Chronic kidney disease and incident cancer risk: an individual participant data meta-analysis.

Background: Studies examining the association of chronic kidney disease (CKD) with cancer risk have demonstrated conflicting results.

Methods: This was an individual participant data meta-analysis including 54 international cohorts contributing to the CKD Prognosis Consortium. Included cohorts had data on albuminuria [urine albumin-to-creatinine ratio (ACR)], estimated glomerular filtration rate (eGFR), overall and site-specific cancer incidence, and established risk factors for cancer.

Mortality and hospitalization among older caregivers: Results from the Atherosclerosis Risk in Communities Study.

Background: Few studies have comprehensively examined health outcomes among older caregivers. We aimed to describe older caregivers and characterize risks for mortality and hospitalization compared to non-caregivers.

Methods: Caregiving status and characteristics were determined for Atherosclerosis Risk in Communities (ARIC) Study participants via a one-time telephone assessment in 2015.

Proteomics-based aging clocks in midlife or late-life and their associated risk of dementia.

Background: Biological age can be quantified by composite proteomic scores, called proteomics-based aging clocks (PACs). We investigated whether a discrepancy between chronological and biological age in midlife and late-life is associated with cognition and dementia risk.

Methods: We used two longitudinal population-based studies: the Atherosclerosis Risk in Communities (ARIC) Study and the Multi-Ethnic Study of Atherosclerosis (MESA).

Estimated glomerular filtration rate, albuminuria, and risk of infection: a collaborative meta-analysis of individual participant data.

Background: Infections are a major cause of hospitalization in people with chronic kidney disease (CKD), with incidence similar to cardiovascular disease, yet the risk of infection has not been systematically studied across stages of CKD.

Methods: We conducted a meta-analysis of individual participant data including 1,246,912 individuals across 47 cohorts in the CKD Prognosis Consortium, with information on estimated glomerular filtration rate based on serum creatinine (eGFRcr) and urinary albuminuria (ACR) (or proteinuria converted to ACR), to examine the association of eGFR and ACR with the risk of hospitalization with infection. Outcomes were ascertained through diagnostic codes on hospital discharge records relevant to acute infections (i.

Trends and Disparities in Technology Use and Glycemic Control in Type 1 Diabetes.

Importance: Characterizing population-level changes in type 1 diabetes (T1D) management can inform public health policies and interventions.

Objective: To characterize trends and disparities in glycemic control and use of diabetes technology among US youths and adults with T1D.

Design, Setting, And Participants: This serial, cross-sectional analysis used the Optum Labs Data Warehouse, a national, deidentified database of electronic health records, to identify US youths (aged <18 years) and adults (aged ≥18 years) with T1D.

A Frailty-Based Plasma Proteomic Signature Capturing Overall Health and Well-Being in Older Adults.

Frailty is an age-related syndrome characterized by an increased vulnerability to adverse health outcomes in the face of stressors. By deriving a blood-based proteomic signature for frailty, the current study aimed to enhance the understanding of frailty biology and created a person-specific predictor for the risk of frailty and other adverse age-related health outcomes. A 25-protein signature (proteomic frailty index [pFI]) predictive of the cumulative frailty index (FI) in the LonGenity cohort was derived using a penalized regression method.

Proteomics and the Risk of Incident Embolic and Thrombotic Stroke.

Objective: Personalized approaches to ischemic stroke diagnosis are needed. We determine differences in proteomic signatures of incident embolic (EIS) and thrombotic stroke (TIS) by age and resultant pathways using large-scale proteomics.

Methods: Participants in the Atherosclerosis Risk in Communities Study (ARIC) from visit 2 (V2, 1990-1992) until 2020 without prevalent stroke with available SomaScan data (4,955 protein targets) at V2 (mid-life, n = 10,929), and then again at visit 5 (V5, 2011-2013, n = 4,463) were included.

Activated GDF11/8 subforms predict cardiovascular events and mortality in humans.

