Adult Life Course Research Articles

Charting well-being over adulthood into pandemic times: a longitudinal perspective

The purpose of this study is to investigate how well-being changes over the adult life course from early adulthood in 1998 through to the COVID-19 pandemic in 2021. We identify diverse well-being trajectories over time in a cohort of British Columbians and explore the extent to which changes in well-being associated with the pandemic varied for individuals in these different trajectory groups. Specifically, we ask: what was the effect of the pandemic on the well-being of individuals with different prior well-being trajectories over adulthood and how were these effects related to personal, educational and employment factors? To address this question, we model well-being trajectories over a large span of adulthood from the age of 28 to 51 years old. We find a diversity of distinct patterns in well-being changes over adulthood. The majority experience high well-being over time, while almost one in five experiences either chronically low or drastically decreased well-being in mid-adulthood, which coincides with the pandemic. Notably, those who have completed post-secondary education are less likely to report low well-being trajectories. Those with the lowest well-being over time also report the largest negative effects of the pandemic, which illustrates the compounding effects of the pandemic on existing inequalities.

Let’s Talk About Single Men: A Qualitative Investigation of Never Married Men’s Experiences of Singlehood

Existing research on singlehood has largely focused on the experiences of single women, and little is known about singlehood among men. The current investigation examined the experience of long-term singlehood through individual, semi-structured interviews with 22 never-married single men living in Poland who were aged 22–43 years. Thematic analysis revealed five key themes: (1) the sense of being deficient—is there something wrong with me?; (2) navigating outside the dominant discourse of traditional masculinity, marriage and family; (3) the benefits and downsides of singlehood; (4) adaptation to singlehood; and (5) the dilemma between waiting and actively searching for a romantic partner. An analysis of single men’s narratives revealed that men experience their single status in the context of their various needs and hopes and as a status that determines their adult life course. This study contributes to the singlehood literature, highlighting the complexity of singlehood for men and the importance of traditional masculinity norms in experiencing long-term singlehood.These findings challenge stereotypical and unrealistic views of singlehood among men and have practical implications for psychotherapists, counsellors and educators working with single men.

Body size over the adult life course and the risk of colorectal cancer.

To assess the associations among several anthropometric measures, as well as BMI trajectories and CRC risk in older women. Prospective cohort study. Forty clinical centres in the USA. 79,034 postmenopausal women in the Women's Health Initiative Observational Study. During an average of 15.8 years of follow-up, 1,514 CRC cases were ascertained. Five BMI trajectories over 18 to 50 years of age were identified using growth mixture model. Compared with women who had a normal BMI at age 18, women with obesity at age 18 had a higher risk of CRC (HR 1.58, 95%CI 1.02-2.44). Compared with women who kept relatively low normal body size during adulthood, women who progressed from normal to obesity (HR 1.29, 95%CI 1.09-1.53) and women who progressed from overweight to obesity (HR 1.37, 95%CI 1.13-1.68) had higher CRC risks. A weight gain > 15 kg from age 18 to 50 (HR 1.20, 95%CI 1.04-1.40) and baseline waist circumference >88 cm (HR 1.33, 95%CI 1.19-1.49) were associated with higher CRC risks, compared to stable weight and waist circumference ≤88cm respectively. Women who have a normal weight in early adult life and gain substantial weight later, as well as those who are persistently heavy over adulthood, demonstrated a higher risk of developing CRC. Our study highlights the importance of maintaining a healthy body weight over the life course for reducing the risk of developing CRC in women.

Longitudinal Dietary Trajectories With Cognitive and Psychosocial Well-Being in Chinese Adults Aged 85 Years and Older in Singapore.

Studies on longitudinal trajectories of diet and the influence on aging in older adults are limited. We characterized diet quality trajectories over the past 2 decades among adults aged ≥85 years and examined their associations with cognitive and psychosocial outcomes. We used data from 861 participants in the population-based Singapore Chinese Health Study. Dietary intakes were assessed at baseline (mean age [range]: 65 [60-74] years) and at follow-ups 3 (85 [81-95]) and 4 (88 [85-97]) years. Diet quality was measured by adherence to the Dietary Approaches to Stop Hypertension pattern, and group-based trajectory modeling was used to derive diet quality trajectories. At Follow-up 4, we assessed cognition using the Singapore-modified Mini-Mental State Examination, depressive symptoms using the 15-item Geriatric Depression Scale, social engagement, and self-rated health. Multivariable logistic regression models examined associations of diet quality trajectories with these outcomes. About 49.7% had a trajectory with consistently low diet quality scores, whereas 50.3% had a trajectory with consistently high diet quality scores. Compared to the "consistently low" trajectory, the "consistently high" trajectory had 29% and 26% lower likelihoods of cognitive impairment and depressive symptoms, respectively (odds ratio, 95% confidence interval: 0.71 [0.51, 0.99] and 0.74 [0.55, 0.99], respectively); as well as 47% higher likelihood of social engagement (1.47 [1.09, 1.98]). No statistically significant association was observed between the trajectories and self-rated health. Maintaining high diet quality throughout the older adult life course was associated with better cognitive and psychosocial well-being in adults aged ≥85 years.

