Multilevel Growth Models Research Articles

Longitudinal associations between mental health and social environment in older adults: a multilevel growth modeling

Objectives This study aimed to assess longitudinal relationships between social environment indicators (social connectedness, social engagement, social contribution) and mental health indicators (depression and anxiety) among community-dwelling adults age 55 years and older. Methods Data were drawn from 3-waves of the national longitudinal survey of Midlife Development in the United States (MIDUS) (N = 2,020; age range = 55-94 years). We developed multilevel growth models to ascertain the relationships of interest, controlling for sociodemographic and physical health factors. Results Over the 20-year period of study, lower levels of emotional social support, social integration and social contribution significantly predicted depression and anxiety, whereas social network and social engagement were not significant predictors of these mental health outcomes in older adults. The models also indicated a moderation effect of the number of chronic conditions on the slopes of depression and anxiety. Discussion Considering our findings, interventions to enhance social contribution and social connectedness could be effective to help older adults maintain positive mental health, as well as programs that facilitate older adults’ connections with their families, communities and health care providers. These interventions must also account for multiple chronic conditions since functional limitations drive declining integration in the community and participation in social activities.

Are some people more consistent? Examining the stability and underlying processes of personality profile consistency.

Personality traits are relatively consistent across time, as indicated by test-retest correlations. However, ipsative consistency approaches suggest there are individual differences in this consistency. Despite this, it is unknown whether these differences are due to person-level characteristics (i.e., some people are just more consistent) or exogenous forces (i.e., lack of consistency is due to environmental changes). Moreover, it is unclear whether the processes promoting long-term consistency are the same across people. We examine these two questions using item-level profile correlations across four to nine waves of data with four data sets (N = 21,616) with multilevel asymptotic growth models. Results indicated that there were, on average, high levels of profile consistency. However, there were notable individual differences in initial profile correlation values as well as in changes in levels of consistency across time, indicating that some people are more stably consistent than others. Moreover, the directions of people's trajectories across increasing time intervals suggest that the mechanisms responsible for reinforcing personality consistency vary across people. These effects were typically moderated by age at 30 years old, maturity-related traits, and education level. Overall, findings indicate some people are more consistent than others, such that this stable level of (in)consistency is a dispositional factor. Additionally, individual differences in profile consistency are shaped by different levels of three processes. On average, stochastic factors are not impactful for most individuals, and transactional processes have an important role in increasing consistency for a sizable amount of people-nuances not previously revealed when focusing on rank-order stability. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Growth curves of common factors in psychotherapy: Multilevel growth modelling and outcome analysis.

A large body of literature discusses change mechanisms underlying psychotherapy with an emphasis on common factors. The present study examined how different comprehensive common factors change over the course of therapy and whether this change was associated with clinical outcome at discharge. Three hundred forty-eight adults (mean age = 32.1, SD = 10.6; 64% female) attended a standardized 14-week day-clinic psychotherapy program. They provided longitudinal data on common factors based on weekly assessments. Additionally, pre- and post-assessment questionnaires on clinical outcome were completed. Using multilevel modelling, we predicted common factors by time (week in therapy). Multiple linear regression models tested the association between changes in common factors and clinical outcome. The common factor 'Therapeutic Alliance' was best fitted by linear growth models, whereas models for the common factors 'Coping', 'Cognitive Integration' and 'Affective Processing' indicated logarithmic changes over time. 'Coping', that is change in patients' ability to cope with their individual problems, was most closely linked with outcome. The present study provides evidence for the changeability of common factors over the course of therapy as well as their specific contributions to psychotherapeutic progress.

Emotion regulation styles and Adolescent adjustment following a COVID-19 lockdown.

This study explored the effect of emotion regulation styles - integrative emotion regulation (IER), suppressive emotion regulation, and dysregulation-on adolescents' psychosocial adjustment following a Covid-19-related lockdown. 114 mother-adolescent dyads were surveyed after lockdown and at two additional time points (three and six months later). Adolescents were aged 10-16years, 50.9% females. Adolescents reported on their emotion regulation styles. Mothers and adolescents reported on adolescents' well-being (depressive symptoms, negative and positive emotions) and social behaviour (aggression and prosocial behaviour). Results of multilevel linear growth models showed IER predicted optimal well-being and social behaviour reported by both mothers and adolescents at baseline and a self-reported reduction in prosocial behaviours over time. Suppressive emotion regulation predicted reduced self-reported well-being after lockdown, evident in higher levels of negative affect and depressive symptoms and reductions in mother-reported prosocial behaviour over time. Dysregulation predicted reduced well-being and impaired social behaviour after lockdown, reported by both mothers and adolescents, and a reduction in self-reported depressive symptoms over time. Results suggest adolescents' adjustment to lockdown was affected by their habitual emotion regulation styles.