Circulating Growth Differentiation Factors 11 and 8 (GDF11/8) exist in both latent and active forms, and it is unclear if specific forms can predict disease outcomes. Our data suggest that a dual-specific aptamer selectively binds GDF11/8 after prodomain activation. In 11,609 patients at risk for future cardiovascular events, low dual-specific aptamer-detected GDF11/8 levels strongly predicted adverse outcomes, including cardiovascular events (HR = 0.

Discovering plasma proteins associated with breast cancer incidence in post-menopausal women in ARIC.

Background: Plasma proteomic data can be used to discover breast cancer risk biomarkers beyond established risk factors. Discovery using a large-scale platform in a diverse population is needed.

Methods: We investigated 4,712 plasma proteins and breast cancer risk among post-menopausal women in a prospective cohort analysis in the Atherosclerosis Risk in Communities study.

Performance of the American Heart Association's PREVENT risk score for cardiovascular risk prediction in a multiethnic population.

The Predicting Risk of Cardiovascular EVENTS (PREVENT) equations, created and endorsed by the American Heart Association, provide cardiovascular risk estimates for the general population, but have not yet been tested in multiethnic populations. In the present study, in a large nationwide multiethnic sample of US veterans, the utility of PREVENT to predict the risk of total cardiovascular disease (CVD: fatal and nonfatal myocardial infarction, stroke or heart failure; PREVENT-CVD), atherosclerotic cardiovascular disease (ASCVD: fatal and nonfatal myocardial infarction or stroke; PREVENT ASCVD) and heart failure was evaluated. We assessed the discrimination and calibration performance of ASCVD prediction with PREVENT ASCVD compared with a previous risk-prediction score, pooled cohort equations (PCEs).

Circulating Proteins for Prediction of Kidney Disease Progression and Cardiovascular Outcomes: Individual Participant Data Meta-Analysis of Four Cohorts.

Introduction: KIM-1, TNFRSF1A, and TNFRSF1B have been accepted as early risk markers in diabetic kidney disease by the US Food and Drug Administration. Whether they may be useful in identifying high-risk patients for cardiovascular/kidney clinical trial enrollment in other important subgroups is uncertain.

Methods: We evaluated the potential prognostic enrichment of KIM-1, TNFRSF1A, and TNFRSF1B in four cohorts: the Atherosclerosis Risk in Communities (ARIC) (N = 4,594, mean age 76 years, 55% women, mean eGFR 68 mL/min/1.

COVID-19 and Cognitive Change in a Community-Based Cohort.

Importance: SARS-CoV-2 infection has been linked to neurotoxic effects and cognitive deficits.

Objective: To determine whether decreases in cognitive function were accelerated after SARS-CoV-2 infection compared with individuals not infected.

Design, Setting, And Participants: Multicenter, prospective cohort study from 2016 to 2022 among 3525 participants alive on March 1, 2020, and enrolled in The Atherosclerosis Risk in Communities (ARIC) study and the Collaborative Cohort of Cohorts for COVID-19 Research study who completed a prepandemic cognitive assessment and a pandemic-era assessment of SARS-CoV-2 infection.

Linking Chronic Kidney Disease to Incident Heart Failure and Adverse Cardiac Remodeling Through the Plasma Proteome: The ARIC Study.

Background: Investigation of circulating plasma proteins may reveal insights into molecular pathways that contribute to the development of heart failure (HF) among people with chronic kidney disease.

Objectives: The authors aimed to identify circulating kidney function-related plasma proteins that are associated with the risk of incident HF.

Methods: The authors studied participants of the ongoing longitudinal ARIC (Atherosclerosis Risk In Communities) study.

Serum Metabolomic Changes Following Bariatric Surgery Adjusted for Measured Glomerular Filtration Rate Suggest Mechanisms of Kidney Protection.

Background: Bariatric surgery reduces glomerular hyperfiltration in the short term and is associated with a reduced risk of glomerular filtration rate decline during long-term follow-up. Assessing surgery-induced changes in serum metabolites may be useful to understand the metabolic benefits to the kidney occurring after bariatric surgery.

Methods: In a prospective, single-center research cohort of 27 adults with severe obesity who underwent bariatric surgery, we measured serum metabolites using untargeted ultrahigh performance liquid chromatography-tandem mass spectrometry and measured glomerular filtration rate (mGFR) by iohexol plasma clearance 1-3 months prior and 6 months after bariatric surgery.

