with being unmarried, being married was only associated with higher total brain and hippocampal volumes. Being physically active was associated with lower dementia risk (HR = 0.73, 95% CI = 0.52; 1.04), as well as larger total brain volume and smaller white matter hyperintensity volume.

Discussion: This study provides further evidence regarding the contribution of education level and physical activity to dementia resilience.

Highlights: Education level, marital status, and physical activity are thought to contribute to resilience against ADRD. We used random-effects meta-analysis to summarize results from six community-based samples from the CCC. In this cross-cohort meta-analysis, higher education level and being physically active were associated with lower risk of dementia. In cross-sectional analyses, being married was associated with larger TBV and HV, while being physically active was associated with larger TBV and lower WMHV.

Keywords: MRI; cohorts; dementia; meta‐analysis; resilience.

Publication types

Meta-Analysis

MeSH terms

Aged
Brain* / diagnostic imaging
Brain* / pathology
Cohort Studies
Cross-Sectional Studies
Dementia* / diagnostic imaging
Dementia* / epidemiology
Educational Status
Exercise*
Female
Humans
Life Style*
Magnetic Resonance Imaging
Male
Marital Status
Middle Aged
Risk Factors

Abstract

Publication types

MeSH terms

Grants and funding