Brain Resilience
A long-term study, not a clinic visit
The Alzheimer's Resilience Core is a University of Washington longitudinal research lab that follows the same group of people over many years to understand what protects thinking and memory as we age. It is not a treatment clinic and it does not replace your regular doctor. It is a partnership between participants and researchers, built to answer questions that take time to answer.
850
participants to be enrolled over 5 years
45%
of dementia risk is potentially modifiable
220+
brain-health proteins measured from one blood draw
6
pillars of brain health studied in every participant
The Question
What makes some brains resilient to Alzheimer's disease?
Close to half of dementia risk is shaped by factors we can potentially change, spread across the whole of life rather than concentrated in old age. Yet the biology behind that protection is still poorly understood. Some people carry the hallmarks of Alzheimer's disease in their brains and never develop the symptoms. Understanding why is the question the Alzheimer's Resilience Core exists to answer.
The 45% figure comes from the 2024 report of the Lancet standing Commission on dementia prevention, intervention, and care, which identifies 14 modifiable risk factors across the life course.
Methods
How we study resilience
Four complementary lines of work, all built around the same group of long-term participants.
The ARC Cohort
The deeply measured cohort at the center of the lab: adults 45 and older, invited from a study registry that is open from age 30, and recruited to reflect the racial, ethnic, geographic, and socioeconomic diversity of the communities most affected by dementia. Participants span the full continuum from cognitively unimpaired to mild cognitive impairment, followed over time rather than studied once.
Deep Phenotyping
Standardized cognitive testing paired with validated lifestyle assessments across the Six Pillars of Brain Health: physical activity, nutrition, sleep, cognitive engagement, social connection, and stress management. A subset of participants also wear devices that capture activity and sleep between visits.
Blood-Based Biomarkers
A single small plasma sample is screened across 220+ proteins tied to amyloid and tau pathology, neurodegeneration, neuroinflammation, and TDP-43. It is one of the most comprehensive blood-based windows into brain aging available today.
Genetics of Resilience
By comparing genetic variants in autopsy-confirmed cases of resilience to those in living participants at high and low resilience, we're narrowing in on the specific genes that may help protect the brain against Alzheimer's pathology.
Our Approach
Many kinds of data, one picture of brain health
No single test captures how a brain is aging. We collect four kinds of data on the same participants, year after year, and study them together rather than one at a time.
Demographics & Social Determinants
Genetics
Blood Biomarkers
Lifestyle (Six Pillars)
Measurement tools in development. Combining these domains is how we are working toward tools that can estimate an individual participant's risk for disease precisely, rather than relying on population averages.
Results return to participants. Our commitment is personalized, actionable feedback about their own brain health, giving people a reason to stay engaged and to act on what the research finds.
Resources
Infrastructure built to last
It's about more than a single visit. Thinking long-term means building resources that can answer questions about lifelong brain health.
Digital Ecosystem
A web and mobile platform, built with plain-language accessible design, serves as the primary point of entry for participants and the backbone for collecting data over years rather than at a single visit.
Biorepository
Blood samples are stored long-term, so that as new assays and technologies emerge, they can be applied retrospectively to specimens collected today, extending the value of every participant's contribution.
ADRC Integration
Participants are co-enrolled with the UW Alzheimer's Disease Research Center, linking the Resilience Cohort to a full suite of clinical, imaging, and biological phenotyping and to long-term NIH funding sustainability.
Community Partnerships
Dedicated outreach coordinators and sustained community events build trusted, lasting relationships in the communities that have historically been underrepresented in dementia research.