Implications of Cumulative Life Event Stress for Daily Stress Exposure and Cardiovascular Reactivity Among Black and White Americans.

Daily stress and cardiovascular reactivity may be important mechanisms linking cumulative life event stress with cardiovascular health and may help to explain racial health disparities. However, studies have yet to examine links between exposure to life event stress, daily stress exposure, and cardiovascular reactivity. This study assessed links between trajectories of life event stress exposure, daily stressors, and cardiovascular reactivity among Black and White individuals. Participants are from the Stress and Well-being in Everyday Life Study in which 238 individuals (109 Black 129 White; ages 33-93), drawn from the longitudinal Social Relations Study, reported life event stress in 1992, 2005, 2015, and 2018. Of those individuals, 169 completed an ecological momentary assessment study in which they reported stress exposure every 3 hr, and 164 wore a heart rate monitor for up to 5 days. Latent class growth curve models revealed 2 longitudinal trajectories of life event stress: moderate-increasing and low-decreasing. Individuals in the moderate-increasing stress trajectory reported greater daily stress exposure and links did not vary by race. Black individuals in the low-decreasing trajectory and White individuals in the moderate-increasing trajectory showed positive associations between daily stress and heart rate (i.e., were reactive to daily stress exposure). The link between daily stress and heart rate was not significant among Black individuals in the moderate-increasing trajectory and White individuals in the low-decreasing trajectory. Individuals who experience more life events across the adult life course report greater daily stress exposure which has important implications for daily cardiovascular health. Black individuals with moderate-increasing life event stress show evidence of blunted daily stress reactivity (nonsignificant association between daily stress and heart rate) whereas Black individuals with low-decreasing life event stress show evidence of stress reactivity (positive association between daily stress and heart rate). White individuals showed the opposite pattern (albeit marginally). These findings expand the weathering hypothesis and indicate that chronic life event stress may be associated with blunted stress reactivity among Black individuals.

Educational Expectation-Attainment Gaps and Mental Health over the Early Adult Life Course

We advance research on the association of educational expectation–attainment gaps with mental health by asking two questions that derive from the stress process and life course frameworks: (1) How does the association change over the early adult life course? and (2) To what extent is the association attributable to adult social roles and socioeconomic attainment? Using the National Longitudinal Study of Adolescent to Adult Health, we find that close to the time when the expectation would have been realized, educational attainment is associated with mental health but expectations and the interaction between expectations and attainments are not, independent of selection factors. As respondents age, expectations themselves become more consistently associated with mental health. Adult social roles and socioeconomic status contribute little to explaining these associations. We discuss the implications for the stress process framework and life course research.

Intergenerational financial support for homeownership and co-residence in Chinese cities

Drawing on questionnaire data from six cities in China, this study explores the relationship between intergenerational financial support from parents in adult children's housing purchases and key life course facts. The regression results indicate an inverted ‘U’-shaped relationship between the age of young adults and the occurrence of financial support from their parents in housing purchases. Intergenerational co-residence, popular in China, is significantly and positively associated with financial support from parents for housing purchases. This suggests that many Chinese parents seek to achieve further intergenerational reciprocity through co-residence after giving financial support to their adult children. Interestingly, the regression results on samples without loans show that intergenerational co-residence is not significantly related to occurrences of parental financial support in housing purchases. This indicates that more affluent families purchasing housing without loans may not need to engage in intergenerational reciprocity through intergenerational co-residence. This paper provides new empirical evidence of intergeneration wealth transfers on homeownership in the context of China. It enriches our understanding of the relationship between intergenerational financial support for homeownership and the phenomenon of co-residence.

Social Vulnerability and Psychosocial Resilience in Adolescents and Young Adults From a Community Art Network.