Mid- to Late-Life Traditional Cardiovascular Risk Factor Exposure and Zero Coronary Artery Calcium: The ARIC (Atherosclerosis Risk in Communities) Study.

Background: Our understanding of traditional atherosclerotic risk factors is based predominantly on one-time measurements and associations with adverse cardiovascular outcomes.

Objectives: The aim of this study was to evaluate the contribution of mid- to late-life cumulative risk factor exposure to healthy arterial aging, represented by a persistent coronary artery calcium (CAC) score of zero.

Methods: Among 2,044 community-dwelling, participants free of coronary heart disease from the ARIC (Atherosclerosis Risk in Communities) study, the associations of ∼30-year time-weighted average mid- to late-life (starting at a median age of 49 years in 1987-1989) traditional atherosclerotic risk factors (cholesterol, systolic blood pressure, fasting glucose, and smoking) with late-life (median age 80 years in 2018-2019) CAC 0 were evaluated.

Contribution of Modifiable Midlife and Late-Life Vascular Risk Factors to Incident Dementia.

Importance: Midlife vascular risk factors are associated with an elevated risk of dementia. However, the total contribution of vascular risk factors in midlife and late life with incident dementia is uncertain.

Objective: To quantify the proportion of incident dementia attributable to modifiable vascular risk factors measured in midlife and late life and to examine differences by apolipoprotein ε4 genotype, self-reported race, and sex.

Proteomic signatures of corona and herpes viral antibodies identify IGDCC4 as a mediator of neurodegeneration.

Mechanisms underlying the dynamic relationships of viral infections and neurodegeneration warrant examination. Using a community-based cohort of older adults, the current study characterized the neurocognitive (cognitive functioning, brain volumes, Alzheimer's disease positron emission tomography, and plasma biomarkers) and plasma proteomic (7268 proteins) profiles of four common coronavirus and six herpesvirus antibody titers. Genetic inference techniques demonstrated the associations between viral antibody titers and neurocognitive outcomes may be attributed to altered expression in a subset of mechanistically relevant proteins in plasma.

Effects of hearing intervention on falls in older adults: findings from a secondary analysis of the ACHIEVE randomised controlled trial.

Background: Hearing loss is highly prevalent among older adults and has been associated with an increased likelihood of falling. We aimed to examine the effect of a hearing intervention on falls over 3 years among older adults in a secondary analysis of the ACHIEVE study.

Methods: The Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study was a 3-year, unmasked, randomised controlled trial of adults aged 70-84 years at enrolment with untreated hearing loss and without substantial cognitive impairment.

Detection of Cancers Three Years prior to Diagnosis Using Plasma Cell-Free DNA.

Unlabelled: To explore how early cancers can be detected prior to clinical signs or symptoms, we assessed prospectively collected serial plasma samples from the Atherosclerosis Risk in Communities study, including 26 participants diagnosed with cancer and 26 matched controls. At the index time point, 8 of these 52 participants scored positively with a multicancer early detection test. All eight participants were diagnosed with cancer within 4 months after blood collection.

Cognitive benefits of hearing intervention vary by risk of cognitive decline: A secondary analysis of the ACHIEVE trial.

Introduction: Results from the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) trial suggest hearing intervention may not reduce 3-year cognitive decline in all older adults with hearing loss but may be beneficial in certain groups. This secondary analysis investigated if participants with multiple risk factors for cognitive decline received greater benefits.

Methods: We used a sample of dementia-free participants (N = 2692) from the Atherosclerosis Risk in Communities (ARIC) cohort to develop a predictive model for cognitive decline.

Hearing Intervention, Social Isolation, and Loneliness: A Secondary Analysis of the ACHIEVE Randomized Clinical Trial.

Importance: Promoting social connection among older adults is a public health priority. Addressing hearing loss may reduce social isolation and loneliness among older adults.

Objective: To describe the effect of a best-practice hearing intervention vs health education control on social isolation and loneliness over a 3-year period in the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study.