Mental toughness and osteoarthritis: Postsurgery improvement in knee pain/functionality in older adults.

To investigate longitudinally the role of mental toughness (MT) in knee rehabilitation in terms of perceived pain and functionality in a sample of older adults with arthritis who adhered to their postsurgery clinic-based rehabilitation protocols and provide suggestions to rehabilitation psychologists. To strengthen the internal validity of this study, we designed our methods and implementation in a way to minimize bias by utilizing the National Institute of Health Quality Assessment Tool for Before-After (Pre-Post) Studies With No Control Group. The data were collected from 92 older-adult patients, who had a diagnosis of osteoarthritis and underwent knee surgery. All patients were diagnosed, underwent surgery, and were evaluated by the same physician. We administered the Oxford Knee Score (OKS) to measure rehabilitation outcomes in terms of pain and functionality and the MT Index (MTI) to measure MT levels three times: 1 day before and 1 and 6 months after the surgery. We used a multilevel growth model to examine the change in the OKS across administrations using MTI scores as a time-varying covariate and sex, age at surgery, and knee as time-invariant covariates. About 62% of the variability in OKS was due to between-patient differences. Of the variability that was attributable to differences within-patient across time, MT accounted for about 38% of the variability. MT could be another, positive psychology-based tool rehabilitation psychologists use to contribute to health promotion efforts to reduce the incidence of disability of older adults with osteoarthritis who undergo knee replacement surgery. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

A Quasi-Experimental, Longitudinal Study of Grade Retention on Language Outcomes for English Language Learners

Grade retention, the practice of holding a student back in the same grade, has been a controversial topic in the United States for decades. English learners, a growing population in US schools, are consistently identified for grade retention more often than their English-only counterparts. The purpose of this study is to test the impact of grade retention on a set of language learning outcomes (reading, listening, and writing) for English language learners over a seven-year period. The data was collected in a large urban school district in the south-central region that serves predominantly Spanish speaking natives. Retained students were matched with non-retained students for a quasi-experimental control group using Propensity Score Matching (PSM) techniques. Multilevel growth models, with time (level 1) nested within students (level 2), were applied to these two groups to estimate the effect of grade retention on their longitudinal trajectory for each language learning outcome. We found that after 7 years, matched-promoted students had higher levels of English proficiency than retained peers in all three domains: listening, reading, and writing.

Effects of panic-specific cognitive behavioural and psychodynamic psychotherapies on work ability in a doubly randomised clinical trial

Objective: The effects of panic-specific psychotherapy on occupational functioning remain under-researched. This study tests whether two brief psychotherapies for Panic Disorder with or without Agoraphobia (PD/A) may generate improvement in work ability. Methods: Adults (N = 221) with a primary diagnosis of PD/A were randomised to wait-list, panic-focused psychodynamic psychotherapy (PFPP), panic control treatment (PCT), or to the choice between the two treatments. Participants completed the Work Ability Inventory (WAI) at baseline, post-treatment, and during 24-month follow-ups. Change in WAI scores were assessed using segmented multilevel linear growth models, and mediation was explored through path analysis. Results: WAI scores changed from the moderate to good range between baseline and post-treatment (SMD = 0.45; 95% CI [0.33, 0.57]) and continued to increase throughout the follow-up (SMD = 0.16; 95% CI [0.03, 0.28]) with no differences between treatments or allocation forms. In PFPP (but not in PCT) pre- to post-treatment change in WAI was mediated by reduction in panic symptoms and WAI predicted employment status and absences. Conclusions: Two brief panic specific psychotherapies, one cognitive behavioural and one psychodynamic, produced short and long-term increases in work ability.

