Evidence map›Paper›PMID 30760633›Full record

ArticleNeurology2019

Systemic inflammation during midlife and cognitive change over 20 years: The ARIC Study.

Keenan A Walker, Rebecca F Gottesman, Aozhou Wu, David S Knopman, Alden L Gross, Thomas H Mosley, Elizabeth Selvin, B Gwen Windham

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Article in Neurology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 179 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
179citing papers in PubMed, 4 pooled it
–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

179 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  10. Independent, but not synergistic, associations ofJournal of clinical and experimental neuropsychology · 2026
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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

8 authors.

Keenan A WalkerFrom the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G., A.W., A.L.G., E.S.), Johns Hopkins University, Baltimore, MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; Department of Medicine (T.H.M., B.G.W.), Division of Geriatrics, University of Mississippi Medical Center, Jackson. Kwalke26@jhmi.edu.ORCID http://orcid.org/0000-0002-5989-
Rebecca F GottesmanFrom the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G., A.W., A.L.G., E.S.), Johns Hopkins University, Baltimore, MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; Department of Medicine (T.H.M., B.G.W.), Division of Geriatrics, University of Mississippi Medical Center, Jackson.
Aozhou WuFrom the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G., A.W., A.L.G., E.S.), Johns Hopkins University, Baltimore, MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; Department of Medicine (T.H.M., B.G.W.), Division of Geriatrics, University of Mississippi Medical Center, Jackson.
David S KnopmanFrom the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G., A.W., A.L.G., E.S.), Johns Hopkins University, Baltimore, MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; Department of Medicine (T.H.M., B.G.W.), Division of Geriatrics, University of Mississippi Medical Center, Jackson.
Alden L GrossFrom the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G., A.W., A.L.G., E.S.), Johns Hopkins University, Baltimore, MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; Department of Medicine (T.H.M., B.G.W.), Division of Geriatrics, University of Mississippi Medical Center, Jackson.
Thomas H MosleyFrom the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G., A.W., A.L.G., E.S.), Johns Hopkins University, Baltimore, MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; Department of Medicine (T.H.M., B.G.W.), Division of Geriatrics, University of Mississippi Medical Center, Jackson.
Elizabeth SelvinFrom the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G., A.W., A.L.G., E.S.), Johns Hopkins University, Baltimore, MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; Department of Medicine (T.H.M., B.G.W.), Division of Geriatrics, University of Mississippi Medical Center, Jackson.
B Gwen WindhamFrom the Departments of Neurology (K.A.W., R.F.G.) and Epidemiology (R.F.G., A.W., A.L.G., E.S.), Johns Hopkins University, Baltimore, MD; Department of Neurology (D.S.K.), Mayo Clinic, Rochester, MN; Department of Medicine (T.H.M., B.G.W.), Division of Geriatrics, University of Mississippi Medical Center, Jackson.

