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INTRODUCTIONNumerous neuroimaging studies demonstrated racial and ethnic disparities in brain health at older ages. It remains unclear whether racial and ethnic disparities increase with aging and whether they are already apparent in midlife.METHODSWe investigated differences in MRI markers of aging and cerebrovascular disease in 969 participants from the Washington Heights-Inwood Columbia Aging Project (WHICAP; mean age: 75 years) and 496 participants from the Offspring study (mean age: 55 years) across race and ethnicity (white, Black, Latinx).RESULTSOlder whites had greater cortical thickness compared with Latinxs, who also had greater thickness than Blacks. Cortical thickness was similar across race in the middle-aged cohort. Regarding white matter hyperintensity (WMH) volume, Blacks had disproportionately greater WMH volume compared to both whites and Latinxs at older ages. Racial disparities are already apparent in midlife, where Blacks have disproportionately greater WMH than whites.DiscussionThese findings suggest that racial disparities in WMH volume are already apparent in midlife.

IntroductionAssessment of cognition and everyday function is essential in clinical trials for Alzheimer’s disease (AD). Two novel measures of cognition (No Practice Effects (NPE) cognitive battery and Miami Computerized Functional Assessment Scale (CFAS)) were designed to have robust psychometric properties and reduced practice and ceiling effects. This study aims to evaluate if the NPE and CFAS demonstrate stronger psychometric properties and reduced practice effects compared with established measures, including the Preclinical Alzheimer Cognitive Composite (PACC), Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), and Functional Activities Questionnaire (FAQ).MethodsThis parallel group, four-site study will randomize 320 cognitively intact adults aged 60 to 85 years to novel or well-established measures of cognition and function. All participants will receive assessments at baseline (week 0), week 12, and week 52, as well as a brain MRI scan and Apolipoprotein E genetic test at study entry. Analyses will determine psychometric properties of the NPE and CFAS, compare the sensitivity of measures to AD risk markers, and identify cognitive domains within the NPE.DiscussionPractice effects have been a major limitation of Alzheimer’s disease clinical trials that typically assess cognitive changes over serial assessments. Detection of functional impairment in cognitively normal individuals with biomarkers for Alzheimer’s disease requires instruments sensitive to very subtle functional changes. This study is intended to support the validation of two new composite measures, the NPE battery and the CFAS, which may advance clinical testing of interventions for individuals across the spectrum of early stage Alzheimer’s disease.Trial RegistrationNCT03900273