Social and Emotional Learning and Early Literacy Skills: A Quasi-Experimental Study of RULER

RULER is a pre-K–12 systemic approach to social and emotional learning (SEL) that supports educators in cultivating emotion skills and provides them with pedagogical principles and tools to help them explicitly teach social and emotional skills to students. The current study tests whether preschool-level access to RULER was associated with growth in early literacy skills using a sample of 1051 preschoolers in 95 classrooms across 19 community-based centers in a small urban northeastern US community. The Preschool Early Literacy Indicators were collected three times over an academic year by district staff. Multi-level growth modeling with inverse probability weighting revealed that children in preschools with access to RULER grew significantly more in their early literacy skills than children without access to RULER—an end-of-year difference equivalent to 0.25 standard deviations, 95% CI [0.14, 0.40]. The current study demonstrates that RULER may promote young children’s early literacy skills.

The impact of long-term conditions on the progression of frailty.

To explore longitudinally the impact of multiple long-term conditions (LTCs) on frailty progression separately for males and females. A functional frailty measure (FFM) was used to examine putative determinants of frailty progression among participants aged 65 to 90 in the English Longitudinal Study of Ageing (ELSA), across nine waves (18 years) of data collection. A multilevel growth model was fitted to measure the FFM progression over 18 years, grouped by LTC categories (zero, one, two and more). There were 2396 male participants at wave 1, of whom 742 (31.0%) had 1 LTC and 1147 (47.9%) had ≥2 LTCs. There were 2965 females at wave 1 of whom 881 (29.7%) had one LTC and 1584 (53.4%) had ≥2 LTCs. The FFM increased 4% each 10 years for the male participants with no LTCs, while it increased 6% per decade in females. The FFM increased with the number of LTCs, for males and females. The acceleration of FMM increases for males with one long-term health condition or more; however in females the acceleration of FMM increases when they have two LTCs or more. Frailty progression accelerates in males with one LTCs and females with two LTCs or more. Health providers should be aware of planning a suitable intervention once the elderly have two or more health conditions.

Self-compassion as a mechanism of change in patients with eating disorders and childhood trauma receiving CFT-E; a study of within-person processes

Objective: This study examines the reciprocal relationship between self-compassion and eating disorder (ED) and trauma symptoms for patients receiving compassion- focused therapy for eating disorders (CFT-E). Method: A total of thirty-six patients with EDs and childhood trauma received inpatient treatment over 13 weeks. Levels of self-compassion and symptoms were assessed using repeated measures. A multilevel growth model was applied, and the effects of self-compassion and symptoms were separated into between- and within-patient effects. Results: The results show that ED symptoms did decrease significantly during treatment. Furthermore, the analyses demonstrated a reciprocal between-patient relationship between self-compassion and ED symptoms, and between self-compassion and trauma symptoms. However, regarding within-patient effects, only self-compassion predicted trauma symptoms. Discussion: The outcome of the current study demonstrates a favourable course for patients with EDs and childhood trauma receiving CFT-E in an inpatient facility. While there is a reciprocal relationship between the variables, the within-patient analyses imply the role of self-compassion in the therapy process for trauma symptoms.

A multi-level growth modeling approach to measuring learner attention with metacognitive pedagogical agents

A multi-level growth modeling approach to measuring learner attention with metacognitive pedagogical agents