Adolescence is a stage of transition with multiple changes and transformations. It is a critical phase to potentiate or disrupt the life course of human beings. In Latin America, adolescents and young adults from countries like Colombia have unequal access to socioeconomic resources, education, and the job market. This may generate social disadvantages and vulnerability. We aimed to identify conditions of social vulnerability and psychosocial resilience in the life course of adolescents and young adults from a community art network in Bogota, Colombia. We conducted a qualitative study with a multivocal design supported by the ethnic-social life history construction. The data were collected using narrative interviews. The interviews were transcribed, coded, categorized, and triangulated according to the principles of grounded theory as an analytical method. We adhered to the consolidated criteria for reporting qualitative research (COREQ) checklist. Eight adolescents and young adults between the ages of 12 and 24 years participated in the study. Five categories emerged: social vulnerability, social environment, artistic processes, psychosocial resilience, and life course. Social vulnerability and psychosocial resilience coexist during the life course of adolescents and young adults. Social support networks and community art processes have the potential to promote psychosocial resilience in adolescents and young adults.

Association between psychological distress trajectories from adolescence to midlife and mental health during the pandemic: evidence from two British birth cohorts.

This paper examined whether distinct life-course trajectories of psychological distress from adolescence to midlife were associated with poorer mental health outcomes during the pandemic. We present a secondary analysis of two nationally representative British birth cohorts, the 1958 National Child Development Study (NCDS) and 1970 British Cohort Study (BCS70). We used latent variable mixture models to identify pre-pandemic longitudinal trajectories of psychological distress and a modified Poisson model with robust standard errors to estimate associations with psychological distress, life satisfaction and loneliness at different points during the pandemic. Our analysis identified five distinct pre-pandemic trajectories of psychological distress in both cohorts. All trajectories with prior symptoms of psychological distress irrespective of age of onset, severity and chronicity were associated with a greater relative risk of poorer mental health outcomes during the pandemic and the probability of poorer mental health associated with psychological distress trajectories remained fairly constant. The relationship was not fully attenuated when most recent pre-pandemic psychological distress and other midlife factors were controlled for. Whilst life-course trajectories with any prior symptoms of psychological distress put individuals at greater risk of poor mental health outcomes during the pandemic, those with chronic and more recent occurrences were at highest risk. In addition, prior poor mental health during the adult life-course may mean individuals are less resilient to shocks, such as pandemics. Our findings show the importance of considering heterogeneous mental health trajectories across the life-course in the general population in addition to population average trends.

What Do EURO-D Scores Capture? Disentangling Trait and State Variances in Depression Symptoms Across the Adult Life Span in Nine European Nations.

The primary purposes of the present study were to determine (a) whether the EURO-D measures trait (i.e., time-invariant) versus state (i.e., time-variant) aspects of depression and (b) whether these aspects are stable across countries and ages. In five waves of the SHARE survey (a nationally representative Survey of Health, Ageing, and Retirement in Europe), we estimated trait-state-occasion models (TSO), including multiple-nation TSO, based on data from nine European nations over a 10-year period. Also, we used local structural equation modeling to test for the moderating effects of age on the TSO parameters. Our main findings were: (a) there were differences in the trait/state variances of depressive symptoms across nations. The amount of trait variance was above 60% for Belgium, Denmark, and France. It was between 50% and 60% for Austria, Germany, Sweden, and Switzerland, while it was below 50% for Italy and Spain. (b) The effects of trait and state were almost equally the source of variance for depression symptoms across ages, with a slight advantage for the effects of trait (56% of the variance). This trend showed substantial stability across the adult life course (from age 40 up to age 95).

Examination of potentially modifiable dementia risk factors across the adult life course: The Framingham Heart Study.

We examined for associations between potentially modifiable risk factors across the adult life course and incident dementia. Participants from the Framingham Heart Study were included (n=4015). Potential modifiable risk factors included education, alcohol intake, smoking, body mass index (BMI), physical activity, social network, diabetes, and hypertension. Cox models were used to examine associations between each factor and incident dementia, stratified by early adult life (33-44 years), midlife (45-65 years), and late life (66-80 years). Increased dementia risk was associated with diabetes (hazard ratio [HR]=1.62; 95% confidence interval [CI]=1.07-2.46) and physical inactivity (HR=1.57; 95% CI=1.12-2.20) in midlife, and with obesity (HR=1.76; 95% CI=1.08-2.87) in late life. Having multiple potential modifiable risk factors in midlife and late life was associated with greater risk. Potentially modifiable risk factors individually have limited impact on dementia risk in this population across the adult life course, although in combination they may have a synergistic effect. Diabetes and physical inactivity in midlife is associated with increased dementia risk. Obesity in late life is associated with increased dementia risk. Having more potentially modifiable risk factors in midlife and late life is associated with greater dementia risk.

