Epidemiology of cardiometabolic and cognitive aging – Ida Karlsson's research group

Our group investigates how long-term genetic, biological, and lifestyle factors shape risk and resilience to age-related diseases, with a particular focus on dementia and cardiometabolic aging.

Our research

Our research focuses on understanding why individuals age differently, with particular emphasis on cardiometabolic health and cognitive aging. One line of work examines heterogeneity in obesity, distinguishing genetically versus environmentally driven adiposity, the role of metabolic health, and age-specific changes. A parallel line studies life course risk factors for dementia and leverages recent advances in blood-based biomarkers to characterize preclinical trajectories and study causal risk factors and resilience. 

The heterogeneity of obesity and cardiometabolic aging

Cardiometabolic risk factors such as obesity, dyslipidemia, and hypertension are strongly linked to morbidity and mortality in later life, yet their consequences vary widely between individuals. Our research examines obesity and cardiometabolic health as heterogeneous and dynamic processes rather than static risk states. We study how genetic predisposition, lifestyle, metabolic profiles, sex, and life stage influence associations between obesity and risk of e.g. cardiovascular disease, type 2 diabetes, dementia, and survival. By integrating longitudinal cohort data with genetically informed designs, we aim to disentangle causal effects from reverse causation and confounding, refine risk assessment beyond BMI, and inform more individualized and less stigmatizing approaches to cardiometabolic prevention in aging populations.

Life‑course pathways to dementia and brain aging

Dementia develops over decades, with a long preclinical phase during which pathological brain changes accumulate silently. Our research investigates how life-course exposures, cardiometabolic factors, and genetic susceptibility shape trajectories toward cognitive decline and dementia, as well as why some individuals remain cognitively resilient despite substantial pathology. We combine longitudinal twin studies, population-based cohorts, and blood-based biomarkers of neurodegeneration and Alzheimer’s disease, together with multi-omics data, to study early disease mechanisms and strengthen causal inference. A major focus is the use of new blood‑based biomarkers to identify biological pathways linking modifiable risk factors to neurodegenerative and vascular processes, and to develop interpretable prediction models that improve early identification and stratification of dementia risk in the general population.

This theme also includes work within the Interplay of Genes and Environment across Multiple Studies (IGEMS) consortium, a collaboration involving over fifteen longitudinal twin studies of adult development and aging. Ongoing projects in IGEMS include work to strengthen or refute causal hypotheses and test gene-environment interplay among modifiable factors for dementia risk and resilience, and how country, cohort, and gender disparities influence the relationship between education and dementia.

SATSA – The Swedish Adoption/Twin Study of Aging

Our work includes The Swedish Adoption/Twin Study of Aging(SATSA); PI Ida Karlsson & Sara Hägg), a unique cohort of twin pairs with almost 30 years of follow-up. The rich data includes a broad spectrum of biological, psychological, and social domains, collected in up to 9 waves of questionnaires and 10 waves of in-person testing. The longitudinal follow-up provides opportunities for detailed examinations of individual differences in age-related health, and the twin design provides possibilities to examine the importance of genetic and environmental influences and a quasi-causal setting to compare disease-discordant twin pairs.

