Evidence map›Paper›PMID 40947752›Full record

ArticleJournal of the American Geriatrics Society2025

Association of Early Life Risk Factors and APOE ε4 With Incident Dementia: Evidence From 14 Years of U.S. Data.

Eun Young Choi, Gawon Cho, Virginia W Chang

Abstract read
In one paragraph

Article in Journal of the American Geriatrics Society, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Eun Young ChoiLeonard Davis School of Gerontology, University of Southern California, Los Angeles, California, USA.ORCID 0000-0002-7587-6272
Gawon ChoYale School of Medicine, Yale University, New Haven, Connecticut, USA.
Virginia W ChangDepartment of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, USA.

Funding

HRS Yrs29-34: Y33 SSA CoFundingU01AG009740 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI Jessica Faul, KENNETH M LANGA · 1990 to 2026
$555.8M
RESEARCH TRAINING IN GERONTOLOGYT32AG000037 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI JENNIFER A AILSHIRE, EILEEN M CRIMMINS · 1985 to 2026
$13.2M
Ambient Outdoor Heat and Alzheimer's Disease and Related Dementias Risk: A Biopsychosocial Approach to Vulnerability in Older AdultsK99AG090817 · NIA · UNIVERSITY OF SOUTHERN CALIFORNIA · PI Eunyoung Choi · 2025 to 2026
$216k
Alzheimer's AssociationNIA NIH HHS K99 AG090817NIA NIH HHS T32 AG000037NIA NIH HHS T32-AG000037NIA NIH HHS U01 AG009740
6 · The paper itself

Abstract

backgroundEarly life is a critical period for brain development, laying the foundation for cognitive reserve. However, it remains unclear how various aspects of early life independently contribute to dementia risk, and whether these associations are modified by APOE ε4 genotype. PARTICIPANTS AND

settingWe used data from the U.S. Health and Retirement Study (HRS), a nationally representative cohort of older adults, followed from 2006 to 2020. Our sample included 8678 community-dwelling, dementia-free participants aged ≥ 60 and < 90 at baseline with data on APOE genotype and retrospective early life conditions.

methodsDementia incidence was classified using the validated Langa-Weir algorithm. Early life risk domains included financial capital, social capital, human capital, adversity, and health conditions. Cause-specific Cox proportional hazards models assessed the associations between these domains and incident dementia, adjusting for demographics and adulthood risk factors. To examine effect modification by genetic risk, we created 4-category group variables combining APOE ε4 status and early life risk.

resultsDeficits in financial, social, and human capital, as well as poor childhood health, were each associated with a 12%-46% increased dementia risk, independently of APOE ε4 status. After further adjusting for adulthood risk factors, low social and human capital remained significant predictors (16% and 21% increased risk, respectively). APOE ε4 was associated with an 83%-86% increased risk across all models. In effect modification analyses, early life disadvantage was associated with dementia only among non-carriers of APOE ε4, whereas ε4 carriers had elevated dementia risk regardless of early life conditions.

conclusionsInadequate childhood resources may have enduring impacts on dementia risk among individuals without the APOE ε4 allele. Genetic predisposition via APOE ε4 overwhelms the influence of early life disadvantage. These findings underscore the need for dementia prevention strategies that jointly consider genetic vulnerability and early life conditions.

Indexed as

Apolipoprotein E4DementiaAgedAged, 80 and overFemaleGenotypeHumansIncidenceIndependent LivingMaleMiddle AgedProportional Hazards ModelsRetrospective StudiesRisk FactorsUnited StatesApolipoprotein E4APOE ε4childhood exposuredementiagene–environment interaction

Identifiers

PMID40947752
PMCPMC12448107

What Socratic holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.