Evidence map›Paper›PMID 40832727›Full record

ArticleAlzheimer's & dementia : the journal of the Alzheimer's Association2025

Modeling the importance of life exposure factors on memory performance in diverse older adults: A machine learning approach.

Evan Fletcher, Marianne Chanti-Ketterl, Emily Hokett, Yi Lor, Umesh Venkatesan, Ruijia Chen, Omonigho M Bubu, Rachel Whitmer, Paola Gilsanz, Zvinka Z Zlatar

Abstract read
In one paragraph

Article in Alzheimer's & dementia : the journal of the Alzheimer's Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing 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

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
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

10 authors.

Evan FletcherDepartment of Neurology, School of Medicine, University of California Davis, Davis, California, USA.ORCID 0000-0002-9761-3131
Marianne Chanti-KetterlDepartment of Psychiatry and Behavioral Sciences, School of Medicine, Duke University, Durham, North Carolina, USA.
Emily HokettDepartment of Neurology, Columbia University, New York, New York, USA.
Yi LorDepartment of Public Health Sciences, University of California Davis, Davis, California, USA.
Umesh VenkatesanMoss Rehabilitation Research Institute & Department of Rehabilitation Medicine, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania, USA.
Ruijia ChenDepartment of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA.
Omonigho M BubuDepartments of Psychiatry, Neurology and Population Health and NYU Neuroscience Institute, NYU Grossman School of Medicine, New York, New York, USA.
Rachel WhitmerDepartment of Public Health Sciences and Department of Neurology, University of California Davis, Davis, California, USA.
Paola GilsanzKaiser Permanente Division of Research, Oakland, California, USA.
Zvinka Z ZlatarDepartment of Psychiatry, University of California San Diego, La Jolla, California, USA.

Funding

UCSD Shiley-Marcos Alzheimer's Disease Research Center P30P30AG062429 · NIA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI GUERRY Marie PEAVY · 2019 to 2026
$34.9M
Research Education ComponentP30AG066512 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI Mary Sherman Mittelman · 2020 to 2026
$28.4M
UC Davis Alzheimer's Disease Research CenterP30AG072972 · NIA · UNIVERSITY OF CALIFORNIA AT DAVIS · PI Charles DeCarli, Rachel A Whitmer · 2021 to 2026
$25.2M
Research Education Component CoreP30AG072958 · NIA · DUKE UNIVERSITY · PI Heather E. Whitson · 2021 to 2026
$24.1M
Study of Healthy Aging in African AmericansR01AG050782 · NIA · UNIVERSITY OF CALIFORNIA AT DAVIS · PI Paola Gilsanz, Rachel A Whitmer · 2023 to 2026
$19.1M
Lifecourse health, cerebral pathology and ethnic disparities in dementia (KHANDLE Study)R01AG052132 · NIA · UNIVERSITY OF CALIFORNIA AT DAVIS · PI GILSANZ, PAOLA, GLYMOUR, MEDELLENA MARIA · 2021 to 2025
$18.0M
Brain pathologies, reserve and cognition in aging and dementiaR01AG031563 · NIA · UNIVERSITY OF CALIFORNIA AT DAVIS · PI Evan Fletcher, SARAH E TOMASZEWSKI-FARIAS · 2009 to 2026
$8.9M
Using a Health Disparity Research Framework to examine mechanisms linking Obstructive Sleep Apnea with higher Alzheimer’s disease risk in older Blacks/African-AmericansR01AG082278 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI OMONIGHO A MICHAEL Bubu · 2023 to 2026
$6.9M
Treatment of OSA on sleep-dependent memory and blood biomarkers in blacksRF1AG083975 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI OMONIGHO A MICHAEL Bubu, Korey Kam · 2023 to 2026
$4.2M
The mediating role of Slow Wave Sleep and Vascular Risk Factors on Alzheimer Disease related disparity between African-Americans and non-Hispanic WhitesK23AG068534 · NIA · NEW YORK UNIVERSITY SCHOOL OF MEDICINE · PI BUBU, OMONIGHO A MICHAEL · 2021 to 2025
$958k
Lifecourse Stressors and Social Disparities in Cognitive Aging: The Roles of Social Networks and Sleep DisturbanceK00AG068431 · NIA · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CHEN, RUIJIA · 2021 to 2024
$330k
NIA NIH HHS K00 AG068431NIA NIH HHS K23 AG068534NIA NIH HHS L30 AG064670NIA NIH HHS P30 AG062429NIA NIH HHS P30 AG066512NIA NIH HHS P30 AG072958NIA NIH HHS P30AG072958NIA NIH HHS P30 AG072972NIA NIH HHS R01 AG031563NIA NIH HHS R01 AG050782NIA NIH HHS R01 AG052132NIA NIH HHS R01 AG082278NIA NIH HHS RF1 AG083975
6 · The paper itself

Abstract

introductionMany health life exposure factors (LEFs) influence cognitive decline and dementia incidence, but their relative importance to episodic memory (an early indicator of cognitive decline) among diverse older adults is unclear. We used machine learning to rank LEFs for memory performance in a large and diverse US cohort.

methodsKaiser Healthy Aging and Diverse Life Experiences (KHANDLE) and Study of Healthy Aging in African Americans (STAR), participants underwent neuropsychological testing and answered questionnaires about multiple LEFs. XGBoost and Shapley Additive exPlanation values ranked the importance of factors influencing cross-sectional episodic memory in the full sample and by sex and ethnic group.

resultsAmong 2245 adults (mean age: 74 years; range 54-90), age, sex, education, volunteering, income, vision, hearing, sleep, and exercise contributed to memory performance regardless of group stratification. DISCUSSION: This innovative methodology can help identify risk factors important for memory performance and guide future dementia risk reduction interventions among older adults. HIGHLIGHTS: This work uses a regression tree machine learning model (XGBoost) with highly interpretable Shapley Additive exPlanation values to analyze impacts of 12 life exposure factors plus age, sex and ethnoracial identity on episodic memory outcome. This approach has valuable properties, including the ability to implicitly account for variable interactions, non-linear relations with outcome, and missing values. Age, sex, education, income, volunteering, exercise, hearing and vision, and sleep (quality and duration) have important impacts on memory outcome in a combined model and in stratified models regardless of ethnoracial identity. We also demonstrate individualized models for subgroups of participants, showing how life exposure factors vary in importance between divergent populations and suggesting an approach to personalized interventions. This approach can be valuable for both policy decisions and individualized interventions to support healthy cognitive aging.

Indexed as

AgingCognitive DysfunctionMachine LearningMemory, EpisodicAgedAged, 80 and overBlack or African AmericanCohort StudiesCross-Sectional StudiesFemaleHumansMaleMiddle AgedNeuropsychological TestsRacial GroupsRisk Factorsepisodic memorylife exposure factorsregression tree modelsSHAP valuesXGBoost

Identifiers

PMID40832727
PMCPMC12365611

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.