Publications

Selected publications

All publications from group members

  • Article: MEDICINE & SCIENCE IN SPORTS & EXERCISE. 2026;58(9):1914-1926
    Herranen P; Palviainen T; Nygaard M; Karlsson IK; Thalamuthu A; Mather KA; Reynolds CA; Panizzon MS; Rantanen T; Finkel D; Gatz M; Pedersen NL; Kaprio J; Sillanpaa E
  • Article: DIABETES OBESITY & METABOLISM. 2026;28(9):8418-8427
    Obeso Fernandez A; Eriksson A; Drouard G; Jelenkovic A; Aaltonen S; Ollikainen M; Spector T; Mangino M; Christensen K; Skytthe A; Kyvik KO; Medda E; Fagnani C; Corley RP; Huibregtse BM; Toccaceli V; Rasmussen FE; Tynelius P; Medland SE; Gordon SD; Duncan GE; Buchwald D; Magnusson PKE; Karlsson IK; Dahl Aslan AK; Bartels M; Ligthart L; de Geus EJC; Gatz M; Butler DA; Pyun H; Kim J; Lee SJ; Sung J; Bruins S; Pool R; Martin NG; Boomsma DI; Kaprio J; Silventoinen K
  • Journal article: BLOOD PRESSURE. 2026;:1-15
    Yang Z-K; Martens DS; An D-W; Shi H-Z; Wang Y-C; Yu Y-L; Zhang D-Y; Wojciechowska W; Rajzer M; Stolarz-Skrzypek K; Yang W-Y; Li Y; Janssens S; Verhamme P; Nawrot TS; Staessen JA
  • Preprint: MEDRXIV. 2026
    Ler P; Matta K; Stein MJ; Peruchet-Noray L; Wu D; Gan Q; Beigrezaei S; Lill CM; Masala G; Ricceri F; van der Schouw YT; Verschuren WMM; Vineis P; Zabala AMJ; Zamora-Ros R; Tong TY; Papier K; Gunter MJ; Viallon V; Ferrari P; Kim J; Freisling H
  • Preprint: RESEARCH SQUARE. 2026
    Näsholm MS; Karatas EG; Wang Y; Padilla P; Bereczki E; Aknes M; Bednorz A; Gong J; Ferreira D; Habich A; Ištvánfyová ZW; Kujawska-Danecka H; Lorenzon G; Mangialasche F; Marseglia A; Nalvarte I; Oltra J; Qiu C; Religa D; Xiong Y; Peltonen M; Mitra S; Kivipelto M; Maioli S; Sindi S
  • Article: INTERNATIONAL JOURNAL OF OBESITY. 2026;50(8):1828-1837
    Obeso A; Drouard G; Jelenkovic A; Medda E; Fagnani C; Toccaceli V; Latvala A; Aaltonen S; Medland SE; Gordon SD; Lee J; Lee SJ; Sung J; Pyun H; Duncan GE; Buchwald D; Ordonana JR; Sanchez-Romera JF; Carrillo E; Franz CE; Kremen WS; Corley RP; Huibregtse BM; Magnusson PKE; Karlsson IK; Aslan AKD; Lyons MJ; Bartels M; Ligthart L; de Geus EJC; Gatz M; Butler DA; Pool R; Eriksson A; Bruins S; Martin NG; Boomsma DI; Kaprio J; Silventoinen K
  • Journal article: JOURNAL OF GLOBAL AGEING. 2026;3(2):195-208
    Finkel D; Ericsson M; Karlsson I; Tomlinson S; Sindi S; Ahlskog R; Van Tongeren M; Russ TC
  • Journal article: CARDIOVASCULAR DIABETOLOGY. 2026;25(1):185
    Stein MJ; Viallon V; Leitzmann MF; Gunter MJ; Smith-Byrne K; Ler P; Ricceri F; Masala G; Beigrezaei S; Koop Y; Zamora-Ros R; Jimenez-Zabala A; Lill CM; Riboli E; Ferrari P; Freisling H
  • Journal article: BMC MEDICINE. 2026;24(1):366
    Nakash M; Ojalehto Lindfors E; Zhan Y; Dahl Aslan AK; Reynolds CA; Ler P; Karlsson IK
