Fractal regulation and incident Alzheimer's disease in elderly individuals

Peng Li, Lei Yu, Andrew S.P. Lim, Aron S. Buchman, Frank A.J.L. Scheer, Steven A. Shea, Julie A. Schneider, David A. Bennett, Kun Hu

Research output: Contribution to journalArticlepeer-review

33 Scopus citations


Introduction: Healthy physiological systems exhibit fractal regulation (FR), generating similar fluctuation patterns in physiological outputs across different time scales. FR in motor activity is degraded in dementia, and the degradation correlates to cognitive decline. We tested whether degraded FR predicts Alzheimer's dementia. Methods: FR in motor activity was assessed in 1097 nondemented older adults at baseline. Cognition was assessed annually for up to 11 years. Results: Participants with an FR metric at the 10th percentile in this cohort had a 1.8-fold Alzheimer's disease risk (equivalent to the effect of being ∼5.2 years older) and 1.3-fold risk for mild cognitive impairment (equivalent to the effect of being ∼3.0 years older) than those at the 90th percentile. Consistently, degraded FR predicted faster cognitive decline. These associations were independent of physical activity, sleep fragmentation, and stability of daily activity rhythms. Discussion: FR may be a useful tool for predicting Alzheimer's dementia.

Original languageEnglish (US)
Pages (from-to)1114-1125
Number of pages12
JournalAlzheimer's and Dementia
Issue number9
StatePublished - Sep 2018


  • Fractal physiology
  • Fractal regulation
  • Longitudinal cohort study
  • Mild cognitive impairment
  • Prediction of Alzheimer's disease

ASJC Scopus subject areas

  • Epidemiology
  • Health Policy
  • Developmental Neuroscience
  • Clinical Neurology
  • Geriatrics and Gerontology
  • Cellular and Molecular Neuroscience
  • Psychiatry and Mental health


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