Funding

ARIC Neurocognitive Study (ARIC-NCS) Renewal 2023-2028U01HL096812 · NHLBI · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI JOSEF CORESH, THOMAS H MOSLEY · 2010 to 2026
$65.7M
ARIC Neurocognitive Study (ARIC-NCS) Renewal 2 of 5U01HL096917 · NHLBI · UNIVERSITY OF MISSISSIPPI MED CTR · PI MOSLEY, THOMAS H · 2010 to 2018
$11.9M
ARIC Neurocognitive Study (ARIC-NCS) Renewal UNC 4 of 5U01HL096899 · NHLBI · UNIV OF NORTH CAROLINA CHAPEL HILL · PI COUPER, DAVID J · 2010 to 2018
$7.5M
ARIC Neurocognitive Study (ARIC-NCS)U01HL096902 · NHLBI · UNIVERSITY OF MINNESOTA · PI LUTSEY, PAMELA L. · 2010 to 2018
$7.4M
ARIC Neurocognitive Study (ARIC-NCS) Renewal 4 of 5U01HL096814 · NHLBI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI HUGHES, TIMOTHY M., WAGENKNECHT, LYNNE E · 2010 to 2018
$6.5M
Diabetes and Prediabetes in Older Adults in ARICR01DK089174 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SELVIN, ELIZABETH · 2011 to 2020
$6.4M
Research Training in Age-Related Cognitive DisordersT32AG027668 · NIA · JOHNS HOPKINS UNIVERSITY · PI MARILYN S. ALBERT · 2007 to 2026
$6.3M
The ARIC and Neurocognitive Longitudinal StudyR01HL070825 · NHLBI · UNIVERSITY OF MISSISSIPPI MEDICAL CENTER · PI MOSLEY, THOMAS H · 2002 to 2004
$5.1M
Neuroepidemiology of the vascular contribution to cognitive impairment and Alzheimer's diseaseK24AG052573 · NIA · JOHNS HOPKINS UNIVERSITY · PI GOTTESMAN, REBECCA F · 2016 to 2020
$803k
Research and Mentoring in the Clinical Epidemiology of Type 2 DiabetesK24DK106414 · NIDDK · JOHNS HOPKINS UNIVERSITY · PI SELVIN, ELIZABETH · 2015 to 2019
$654k
Intersection of Physiologic Frailty and Cognitive Performance in Older Adults: An Integrative Data AnalysisK01AG050699 · NIA · JOHNS HOPKINS UNIVERSITY · PI GROSS, ALDEN L. · 2016 to 2020
$648k
NHLBI NIH HHS HHSN268201700001CNHLBI NIH HHS HHSN268201700001INHLBI NIH HHS HHSN268201700002CNHLBI NIH HHS HHSN268201700002INHLBI NIH HHS HHSN268201700003CNHLBI NIH HHS HHSN268201700003INHLBI NIH HHS HHSN268201700005CNHLBI NIH HHS HHSN268201700005INHLBI NIH HHS R01 HL070825NHLBI NIH HHS U01 HL096812NHLBI NIH HHS U01 HL096814NHLBI NIH HHS U01 HL096899NHLBI NIH HHS U01 HL096902NHLBI NIH HHS U01 HL096917NIA NIH HHS K01 AG050699NIA NIH HHS K24 AG052573NIA NIH HHS T32 AG027668NIDDK NIH HHS K24 DK106414NIDDK NIH HHS R01 DK089174
6 · The paper itself

Abstract

objectiveTo examine the association between systemic inflammation measured during midlife and 20-year cognitive decline.

methodsWithin the Atherosclerosis Risk in Communities cohort study, inflammatory biomarkers were measured during middle adulthood. We created an inflammation composite score using 4 blood biomarkers measured at visit 1 (fibrinogen, white blood cell count, von Willebrand factor, and factor VIII); we measured C-reactive protein (CRP) at visit 2. Cognition was assessed over 3 visits spanning 20 years using measures of memory, executive function, and language.

resultsA total of 12,336 participants (baseline age 56.8 [5.7], 21% black, 56% women) were included. After adjusting for demographic variables, vascular risk factors, and comorbidities, each standard deviation (SD) increase in midlife inflammation composite score was associated with an additional 20-year decline of -0.035 SD (95% confidence interval: -0.062 to -0.007) on the cognitive composite score. We found a similar association between each SD increase in midlife CRP level and additional 20-year cognitive decline (-0.038 SD, 95% confidence interval: -0.057 to -0.019). Participants with a midlife inflammation composite score in the top quartile had a 7.8% steeper cognitive decline, compared to participants in the lowest quartile; CRP in the top quartile was associated with an 11.6% steeper cognitive decline. In cognitive domain-specific analyses, elevated midlife inflammatory markers were most consistently associated with declines in memory. Results were similar after adjusting for attrition using inverse probability weighting.

conclusionsOur findings highlight what may be an early pathogenic role for systemic inflammation as a driver of cognitive decline in the decades leading up to older adulthood.

Indexed as

CognitionAgedAged, 80 and overCognitive DysfunctionCohort StudiesC-Reactive ProteinExecutive FunctionFactor VIIIFemaleFibrinogenHumansInflammationLanguageLeukocyte CountLongitudinal StudiesMaleC-Reactive ProteinFactor VIIIFibrinogenvon Willebrand Factor

Identifiers

PMID30760633
PMCPMC6511107

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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 OpenQuestion graph.