  • Article: SSM-POPULATION HEALTH. 2026;34:101914
    Finch BK; Nimmagadda S; Finkel D; Gatz M; Reynolds CA; Nygaard M; Catts V; Thalamuthu A; Sachdev P; Ericsson M; Karlsson I; Thorvaldsson V; Hassing L
  • Journal article: NATURE GENETICS. 2026;58(6):1214-1225
    Bellenguez C; Amin N; van der Lee SJ; Muntaner M; Parveen K; Kucukali F; Heikkinen S; de Rojas I; Dalmasso MC; Kleineidam L; Peters O; Schneider A; Dichgans M; Rujescu D; Scherbaum N; Deckert J; Riedel-Heller S; Hausner L; Molina-Porcel L; Duzel E; Grimmer T; Wiltfang J; Heilmann-Heimbach S; Moebus S; Schmid M; Tegos T; Scarmeas N; Pastor P; Sanchez-Valle R; Alvarez V; Garcia-Gonzalez P; Real LM; Rodriguez-Rodriguez E; Soininen H; de Mendonca A; Mehrabian S; Hort J; Vyhnalek M; Sandau N; Luo J; Thomassen JQ; Pijnenburg YAL; van der Flier W; Seelaar H; Ramakers I; Papma J; Hulsman M; Biessels G-J; Graff C; Thonberg H; Ullgren A; Papenberg G; Giedraitis V; Lowenmark M; Kilander L; Williams J; Le Borgne J; Palmal S; Nicolas A; Amouyel P; Boland A; Deleuze J-F; Nicolas G; Dufouil C; Pasquier F; Hanon O; Debette S; Grunblatt E; Popp J; Galimberti D; Arosio B; Mecocci P; Solfrizzi V; Parnetti L; Squassina A; Tremolizzo L; Borroni B; Wagner M; Nacmias B; Spallazzi M; Seripa D; Rainero I; Daniele A; Bossu P; Masullo C; Rossi G; Jessen F; Holstege H; Mather K; van Duijn C; Frikke-Schmidt R; Ghidoni R; Sanchez-Juan P; Sleegers K; Ingelsson M; Hiltunen M; Sims R; Andreassen O; Ramirez A; Lambert J-C; Naj AC; Rajabli F; Benchek P; Shade LMP; Qiao Q; Kushch N; Sha J; Bazemore K; Zhu C; Lee W-P; Haut J; Hamilton-Nelson KL; Wheeler NR; Zhao Y; Farrell JJ; Grunin MA; Leung YY; Kuksa PP; Li D; da Fonseca EL; Mez JB; Palmer EL; Pillai J; Sherva RM; Song YE; Zhang X; Ikeuchi T; Iqbal T; Valladares O; Reyes-Dumeyer D; Kuzma AB; Abner E; Adams LD; Aguirre A; Albert MS; Albin RL; Allen M; Apostolova LG; Arnold SE; Asthana S; Atwood CS; Auerbach S; Baldwin CT; Barber RC; Barnes LL; Barral S; Beach TG; Becker JT; Beecham GW; Beekly D; Bennett DA; Bertelson J; Bird TD; Blacker D; Boeve BF; Bowen JD; Boxer A; Brewer J; Burns JM; Buxbaum JD; Cairns NJ; Cantwell LB; Cao C; Carlson CS; Carlsson CM; Carney RM; Carrasquillo MM; Chesselet M-F; Chin NA; Chui HC; Chung J; Claas SA; Craft S; Crane PK; Cribbs DH; Crocco EA; Cruchaga C; Cuccaro ML; Cullum M; Darby E; Davis B; De Jager PL; DeCarli C; DeToledo J; Dick M; Dickson DW; Dombroski BA; Doody RS; Duara R; Dumitrescu LC; Ertekin-Taner N; Evans DA; Faber KM; Fairchild TJ; Fallon KB; Farlow MR; Fernandez-Hernandez V; Friedland RP; Foroud TM; Frosch MP; Fulton-Howard B; Galasko DR; Gearing M; Geschwind DH; Ghetti B; Gilbert JR; Go RCP; Goate AM; Grabowski TJ; Graff-Radford NR; Gray NE; Growdon JH; Hakonarson H; Hall