Health, Suicidal Thoughts, and the Life Course: How Worsening Health Emerges as a Determinant of Suicide Ideation in Early Adulthood.

Poor physical health places adults at greater risk for suicide ideation. However, the linkage between health and suicidal thoughts may emerge and become established during early adulthood, concomitant with other social processes underlying suicidality. Using nationally representative survey data from Waves III through V of the National Longitudinal Study of Adolescent to Adult Health (n = 8,331), we examine the emergence of health as a predictor of suicide ideation across the early adult life course (ages 18-43). We find that worsening health does not significantly predict suicide ideation until young adults approach the transition into midlife. Our findings suggest this may be due to the increasing severity of health problems, reduced social network engagement, and disruption of social responsibilities later in early adulthood. Our findings underscore the need for social science research to examine the relationship between mental and physical health from a life course perspective.

Selected Articles from This Issue

During the COVID-19 pandemic, many colorectal cancer-related procedures were suspended, with unclear implications for colorectal cancer mortality. In this study, van den Puttelaar and colleagues used observed data and simulation modeling to estimate the impact on colorectal cancer outcomes, clinical resources, and associated tradeoffs, for longer versus shorter recovery periods to catch up procedures. The authors estimate that the disruptions may cause 4,200 to 14,400 excess colorectal cancer deaths in the US in the next 20 years, depending on the assumed extent of disruption, length of recovery period, and resources used. These estimates may help inform strategies to mitigate the broader impact of the COVID-19 pandemic or future crises.Christopher and colleagues used a data-driven approach to identify exercise trajectories over the adult life course and examined how these trajectories were associated with colon cancer risk within the NIH-AARP Diet and Health Study. Adults maintaining moderate-to-high amounts of exercise consistently throughout adulthood had a lower risk of colon cancer. Being inactive early in adulthood but increasing exercise participation by midlife was also suggestive of a lower risk. These findings are aligned with the current physical activity recommendations and add new evidence that promoting physical activity at all stages of the adult life course is needed for population-based colon cancer prevention.Few empirical data are available for older adults on the absolute risk of colorectal cancer and its associated mortality in the context of prior screening. Dalmat and colleagues address this evidence gap with estimates from a large population of screen-eligible adults ages 76 to 85 years who had a negative colonoscopy ten years ago. Estimates of cumulative incidence and mortality were 1.29% (95% CI: 1.02–1.61%) and 0.46% (95% CI: 0.30–0.70%), respectively, in eight years following screening eligibility date, after accounting for competing risk of death from another cause. Patients were approximately 90 times more likely to die from another cause than colorectal cancer, which may be an important context for older adults’ decision making.Nicotine metabolism significantly influences nicotine dependence. The goal of this study, by Perez-Paramo and colleagues, was to examine the impact of genetic variants in nicotine metabolizing enzyme genes on urinary levels of nicotine metabolites. Functional deficiency of cytochrome P450 2A6 caused multiple changes in nicotine metabolites in smokers’ urine. Genetic polymorphisms in multiple functional metabolizing enzyme genes showed a significant impact on urinary levels of many nicotine metabolites. These data suggest that multiple genes in several pathways are involved in the metabolism of nicotine, which may influence nicotine dependence and smoking behavior.

Mental Health Effects of Income over the Adult Life Course

While a gradient between income and depression is well documented, associational estimates are subject to bias due to measurement errors, reverse causation, and other sources of confounding. Causal studies are few and report small and divergent estimates, even in their direction. But prior research has important limitations for causal inference, such as relying on comparisons between individuals sensitive to each other’s relative income or capturing only a subset of pathways through which income affects well-being. This study leverages longitudinal and genomic data to assess how much some known biases affect the income-depression gradient and to what extent the gradient might be reflective of a causal effect. Findings from three U.S. samples—representing early midlife, late midlife, and older adulthood—are suggestive of a beneficial effect of income on mental health, especially in late midlife and beyond. The results have implications for interpreting the nature of socioeconomic disparities in mental health.