The Effects of the School-Family-Community Partnerships on Students' Outcomes

이 연구의 목적은 학교 주체의 협력 활동이 학생의 인지적, 정의적 성취 변화에 어떤 교육적 효과를 갖는지 분석하는 것이다. 나아가 학교의 사회자본이 학생의 인지적, 정의적 성취 격차에 미치는 가정배경의 영향을 완화시키는 효과가 있는지를 확인하였다. 이를 위해 경기교육종단연구(Gyeonggi Education Panel Study)의 4차년도(2015년)~6차년도(2017년)자료를 활용하여 3-수준 다층 성장모형(Multilevel Growth Model)으로 분석하였다. 분석결과, 학부모 참여와 지역사회 연계 활동이 중학교 1학년의 인지적, 정의적 성취에 정적으로 영향을 주는 것으로 나타났다. 학부모의 참여가 높은 학교일수록 학업성취 수준이 높았으며, 학교가 지역사회와 밀접히 연계하여 학교 교육과정을 운영하는 학교일수록 학생들의 자기효능감이 더 높은 것으로 나타났다. 하지만, 학교 내 교사 간 협력은 학생의 인지적, 정의적 성취에 유의미한 효과를 갖지 않는 것으로 나타났다. 특히, 지역사회와 유기적으로 협력하면서 교육과정을 운영하는 학교는 학년이 올라감에 따라 변화되는 학업성취의 수준을 더 높여주는 효과가 있었고, 자기효능감의 감소폭을 완화해주는 효과가 있는 것으로 나타났다. 그러나, 학교 주체의 협력 활동은 가정배경이 학생의 인지적, 정의적 성취에 미치는 영향을 감소시킬 만큼 효과가 크지는 않았다. 이러한 결과를 토대로 학생의 인지적, 정의적 성장을 위한 교육 주체의 교육과정 참여 및 가정배경에 따른 교육격차를 감소하기 위한 방안에 대해 논하였다.This study examined how the School-Family-Community Partnerships affect changes in students' cognitive and non-cognitive outcomes. It also investigated whether increasing social capital in schools reduced educational gaps due to family background. The three-level growth curve model was applied using the 4th through 6th Gyeonggi Education Panel (2015−2017). The results showed that parental involvement and community engagement had significant effects on cognitive and non-cognitive outcomes of first grade middle school students. Schools with a higher degree of parental involvement tended to have higher academic achievement. Students in schools with a close connection to their communities in curriculum implementation were likely to have a higher level of self-efficacy than their counterparts. In particular, the connection with the local community had a significant positive effect on students’ growth. Students in schools with a close connection to their communities were also likely to improve academic achievement and inhibit self-efficacy deterioration compared to those in schools with a poor connection. However, such cooperation did not lead to a reduction in the educational gap due to family background. In addition, the cooperation of teachers had no significant effect on students' outcomes, either. The concluding section discusses how to improve school−family−community partnerships in the implementation of school curriculum and how to reduce the educational gap caused by family background.

Trends in Young Adult Alcohol and Cannabis Use Through the First 1.5 Years of the COVID-19 Pandemic From a Community Cohort Sample.

There has been concern regarding increased substance use during the COVID-19 pandemic, particularly among young adults, but much of this concern stemmed from cross-sectional or short-term data collected early in the pandemic. This study followed a young adult community cohort throughout the first 1.5 years of the pandemic to examine longer-term trends/trajectories in alcohol and cannabis use behaviors. Beginning before the COVID-19 pandemic (January 2020), 656 young adults completed up to eight surveys on substance use and other behaviors, which extended through August 2021. Multilevel spline growth models estimated changes in alcohol/cannabis use in three segments: (a) from pre-pandemic to April 2020, (b) from April 2020 to September/October 2020, and (c) from September/October 2020 to July/August 2021. Abstainers were removed from the analyses, yielding subsamples for alcohol models (n = 545; M age = 25.6 years; 59.8% female) and cannabis models (n = 303; M age = 25.6; 61.4% female). Drinking frequency initially increased (3% per month), decreased in the second segment (4% per month), and plateaued in the final segment. Drinking quantity significantly decreased in all three segments: 4% per month in segment one, 3% per month in segment two, and 1% per month in the final segment. Cannabis frequency and quantity showed no significant changes across the first two segments, then significantly decreased in the final segment (3% and 6% per month, respectively). The significant changes for cannabis frequency/quantity were moderated by age, such that older participants had steeper decreases in the final segment. Findings highlight that young adult alcohol and cannabis use generally declined across the first 1.5 years of the COVID-19 pandemic, contrary to widespread concerns.

Longitudinal association between executive function and academic achievement in children with neurofibromatosis type 1 and plexiform neurofibromas.

To examine how executive functioning (EF) relates to academic achievement longitudinally in children with neurofibromatosis type 1 (NF1) and plexiform neurofibromas (PNs) and whether age at baseline moderates this relationship. Participants included 88 children with NF1 and PNs (ages 6-18 years old, M = 12.05, SD = 3.62, 50 males) enrolled in a natural history study. Neuropsychological assessments were administered three times over 6 years. EF (working memory, inhibitory control, cognitive flexibility, and attention) was assessed by performance-based (PB) and parent-reported (PR) measures. Multilevel growth modeling was used to examine how EF at baseline related to initial levels and changes in broad math, reading, and writing across time, controlling for demographic variables. The relationship between EF and academic achievement varied across EF and academic domains. Cognitive flexibility (PB) uniquely explained more variances in initial math, reading, and writing scores; working memory (PB) uniquely explained more variances in initial levels of reading and writing. The associations between EF and academic achievement tended to remain consistent across age groups with one exception: Lower initial levels of inhibitory control (PR) were related to a greater decline in reading scores. This pattern was more evident among younger (versus older) children. Findings emphasize the heterogeneous nature of academic development in NF1 and that EF skills could help explain the within-group variability in this population. Routine cognitive/academic monitoring via comprehensive assessments and early targeted treatments consisting of medication and/or systematic cognitive interventions are important to evaluate for improving academic performance in children with NF1 and PNs.

