Midlife sensory and motor functions improve long‐term predictions of cognitive decline and incidence of cognitive impairment

Abstract INTRODUCTION We aimed to assess whether midlife sensory and motor functions improve risk prediction of 10‐year cognitive decline and impairment when added to risk prediction models using the Cardiovascular Risk Factors, Aging, and Incidence of Dementia Score (CAIDE) and Framingham Risk Score (FRS). METHODS Longitudinal data of N = 1529 (mean age 49 years; 54% women) Beaver Dam Offspring Study (BOSS) participants from baseline, 5 and 10‐year follow‐up were included. We tested whether including baseline sensory (hearing, vision, olfactory) impairment and motor function improves CAIDE or FRS risk predictions of 10‐year cognitive decline or cognitive impairment incidence using logistic regressions. RESULTS Adding sensory and motor measures to CAIDE‐only and FRS‐only models significantly improved areas under the curve for cognitive decline and impairment models. DISCUSSION Including midlife sensory and motor function improved risk predictions of long‐term cognitive decline and impairment in middle‐aged to older adults. Sensory and motor assessments could contribute to cost‐effective and non‐invasive screening tools that identify high‐risk individuals earlier to target intervention and prevention strategies. Highlights Sensory and motor measures improve risk prediction models of cognitive decline. Sensory and motor measures improve risk prediction models of cognitive impairment. Prediction improvements were strongest in midlife (adults < 55 years of age). Sensory and motor changes may help identify high‐risk individuals early

Midlife sensory and motor functions improve prediction of blood‐based measures of neurodegeneration and Alzheimer's disease in late middle‐age

Abstract INTRODUCTION We assessed whether midlife sensory and motor functions added to prediction models using the Cardiovascular Risk Factors, Aging, and Incidence of Dementia Score (CAIDE) and Framingham Risk Score (FRS) improve risk predictions of 10‐year changes in biomarkers of neurodegeneration and Alzheimer's disease. METHODS Longitudinal data of N = 1529 (mean age 49years) Beaver Dam Offspring Study participants from baseline, 5‐year, and 10‐year follow‐up were included. We tested whether including baseline sensory (hearing, vision, olfactory) impairment and motor function measures improves CAIDE or FRS risk predictions of 10‐year incidence of biomarker positivity of serum‐based neurofilament light chain (NfL) and amyloid beta (Aβ)42/Aβ40 using logistic regression. RESULTS Adding sensory and motor measures to CAIDE‐only and FRS‐only models significantly improved NfL and Aβ42/Aβ40 positivity predictions in adults above the age of 55. DISCUSSION Including midlife sensory and motor function improved long‐term biomarker positivity predictions. Non‐invasive sensory and motor assessments could contribute to cost‐effective screening tools that identify individuals at risk for neurodegeneration early to target interventions and preventions. Highlights Sensory and motor measures improve risk prediction models of neurodegenerative biomarkers Sensory and motor measures improve risk prediction models of AD biomarkers Prediction improvements were strongest in late midlife (adults >55 years of age) Sensory and motor assessments may help identify high‐risk individuals earl

Prevalence and Clinical Outcomes of Poor Immune Response Despite Virologically Suppressive Antiretroviral Therapy Among Children and Adolescents With Human Immunodeficiency Virus in Europe and Thailand: Cohort Study

BACKGROUND: In human immunodeficiency virus (HIV)-positive adults, low CD4 cell counts despite fully suppressed HIV-1 RNA on antiretroviral therapy (ART) have been associated with increased risk of morbidity and mortality. We assessed the prevalence and outcomes of poor immune response (PIR) in children receiving suppressive ART. METHODS: Sixteen cohorts from the European Pregnancy and Paediatric HIV Cohort Collaboration (EPPICC) contributed data. Children &lt;18 years at ART initiation, with sustained viral suppression (VS) (≤400 copies/mL) for ≥1 year were included. The prevalence of PIR (defined as World Health Organization advanced/severe immunosuppression for age) at 1 year of VS was described. Factors associated with PIR were assessed using logistic regression. Rates of acquired immunodeficiency syndrome (AIDS) or death on suppressive ART were calculated by PIR status. RESULTS: Of 2318 children included, median age was 6.4 years and 68% had advanced/severe immunosuppression at ART initiation. At 1 year of VS, 12% had PIR. In multivariable analysis, PIR was associated with older age and worse immunological stage at ART start, hepatitis B coinfection, and residing in Thailand (all P ≤ .03). Rates of AIDS/death (95% confidence interval) per 100 000 person-years were 1052 (547, 2022) among PIR versus 261 (166, 409) among immune responders; rate ratio of 4.04 (1.83, 8.92; P &lt; .001). CONCLUSIONS: One in eight children in our cohort experienced PIR despite sustained VS. While the overall rate of AIDS/death was low, children with PIR had a 4-fold increase in risk of event as compared with immune responders

Prevalence and Clinical Outcomes of Poor Immune Response Despite Virologically Suppressive Antiretroviral Therapy Among Children and Adolescents With Human Immunodeficiency Virus in Europe and Thailand: Cohort Study

International audienceIn human immunodeficiency virus (HIV)-positive adults, low CD4 cell counts despite fully suppressed HIV-1 RNA on antiretroviral therapy (ART) have been associated with increased risk of morbidity and mortality. We assessed the prevalence and outcomes of poor immune response (PIR) in children receiving suppressive ART

Children living with HIV in Europe: do migrants have worse treatment outcomes?

International audienceTo assess the effect of migrant status on treatment outcomes among children living with HIV in Europe