Interventions Addressing Black/African American Adults Affected by Adverse Childhood Experiences (ACEs): A Scoping Review

Objective: The aim of this scoping review was to provide an overview of the literature on interventions to mitigate the negative impacts of adverse childhood experiences (ACEs) among Black/ African American adults. The specific objectives were to qualitatively examine, compare, and contrast the literature; to provide a narrative summary of each intervention identified in the search; and to identify gaps in the literature.Introduction: ACEs have been identified as a significant public health problem due to their destructive nature on a person's subsequent adult life course. Among the three largest racial/ethnic groups in the United States (White/Caucasian, Black/African American, and Hispanic American), the Black/African American community suffers the highest incidence of ACEs. However, there is a paucity of research examining interventions specifically for Black/African American adults suffering from the negative impacts of ACEs.Inclusion criteria: This study only included published material from the United States within the past ten years. Studies included must have had at least 25% of participants identified as Black/African American adults. The study had to entail an intervention directly applied with the identified population targeting an ACE-related outcome.Methods: The literature search was conducted between December 2022 and January 2023 using the Social Work Abstracts, PsychInfo, Applied Social Sciences Index and Abstracts (ASSIA), and the Social Services Abstracts. Data were extracted on author(s) name, year of publication, the type of intervention, the sample demographics (i.e. age, race, and location), the purpose of the study, the reported outcomes, and the results. Results were summarized in tabular and narrative forms.Results: The search identified 1,146 relevant studies according to the search criteria. Of these, 784 were screened as meeting all or some of the inclusion criteria. The final assessment left 6 studies as fully meeting all the inclusion criteria. Overall, the analysis found that psychosocial and psychoeducation-based interventions positively affected the reduction of ACE-related symptoms. Nevertheless, it is difficult to develop intervention themes as there is tremendous variation in the intervention designs, execution, location, and methods. Additionally, only two of the studies were randomized control trials (RCTs), thus limiting overall methodological rigor.Conclusions: This study highlights the limited evidence of interventions specifically addressing this population. The evidence suggests a positive impact of the interventions on the ACE symptoms identified. However, the rigor of the few existing studies is limited. The Black/African American community will benefit from the development of RCTs on culturally appropriate interventions to combat the damaging effects of adverse childhood experiences.

Exploring the social power of Christmas: a prospective qualitative study of assigning meaning to Christmas along the life course.

This article relies on a prospective qualitative study, that provides valuable insight into the mechanism through which the meaning of holidays is built over time. Following a life course perspective, the article analyses the continuities as well as the twists and turns of the meaning of Christmas in relation to significant turning points that occur along the paths of individual lives in transition to adulthood. Grounded on an inductive approach, the study draws on longitudinal qualitative data collected through solicited diaries, kept by 14 young Romanian adults, around Christmas time, along four panel waves (2004, 2010, 2016, 2020). Results show that there is no universal configuration of the meaning of Christmas, but rather a diversity of personalised dynamic configurations, in line with individuals' subjective realities, which are sensitive to family traditions passed down during socialisation, and constantly updated with each generation that assumes them, but also to significant life events that occurred on their early adult life course trajectories, determining a re-evaluation of attitudes about self, life, religion and others. The article concludes that Christmas, as a social construct, is a malleable bearer of values, which acts both as a 'sword' and as a 'shield' that diarists use according to the needs, wishes and challenges that arise in their transition from adolescence to enhanced adulthood.

Age- and sex-specific modifiable risk factor profiles of dementia: evidence from the UK Biobank.

Dementia constitutes a worldwide concern. To characterize the age- and sex-specific modifiable risk factor profiles of dementia, we included 497,401 UK Biobank participants(mean age= 56.5 years) without dementia at baseline (2006-2010) and followed them until March 2021. Cox proportional hazard models were used to estimate the age- and sex-specific hazard ratios (HRs) of incident dementia associated with socioeconomic (less education and high Townsend deprivation index), lifestyle (non-moderate alcohol intake, current smoking, suboptimal diet, physical inactivity, and unhealthy sleep duration), and health condition factors (hypertension, diabetes, cardiovascular diseases, and depressive symptoms).We also calculated the population attributable fractions (PAFs) of these factors. During follow-up (mean = 11.6years), we identified 6564 dementia cases. HRs for the risk factors were similar between the sexes, while most factors showed stronger associations among younger participants. For example, the HRs of smoking were 1.74 (95% CI: 1.23, 2.47) for individuals aged < 50years, and 1.18 (1.05, 1.33) for those aged ≥ 65years. Overall, 46.8% (37.4%, 55.2%) of dementia cases were attributable to the investigated risk factors. The PAFs of the investigated risk factors also decreased with age, but that for health condition risk factors decreasedwith lower magnitude than socioeconomic and lifestyle risk factors. The stronger associations and greater PAFs of several modifiable risk factors for dementia among younger adults than older participants underscored the importance of dementia prevention from an earlier stage across the adult life course.

