# P-CARRS-BRAIN: Multi-domain (genetic, socio-behavioral, vascular) risk factors and prediction of Alzheimer’s Disease continuum in South Asians in India

> **NIH NIH R01** · EMORY UNIVERSITY · 2024 · $4,282,638

## Abstract

PROJECT SUMMARY/ABSTRACT
While it is widely acknowledged that Alzheimer’s disease and related dementias (AD/ADRD) have an extended
preclinical phase, there are sparse data on the cognitive and pathobiological changes in middle-ages, a critical
window for preventative intervention in people likely to progress to full-blown clinical disease. South Asians, a
population with heightened risk of AD/ADRD and vascular/metabolic risks at younger ages, offer a unique
opportunity to investigate preclinical AD/ADRD and related modifiable risk factors of its progression. Predictive
models leveraging multimodal data could transform prospects for early AD/ADRD detection and phenotype
identification in middle-aged people, but are currently lacking. To address these gaps, we propose to efficiently
leverage the NHLBI-funded PPG, the Precision-CARRS cohort (P01HL154996; n=21,864), which has ~15
years of detailed, repeated measures of socio-behavioral, environmental, and vascular/metabolic data. Our
specific aims are: (Aim-1) Perform multimodal AD/ADRD phenotyping and genetically characterize the risk of
AD/ADRD across the continuum; (Aim-2) Investigate modifiable risk factors (socio-behavioral and
vascular/metabolic factors) associated with the AD/ADRD continuum; and (Aim-3) Develop and validate a
longitudinal machine learning network by employing high-dimensional data to distinguish AD/ADRD risk. We
will achieve these aims by augmenting the cohort with AD/ADRD phenotyping and genotyping protocols
aligned with the NIA-funded Alzheimer's Disease Research Centers (P50 AG025688). This study will focus on
characterizing risks and outcomes in individuals who were enrolled in P-CARRS in two waves (2010, 2015) at
ages ≥40 years (n=8,142, 51% female, 78% literate, 38% diabetes, and 48% hypertension). We will
characterize middle-life AD/ADRD risks through newly measuring: (a) Using baseline stored samples (2010 or
2015) to perform plasma AD/ ADRD biomarkers (pTau217, NfL, and GFAP) and whole genome sequencing
and (b) At a new follow-up examination, assess plasma AD biomarkers and administer sensitive AI-driven
digital cognitive measures; and c) only in those >50 years (n=4,132), we will additionally obtain
comprehensive cognitive battery, retinal, and neuroimaging. In preliminary studies, we have successfully
demonstrated the feasibility of administering novel AI-enabled digital cognitive assessment tools, collecting and
processing plasma AD biomarkers, and pilot standardization of MRI neuroimaging biomarkers. This project will
advance progress in understanding the natural history of the AD/ADRD along the life course and promote early
detection, precise diagnosis and tailored therapeutic strategies for this high-risk, understudied population and
beyond.

## Key facts

- **NIH application ID:** 10992037
- **Project number:** 1R01AG089759-01
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Suvarna Alladi
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $4,282,638
- **Award type:** 1
- **Project period:** 2024-09-15 → 2029-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10992037

## Citation

> US National Institutes of Health, RePORTER application 10992037, P-CARRS-BRAIN: Multi-domain (genetic, socio-behavioral, vascular) risk factors and prediction of Alzheimer’s Disease continuum in South Asians in India (1R01AG089759-01). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10992037. Licensed CC0.

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