J; Hamilton RL; Harari O; Hardy J; Head E; Henderson VW; Hernandez M; Hohman TJ; Honig LS; Huebinger RM; Huentelman MJ; Hyman BT; Hynan LS; Ibanez L; Jarvik GP; Jayadev S; Jin L-W; Johnson K; Johnson L; Kamboh MI; Katsumata Y; Katz MJ; Kauwe JS; Kaye JA; Keene CD; Khaleeq A; Kikuchi M; Knebl J; Kowall NW; Kramer JH; Kukull WA; LaFerla FM; Lah JJ; Larson EB; Lerner A; Leverenz JB; Levey AI; Lieberman AP; Lipton RB; Logue M; Lopez OL; Lunetta KL; Lyketsos CG; Mains D; Marson DC; Martin ERR; Martiniuk F; Mash DC; Masliah E; Massman P; Masurkar A; McCormick WC; McCurry SM; Mckee AC; Mesulam M; Miller BL; Miller CA; Miller JW; Montine TJ; Monuki ES; Morris JC; Mukherjee S; Myers AJ; Trung N; Obisesan T; O'Bryant S; Olichney JM; Palmer R; Parisi JE; Paulson HL; Pavlik V; Paydarfar D; Perez V; Peskind E; Petersen RC; Petrovitch H; Polk M; Poon WW; Potter H; Qu L; Quiceno M; Quinn JF; Raj A; Raskind M; Reiman EM; Reisberg B; Reisch JS; Ringman JM; Roberson ED; Rodriguear M; Rogaeva E; Rosen HJ; Rosenberg RN; Royall DR; Sabbagh M; Sadovnick AD; Sager MA; Sano M; Saykin AJ; Schneider JA; Schneider LS; Seeley WW; Slifer SH; Small S; Smith AG; Sonnen JA; St George-Hyslop P; Starks TD; Stern RA; Stevens AB; Strittmatter SM; Sultzer D; Swerdlow RH; Tanzi RE; Tilson JL; Troncoso JC; Tsolaki M; Tsuang DW; Van Deerlin VM; Van Eldik LJ; Vance JM; Vardarajan BN; Vassar R; Vinters HV; Vonsattel J-P; Weintraub S; Welsh-Bohmer KA; Whitehead PL; Wijsman EM; Wilhelmsen KC; Williams B; Williamson J; Wilms H; Wingo TS; Wisniewski T; Woltjer RL; Wright CB; Wu C-K; Younkin SG; Yu C-E; Yu L; Zhu X; Kunkle BW; Bush WS; Miyashita A; Tosto G; Jun GR; Reitz C; Byrd GS; Fardo DW; Wang L-S; Farrer LA; Haines JL; Mayeux R; Pericak-Vance MA; Schellenberg GD; Fongang B; Yaqub A; Sargurupremraj M; Jian X; Mishra A; Bis JC; Gireud-Goss M; Himali JJ; Zare H; Guonason V; Launer L; Bressler J; Grabe HJ; Ikram MA; Psaty BM; Longstreth WT; Sigurdsson S; Ghanbari M; Wolters FJ; Boerwinkle E; Beiser AS; Sarnowski C; Mosley TH; Lopez OL; van Duijn C; Satizabal C; Ikram MK; Qiong Y; Dufouil C; Debette S; Fornage M; Seshadri S; Mahoney R; Denning N; Meggy A; Marshall R; LeRoux D; Bresner C; Escott-Price V; Morgan K; Brookes K; Guetta-Baranes T; Holmes C; Windle G; Burholt V; Green E; Macleod C; Woods B; Mead S; Schott JM; Fox N; Love S; Sims R; Williams J; Montrreal L; Marquie M; Cano A; Valero S; Sotolongo-Grau O; Perez-Cordon A; Espinosa A; Sanabria A; Ortega G; Rosende-Roca M; Alegret M; Tarraga L; Saez ME; Quintela I; Carracedo A; Real LM; Macias J; Corma-Gomez A; Pineda JA; Mendoza S; Royo JL; Garcia-Ribas G; Garcia-Madrona S; Franco-Macias E; Buiza-Rueda D; Sanchez-Arjona MB; Vilas RH; Pastor AA; Pastor P; Diez-Fairen M; Alvarez I; Rodriguez-Rodriguez