Ethnic-Racial Identity Developmental Trajectories Across the Transition to College.

There is limited longitudinal research examining multiple ethnic-racial identity (ERI) components from adolescence into young adulthood. The current study modeled Latino adolescents' ERI trajectories across the college transition (N = 206; Mage = 18.10 years, SD = 0.41; 65.0% female). Longitudinal data from a survey administered on five occasions across 3 years were analyzed using multilevel growth modeling. Prior to college, Latino heritage culture orientation was positively associated with ERI exploration and resolution. ERI exploration increased over time. ERI resolution was high with no average change; Latino heritage culture orientation predicted variability in resolution over time. Before college, male-identifying youth reported higher ERI public regard from teachers/professors compared to female-identifying youth. Public regard increased to a greater extent for female compared to male adolescents. The findings join evidence for lifespan and intersectional models of ERI development.

A Prospective Evaluation of the Effects of the COVID-19 Pandemic on Youth with Primary Headache Disorders

Alterations in certain academic and social/family routines during the COVID-19 pandemic have been speculated to be either a risk factor or buffer for poor health outcomes for youth with stress-sensitive health conditions such as primary headache disorders. The current study evaluated patterns and moderators of pandemic impacts on youth with primary headache disorders, with an aim of extending our understanding of the relationship between stress, resilience, and outcomes in this population. Children recruited from a headache clinic in the midwestern United States reported on their headaches, schooling, routines, psychological stress, and coping at four timepoints ranging from within a few months of the pandemic onset to a long-term follow-up 2 years later. Changes in headache characteristics over time were analyzed for association with demographics, school status, altered routines, and stress, and coping. At baseline, 41% and 58% of participants reported no change in headache frequency or intensity, respectively, relative to pre-pandemic levels, with the remainder almost equally divided between reporting an improvement or worsening. The results of multilevel growth model analyses indicated that headache intensity remained more elevated over time since the start of the pandemic for respondents whose stress scores were relatively higher (b = 0.18, t = -2.70, p = 0.01), and headache-related disability remained more elevated over time for older respondents (b = 0.01, t = -2.12, p = 0.03). The study results suggest, overall, that the outcomes of primary headache disorders in youth were not systematically altered by the COVID-19 pandemic.

The Australian and New Zealand brain injury lifespan cohort protocol: Leveraging common data elements to characterise longitudinal outcome and recovery

IntroductionCognitive, behavioural, academic, mental health and social impairments are common following paediatric traumatic brain injury (TBI). However, studies are often reliant on small samples of children drawn from narrow age...

Childhood Bullying Victimization, Substance Use and Criminal Activity among Adolescents: A Multilevel Growth Model Study

This study aims to examine the effects of childhood bullying victimization (CBV) on substance use and criminal activity among adolescents over time. In addition, it identifies the moderating effects of gender and race/ethnicity on the associations of CBV with substance abuse and criminal activity in adolescence and young adulthood. This study included 8984 adolescents aged 12 to 18 years (Mage = 14.22 years) assessed biennially at four time points utilizing the National Longitudinal Survey of Youth 1997. The two-level hierarchical linear modeling was employed to test the effects of CBV on substance use and criminal activity. The incidence of substance use increased over time throughout adolescence to young adulthood, while that of criminal activity decreased. CBV increased the risks of cigarette use, marijuana use, and criminal activity. Gender and race/ethnicity significantly moderated the effect of CBV on alcohol use and alcohol binges. The effect of CBV on alcohol use was stronger among females than males. Among Hispanic adolescents, CBV was more strongly related to alcohol use and binges compared to non-Hispanic White. Findings suggest the need for early intervention for children at high risk of being bullied to reduce later substance abuse and involvement in criminal activities. Considering the moderating effects of gender and ethnicity on the associations, target-specified intervention and prevention programs are also required. Further studies focusing on the lifelong effects of CBV beyond adolescence are recommended.

