Large-scale datasets enable novel strategies to refine and discover relations among biomarkers of disease. Here 30,863 individuals ages 44-82 from the UK Biobank were analyzed to explore MRI biomarkers associated with Alzheimer's disease (AD) genetic risk as contrast to general effects of aging. Individuals homozygotic for the E4 variant of apolipoprotein E (APOE4) overlapped non-carriers in their 50s but demonstrated neurodegenerative effects on the hippocampal system beginning in the seventh decade (reduced hippocampal volume, entorhinal thickness, and hippocampal cingulum integrity). Phenome-wide exploration further nominated the posterior thalamic radiation (PTR) as having a strong effect, as well as multiple diffusion MRI (dMRI) and white matter measures consistent with vascular dysfunction. Effects on the hippocampal system and white matter could be dissociated in the homozygotic APOE4 carriers supporting separation between AD and cerebral amyloid angiopathy (CAA) patterns. These results suggest new ways to combine and interrogate measures of neurodegeneration.
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