E; Lage C; Alcolea D; Fortea J; Lleo A; Frank-Garcia A; Montes AM; Sanchez-Valle R; Antonell A; Molina-Porcel L; Menendez-Gonzalez M; de Munain AL; Medina M; Sanchez-Juan P; Calero M; Rabano A; Pastor AB; del Ser T; Sanchez-Garcia F; Munoz-Fernandez C; Deniz-Naranjo MC; Ruiz A; Posthuma D; Andreassen OA; Wightman DP; Uffelmann E; Stefansson H; Walters GB; Stefansson K; Snaedal J; Eyjolfsdottir H; Pedersen NL; Reynolds CA; Karlsson IK; Hagg S; Zettergren A; Skoog I; Kern S; Waern M; Blennow K; Zetterberg H; Moreno E; Moksnes MR; Hveem K; Winsvold BS; Brumpton B; Selbaek G; Fladby T; Aarsland D; Djurovic S; Rongve A; Bahrami S; Shadrin AA; Saltvedt I; Brathen G; Morales AC; Grenier-Boley B; Dols-Icardo O; Moreno F; Perez-Tur J; Kehoe PG; Bullido MJ; Boada M; Puerta R; Mir P; Pinol-Ripoll G; Garcia-Alberca JM; Holmans P; Victoria Fernandez M
  • Review: CARDIOVASCULAR RESEARCH. 2026;122(7):835-857
    Rajzer M; Wojciechowska W; Januszewicz A; Yu Y-L; Wang J-G; Hahad O; Daiber A; Spitschan M; van de Borne P; Jelaković B; Jelaković A; An D-W; Ye X-F; Jakubiak GK; Burnier M; Persu A; Weber T; Guzik TJ; Kreutz R; Münzel T; Staessen JA
  • Article: ALZHEIMERS RESEARCH & THERAPY. 2026;18(1):76
    Mostafaei S; Shemer DW; Mak JKL; Karlsson IK; Hagg S
  • Article: HYPERTENSION. 2026;83(3):e25442
    Cheng Y-B; An D-W; Zhang D-Y; Yu Y-L; Melgarejo JD; Boggia J; Martens DS; Hansen TW; Asayama K; Ohkubo T; Stolarz-Skrzypek K; Huang Q-F; Malyutina S; Casiglia E; Lind L; Maestre GE; Wang J-G; Kikuya M; Kawecka-Jaszcz K; Dolan E; Sandoya E; Rajzer M; Nawrot TS; Narkiewicz K; Yang W-Y; Verhamme P; Filipovsky J; Graciani A; Banegas JR; Li Y; Staessen JA
  • Article: BEHAVIOR GENETICS. 2026;:1-13
    Finkel D; Finch BK; Gatz M; Karlsson IK; Reynolds CA; Mosing M; Nimmagadda S; Ericsson M
  • Article: ALZHEIMER'S AND DEMENTIA: TRANSLATIONAL RESEARCH AND CLINICAL INTERVENTIONS. 2026;12(1):e70209
    Romic E; Karlsson I; Karalija N; Adolfsson AN; Adolfsson R; Kauppi K
  • Article: JAMA NETWORK OPEN. 2026;9(1):e2551361
    Yu Y-L; Renaers E; Martens DS; Sleurs H; Massot A; Berden D; Verheyen L; Alfano R; Zhang D-Y; An D-W; Raaijmakers A; Allegaert K; Verhamme P; Plusquin M; Staessen JA; Nawrot TS
  • Journal article: PULSE. 2026;14(1):62-77
    Zhang D-Y; Martens DS; An D-W; Gonzalez-Marrachelli V; Yu Y-L; Stolarz-Skrzypek K; Rajzer M; Li Y; Verhamme P; Nawrot TS; Monleon D; Redon J; Staessen JA
  • Article: BLOOD PRESSURE. 2025;34(1):2533456
    An D-W; Mokwatsi GG; Zhang D-Y; Martens DS; Yu Y-L; Chori BS; Odili AN; Kruger R; Gafane-Matemane LF; Siwy J; Latosinska A; Mischak H; Mels CMC; Schutte AE; M'Buyamba-Kabangu J-R; Nawrot TS; Li Y; Staessen JA
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Funding

