Metal Exposures, Omics, and AD/ADRD risk in Diverse US Adults
openNIA - National Institute on Aging
SUMMARY
Metals are neurotoxic at high doses yet can contribute to motor and cognitive deficits even at environmentally
relevant doses. Metals contribute to amyloid β misfolding and tau hyperphosphorylation, which are pathological
hallmarks of Alzheimer’s disease (AD) and AD-related dementia (ADRD) risk as well as cognitive decline. Metals
also interact with the APOE4 allele to influence AD risk, advance neurodegeneration, and have vascular effects
that may further contribute to dementia risk. Metals may thus represent multiple hits for risk of cognitive
impairment and dementia. Yet, few cohort studies have comprehensively evaluated the association of metal
exposures with mild cognitive impairment (MCI) and AD/ADRD. To fill this knowledge gap, we propose to
leverage the NIH-funded Atherosclerosis Risk in Communities (ARIC) and Multi-Ethnic Study of Atherosclerosis
(MESA) cohorts of diverse US adults to test the hypothesis that widespread exposure to metals—determined by
established and novel biomarkers—is associated with MCI and AD/ADRD risk and with key pathophysiological
processes that explain this risk. ARIC and MESA have rich biorepositories, as well as examination, laboratory,
omics and clinical data. In these unique and diverse cohorts, we propose to add a metallome profile to quantify
metal exposure and internal dose for each participant by measuring metals in urine, blood, and serum at repeated
visits in all participants, as well as in brain-derived extracellular vesicles in a subset of participants. Priority metals
include lead, cadmium, copper, mercury, manganese and zinc, although other metals will also be measured. We
will connect these metallome profiles with rich brain health and multi-omics data (whole genome sequencing,
epigenomic/methylomic, transcriptomic, proteomics, targeted and untargeted metabolomics). We will use
powerful, state-of-the-art analyses to determine the prospective associations of long-term metal exposures with
risk of cognitive decline, MCI and AD/ADRD risk (Aim 1), and with the trajectory of plasma AD and brain imaging
biomarkers (Aim 2) in diverse US adults overall and by sex, race/ethnicity, and APOE4 genotype. We will then
develop a predictive multi-omics fingerprint that quantifies risk of MCI, AD/ADRD, and cognitive decline due to
metal exposures (Aim 3). Because metal exposures are preventable and treatable, adding high-quality measures
of the metallome profile to diverse cohorts with longitudinal brain health and extensive omics data will enable
this project to contribute key knowledge of the molecular/biological pathways involved in development of
cognitive decline as well as identify new targets for the prevention and treatment of AD/ADRD. This work will
generate critical knowledge and serve as a robust model for generating highly valuable data that can be
leveraged to prevent/mitigate harmful metal exposures and protect cognitive health.
Up to $10.2M
health research