title: Dementia Risk and Protective Factors Differ in the Context of Memory Trajectory Groups.
abstract: Previous research has identified multiple risk and protective factors for late onset Alzheimer's disease (LOAD). However, it is not known whether these risk and protective factors differ for individuals who are cognitively stable versus those already experiencing declines.
  
  
  
  This study examined how dementia risk factors differ across subgroups of older adults defined by memory trajectory. This line of research may lead to more individualized risk profiles.
  
  
  
  Risk factors for incident LOAD were compared across previously-validated groups of older adults exhibiting different memory trajectories ("Stable-High," "Stable-Low," "Decliner," "Rapid Decliner") using stratified Cox regressions. Participants included 2,593 racially/ethnically diverse older adults (mean age of 76 at study entry) in the Washington Heights-Inwood Columbia Aging Project.
  
  
  
  Predictors of incident dementia differed across trajectory groups: older age only incurred independent risk in stable groups, education did not incur independent protection in the rapidly declining group, depression only incurred independent risk in the stable-low group, stroke incurred independent risk in the two extreme groups, and APOE-ɛ4 only incurred independent risk in the rapidly declining group.
  
  
  
  The finding that different risk factors for LOAD were associated with specific memory trajectories may reflect the existence of resilience or vulnerability factors that modify the individual influences of risk/protective factors. This study highlights the utility of considering interactions between dementia risk factors and a patient's unique cognitive history.
authors.affiliation: Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Gertrude H. Sergievsky Center, Columbia University College of Physicians & Surgeons, New York, NY, USA.
authors.forename: Laura B
authors.initials: LB
authors.lastname: Zahodne
authors.affiliation: Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
authors.forename: Nicole
authors.initials: N
authors.lastname: Schupf
authors.affiliation: Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Gertrude H. Sergievsky Center, Columbia University College of Physicians & Surgeons, New York, NY, USA.
authors.forename: Adam M
authors.initials: AM
authors.lastname: Brickman
authors.affiliation: Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Gertrude H. Sergievsky Center, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
authors.forename: Richard
authors.initials: R
authors.lastname: Mayeux
authors.affiliation: Department of Psychiatry, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Department of Biostatistics, Columbia University Mailman School of Public Health, New York, NY, USA.
authors.forename: Melanie M
authors.initials: MM
authors.lastname: Wall
authors.affiliation: Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Gertrude H. Sergievsky Center, Columbia University College of Physicians & Surgeons, New York, NY, USA.
authors.forename: Yaakov
authors.initials: Y
authors.lastname: Stern
authors.affiliation: Department of Neurology, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University College of Physicians & Surgeons, New York, NY, USA.|Gertrude H. Sergievsky Center, Columbia University College of Physicians & Surgeons, New York, NY, USA.
authors.forename: Jennifer J
authors.initials: JJ
authors.lastname: Manly
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000453:epidemiology* / Q000235:genetics / Q000523:psychology*; D053327:Apolipoprotein E4 / Q000235:genetics; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology* / Q000209:etiology; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales; D012044:Regression Analysis; D012307:Risk Factors
chemical_list: D053327:Apolipoprotein E4
keywords: Aging; Alzheimer’s disease; dementia; memory; neuropsychology