LONGITUDINAL ASSOCIATIONS OF SOCIAL CONNECTEDNESS, SOCIAL CONTRIBUTION, SOCIAL ENGAGEMENT, AND LATE-LIFE DRUG USE

Abstract Substance misuse among older adults is a growing and complex problem with implications for society, aging adults, and their families. It is understudied in research and clinical practice. Limited and mixed evidence exists that suggests relationships between changes in older adults’ social environment and their drug use over time. This study addressed this gap by examining potential associations between social environment and drug use among community-dwelling older adults. Data were drawn from 3-waves of the national longitudinal survey of Midlife Development in the United States (MIDUS) (N= 2,020; age range=55-94 years; Mean=63.10, SD=5.66 at Wave 1). We estimated multilevel logistic growth models to assess the relationships between social environment indicators (social connectedness, social contribution, social engagement) and drug use, controlling for age, marital status, race/ethnicity, education level, household income, employment status, and number of chronic conditions. Our findings showed significant odds of drug use over the 20-year period of study, which were increased among older adults with multiple chronic conditions with a 59.5% risk of drug-related problems. Social contribution (feelings of being valued by society) negatively predicted older adults’ drug use whereas social connectedness and social engagement were not significant predictors over time. The models also indicated a moderating effect of social contribution on drug use, showing low changes in drug use over time with low social contribution. Our findings illuminate the differential roles of social environment indicators in drug use. Future research, policy, and practice may particularly focus on the role of social contribution in late-life drug use.

Gut microbe‐modulated metabolites are longitudinally associated with higher neurodegeneration biomarkers in cerebrospinal fluid (CSF)

AbstractBackgroundGut bacterial metabolites in circulation and postmortem brain tissue differ in abundance between cognitively unimpaired (CU) and Alzheimer’s disease (AD) individuals. Furthermore, in mice chronic injection of bacterial components exacerbates AD pathology. In CSF, we found the microbially‐produced trimethylamine‐N‐oxide was linked to AD and neurodegeneration biomarkers. However, the broader extent to which microbe‐modulated metabolites relate to AD and neurodegeneration is unknown. We tested the hypothesis that in CSF of non‐demented adults, elevated metabolites would longitudinally associate with higher biomarkers.MethodCSF was collected biannually in the Wisconsin Alzheimer’s Disease Research Center and Wisconsin Registry for Alzheimer’s Prevention studies. Biomarkers of pTau181, Aβ42, tTau, axonal (NfL) and synaptic (neurogranin, α‐synuclein) degeneration were quantified using Elecsys assays (NeuroToolKit robust prototype, Roche Diagnostics). Metabolite relative abundances were quantified via untargeted metabolomics analysis (ultrahigh performance liquid chromatography‐tandem mass spectrometry, Metabolon). A priori literature and database review identified 76 detected microbe‐modulated metabolites. 200 CU participants with two or more analyzed CSF samples were included in statistical analysis (Table 1). For each metabolite‐biomarker pair, multilevel linear growth modeling tested person‐level mean metabolite effects on biomarker slope and intercept, and time‐varying metabolite effects on biomarker intercept (Figure 1). Covariates included age, sex, and APOE risk score; Benjamini‐Hochberg corrections adjusted for Type I error inflation.ResultSeven metabolites were positively associated with biomarker slope or intercept (Table 2). Mean gluconate, glycerate, and oxalate levels were correlated with increased tTau slope, and N‐acetylaspartate, N‐acetylglutamate and cholesterol were correlated with higher a‐synuclein or neurogranin intercepts. Phenol sulfate was linked to tTau and α‐synuclein trajectories. To our knowledge, this is the first study detecting phenol sulfate in human CSF. No metabolites significantly associated with NfL or pTau181/Aβ42.ConclusionIn CSF, participants with higher mean levels of bacteria‐utilized metabolites exhibited accelerated neurodegeneration (tTau). Gluconate is metabolized by Bifidobacterium and Lactobacillus, two genera reduced in AD. Furthermore, the microbially‐produced phenol sulfate predicted greater tTau development and synaptic degeneration. Uremic toxins related to phenol sulfate dysregulate endothelial barriers in the central nervous system and vascular tissues. Additional studies should evaluate microbial metabolites as mediators of gut microbiome‐neurodegeneration relationships, and should determine if they represent modifiable pathways.