Reported sleep duration reveals segmentation of the adult life-course into three phases

Classically the human life-course is characterized by youth, middle age and old age. A wide range of biological, health and cognitive functions vary across this life-course. Here, using reported sleep duration from 730,187 participants across 63 countries, we find three distinct phases in the adult human life-course: early adulthood (19-33yrs), mid-adulthood (34-53yrs), and late adulthood (54+yrs). They appear stable across culture, gender, education and other demographics. During the third phase, where self-reported sleep duration increases with age, cognitive performance, as measured by spatial navigation, was found to have an inverted u-shape relationship with reported sleep duration: optimal performance peaks at 7 hours reported sleep. World-wide self-reported sleep duration patterns are geographically clustered, and are associated with economy, culture, and latitude.

ONE-seq: epitranscriptome and gene-specific profiling of NAD-capped RNA.

The hub metabolite, nicotinamide adenine dinucleotide (NAD), can be used as an initiating nucleotide in RNA synthesis to result in NAD-capped RNAs (NAD-RNA). Since NAD has been heightened as one of the most essential modulators in aging and various age-related diseases, its attachment to RNA might indicate a yet-to-be discovered mechanism that impacts adult life-course. However, the unknown identity of NAD-linked RNAs in adult and aging tissues has hindered functional studies. Here, we introduce ONE-seq method to identify the RNA transcripts that contain NAD cap. ONE-seq has been optimized to use only one-step chemo-enzymatic biotinylation, followed by streptavidin capture and the nudix phosphohydrolase NudC-catalyzed elution, to specifically recover NAD-capped RNAs for epitranscriptome and gene-specific analyses. Using ONE-seq, we discover more than a thousand of previously unknown NAD-RNAs in the mouse liver and reveal epitranscriptome-wide dynamics of NAD-RNAs with age. ONE-seq empowers the identification of NAD-capped RNAs that are responsive to distinct physiological states, facilitating functional investigation into this modification.

Modifying adult life course dementia risk: results from the Framingham Heart Study

AbstractBackgroundModifiable risk factors of dementia identified by the 2020 Lancet Commission, including less education, high alcohol intake, smoking, obesity, physical inactivity, social isolation, diabetes, and hypertension, measured at early adult life, midlife, and late‐life were analyzed for their associations with risk of incident dementia.MethodParticipants from the Framingham Heart Study Offspring cohort who attended the fourth examination cycle (1987‐1991) and were free of prevalent dementia were included in the study sample (n = 4,015). They were stratified into three age epochs: early adult life (&lt;45 years, n = 1,079); midlife (45‐65 years, n = 2,476); and late‐life (&gt;65 years, n = 460). Information on alcohol intake, smoking, body mass index, physical activity, and social network, as well as diabetes and hypertension status, were ascertained at the fourth examination cycle, while information on education was ascertained from the second examination cycle. Dementia diagnoses, including all‐cause dementia and Alzheimer’s disease (AD) dementia, were adjudicated by a multi‐disciplinary consensus committee through 2019. Cox proportional hazards models were used to examine associations between each risk factor and incident all‐cause dementia and Alzheimer’s disease (AD) dementia, stratified by age epoch.ResultOver an average of 21 years of follow‐up (early adult life = 24.0 years; midlife = 20.9 years; late‐life = 13.9 years), increased risk of all‐cause dementia was significantly associated with diabetes (HR = 1.62; 95% CI = 1.07‐2.46; p = 0.023) and physical inactivity (HR = 1.57; 95% CI = 1.12‐2.20; p = 0.009) in midlife, and with obesity (HR = 1.76; 95% CI = 1.08‐2.87; p = 0.024) in late‐life. Obesity in late‐life was associated with increased risk of AD dementia (HR = 2.19; 95% CI = 1.27‐3.77; p = 0.005). All other risk factors examined in early adult life, midlife, and late‐life were not significantly associated with risk of all‐cause dementia (Figure 1) or AD dementia (Figure 2).ConclusionResults suggest that modifiable risk factors individually may have modest to no impact across the adult life course on dementia risk. Additional studies are needed to determine if these risk factors in combination may have a more synergistic effect.