The largest contributing TSPAN18 variant (rs138778813; 10 and 21 minor allele copies in ARIC and FHS EAs) had opposite directions of effects and different allele frequencies (0.005 and 0.015, respectively) in the two cohorts, possibly due to study design issues (relateds in FHS, required survival to older age and oversampling for cognitive impairment in ARIC). Here, TSPAN18 is linked to Cognitive impairment.