Our cohort mean age is 69 years (range=41-93; 56% female) and represents Houston’s diversity (65% Non-Hispanic White; 31% Hispanic/Latino; 8% African American; 4% Asian). Clinical consensus diagnoses included normal cognition (40%), mild cognitive impairment (40%), AD (17%), or other dementias (3%). Among 167 subjects with completed genomes, 3 had high-penetrance alleles (PSEN1, SORL1, ABCA7), 47% carried APOE-e4, and 4 had secondary findings (LPL, MSH6, PMS2, TSC2). Among participants with AD or MCI, we observed a striking divergence in biomarkers for AD pathophysiology within subgroups recruited from the clinic (75%) versus community (33%) settings. We identified 11 individuals with normal cognition and positive AD biomarkers. To date, 137 participants have received their study results. Based on 2-month post-disclosure surveys, we have not detected evidence of increased participant worry, and 75% reported making behavioral changes to improve brain health, including increased mentally stimulating activities, exercise, and/or dietary modifications.

Overall, these results establish feasibility for our precision neurology workflow and are suggestive of more heterogeneous etiologies for dementia among individuals recruited from the community setting.