Notably, the synergistic effect of SD and the FHS-CVD risk score remained strongly associated with prospective cognitive decline after adjusting for commonly used AD biomarkers, including levels of CSF-Aβ, CSF-Tau, CSF-Ptau, and hippocampal volume, and approximated the effects of these commonly used imaging biomarkers, thus suggesting their possible use as complementing the existing AD pathology markers in assessing the risk of prospective cognitive decline. This evidence concerns the gene MAPT and Alzheimer disease.