A 30-year follow-up of the landmark Diabetes Prevention Program — originally a randomized trial testing lifestyle and metformin interventions in 3,234 adults with prediabetes — has successfully grafted the National Alzheimer's Coordinating Center Uniform Data Set version 3 (NACC-UDSv3) onto its existing infrastructure. Beginning in 2022, researchers harmonized 16 NACC-UDSv3 data forms with pre-existing DPPOS instruments, deployed them via an electronic capture system (MIDAS), and completed 1,561 cognitive adjudications for Alzheimer's disease and related dementias in the first wave.
The metabolic-cognitive connection is one of the more consequential frontiers in dementia research: type 2 diabetes and insulin resistance are established risk factors for Alzheimer's disease, making the DPPOS cohort — with its decades of glycemic, lifestyle, and pharmaceutical exposure data — unusually valuable for untangling these relationships. By aligning with NACC-UDSv3, the study gains interoperability with dozens of federally funded Alzheimer's Disease Research Centers, dramatically expanding potential for pooled analyses.
That said, this preprint, not yet peer-reviewed, describes a methodological implementation rather than a primary clinical finding. Its contribution is infrastructure, not etiology. The practical blueprint it offers — harmonization mapping, automated adjudication reports, EDC adaptation — could meaningfully lower barriers for other aging cohorts seeking NACC compatibility. Incremental in isolation, but potentially catalytic for the field if it accelerates data integration across metabolic and neurodegenerative research networks.
