Takeaway: sex gaps in structural brain aging are modest and we must look beyond atrophy to explain women’s higher AD diagnosis rates. Other biomarkers? Or maybe non-biological causes?

Effects remained even when accounting for amyloid level. Reflect an immune response to accumulating, sub-threshold Aβ? Preexisting effects of higher cortical thickness in those that subsequently develop high Aβ? Protective factor?

People with more education did better — but declined just as fast. The takeaway: To reduce dementia risk, we may need to shift from boosting adult cognitive reserve to investing in early education. #Lifecourse #BrainHealth #DementiaPrevention

The three #LancetCommission reports on #DementiaPrevention have shifted focus from early schooling to longer education as protection against dementia. Our new results suggest this shift may be misguided: early-life factors, not adult education, likely drive the effect.

Finally, similar to the conclusion of @didacvp.bsky.social direct.mit.edu/imag/article... long follow-up time between scans yields much higher sensitivity to detect individual differences in change than many scans: 2 scans over 4 yr better than 12 scans over 1 yr

Brain age models trained on chronological age are almost deemed to pick up signal from regions where there are almost no differences in change - i.e. brain age gap says next-to-nothing about aging before 60 years. Fits perfectly with @fmrib-steve.bsky.social et al www.biorxiv.org/content/10.1...

Some interesting implications: Very difficult to find systematic differences between people in change before 50. The big exception is the ventricles: Larger diffs in change from earlier in adulthood.

For those interested in my opinion, please see journals.sagepub.com/doi/full/10....