Grants

  • Blood-based biomarkers and molecular changes in preclinical dementia
    The SciLifeLab and Wallenberg National Program for Data-Driven Life Science (DDLS), Academic PhD project 2025
    1 October 2026 - 30 September 2026
  • Improving Dementia Screening with Longitudinal Biomarkers and Twin Designs: Evidence from the SATSA Cohort
    Alzheimerfonden
    1 January 2026 - 31 December 2026
  • The heterogeneity of obesity subtypes: From body mass index towards precision medicine
    Karolinska Institutet Research Grants
    1 November 2024 - 31 October 2026
  • National Institute on Aging
    15 May 2024 - 28 February 2029
  • Overweight as a heterogenous phenotype - Leveraging differences to understand effects on age-related diseases
    The Strategic Research Program in Epidemiology at Karolinska Institutet
    1 November 2023 - 31 December 2023
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2023 - 31 December 2026
    Research problem and specific questions The purpose of this project is to leverage the heterogeneity of overweight to understand how overweight increases the risk of cardiovascular disease, type 2 diabetes, and dementia. We will study adiposity in general and specific adiposity-related traits:Metabolically unhealthy vs healthy adiposityEnvironmentally vs genetically driven adiposityAdiposity measured in midlife vs late-lifeThus, we can study differences in how the adiposity-related traits associate with the age-related diseases, and if these differences are explained by mediating factors or by an acceleration of aging. We will study:Overweight in general, to highlight genes and biological pathways shared between adiposity and the age-related diseases, and seek to identify factors driving the associations.How metabolic biomarkers (e.g. cholesterol levels, inflammatory markers) and other potential mediators (e.g. depressive symptoms) differ among the adiposity-related traits, and if these factors influence the associations with the age-related diseases.If cellular or multisystem aging (telomere length, epigenetic clocks, and frailty) differ among the adiposity-related traits, and influence the association with the age-related diseases.Data and methodAim 1 uses genetic designs and public data. Aim 2-3 applies advanced epidemiological designs to large longitudinal data from the Health and Retirement Study (USA
    n=37,494) and twin cohorts in the IGEMS consortium (Australia, Denmark, Sweden, and USA
    n=89-136).Plan for project realizationThe data are already available, and the realization and costs concern analyses to answer the research questions. The project is led by an interdisciplinary team of researchers in Sweden, China, and the USA. We will recruit a PhD student, who will conduct four studies within the project, and budget for partial financing of a present PhD student, whose work falls within the proposed project.RelevancePreliminary analyses indicate important differences among the adiposity-related traits, and by examining these differences the project will advance our understanding of the heterogeneity of overweight, and of what drives the negative health effects of adiposity in general. It thereby has the potential to identify preventive strategies reducing the risk of several of our most common causes of morbidity and mortality, and promote a healthier aging.
  • Overweight as a heterogeneous phenotype: Leveraging differences among adiposity-related traits to understand effects on age-related disease
    Foundation for Geriatric Diseases at Karolinska Institutet
    1 October 2022 - 30 September 2025
  • Overweight as a heterogeneous phenotype - Leveraging differences to understand effects on age-related diseases
    Karolinska Institutet’s Research Foundation
    1 October 2022 - 30 September 2024
  • Overweight as a heterogeneous phenotype: Leveraging differences among adiposity-related traits to understand effects on age-related disease
    Loo and Hans Osterman Foundation for Medical Research
    1 July 2022 - 30 June 2025
  • Overweight as a heterogeneous phenotype: Leveraging differences in adiposity-related traits to understand effects on age-related disease
    The Strategic Research Program in Epidemiology at Karolinska Institutet
    1 November 2021 - 31 December 2023
  • Council for International Exchange of Scholars
    1 August 2019 - 29 February 2020
  • Swedish Research Council for Health Working Life and Welfare
    1 January 2019 - 31 December 2021

Staff and contact

Group leader

All members of the group

Visiting address

Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Nobels väg 12A, Stockholm, 171 77, Sweden

Postal address

Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, PO Box 281, Stockholm, 171 77, Sweden