Smelling the Risk: Early Olfactory Deficits, Brain Networks, and Blood Markers of Alzheimer's Disease Risk in...

Olfactory impairment is a hallmark of early Alzheimer's disease (AD), but the underlying mechanisms connecting sensory decline to genetic and environmental risk factors remain unclear. Our integrative analysis combines ethologically relevant olfactory behavior assays, high-resolution diffusion MRI connectomics, and blood transcriptomics in a large cohort of humanized APOE mice stratified by APOE genotype (APOE2, APOE3, APOE4), age, sex, high-fat diet, and immune background (HN). Behaviorally, APOE4 mice exhibited accelerated deficits in odor salience, novelty detection, and memory, especially when exposed to a high-fat diet, whereas APOE2 mice showed resilience (ANOVA: APOE x HN, F(2,1669)=77.25, p<0.001, eta squared effect size = 0.08). Notably, age and diet exerted compounding effects, with older and HFD-fed mice displaying reduced odor-guided exploration (diet x age: F(1,1669)=16.04, p<0.001, eta squared effect size = 0.01). Memory analyses revealed robust genotype- and age-dependent impairments: at 24- and 48-hour delays, recognition indices were significantly lower in APOE4 mice compared to APOE2 (long-term memory: APOE x HN, F(2,395)=5.6, p=0.004). Elastic Net-regularized multi-set canonical correlation analysis (MCCA) linked behavior to brain network substrates, revealing subnetworks whose connectivity explained up to 24 percent of behavioral variance (sum of canonical correlations: 1.27, 95% CI [1.18, 1.85], p<0.0001). High-weighted connections between the ventral orbital cortex, somatosensory cortex, and cerebellar-brainstem pathways were identified as critical nodes for risk or compensation. Integrative blood transcriptomics revealed eigengene modules strongly correlated with imaging changes in olfactory-memory circuits (for example, eigengene 2 vs. subiculum diffusivity: r = -0.5, p < 1e-30, explaining up to 24 percent of variance). Gene ontology analysis pinpointed shared pathways in synaptic signaling, translation, and metabolic regulation across brain and blood. Notably, glutamatergic and synaptic pathways were enriched among genes linking peripheral and central compartments. Collectively, these results demonstrate that olfactory behavior, quantitatively shaped by genotype, age, diet, and immune status, serves as a sensitive and translatable early biomarker of Alzheimer's disease risk. Our systems-level approach identifies specific brain networks and peripheral molecular signatures underlying sensory-cognitive vulnerability, providing a robust framework for early detection and targeted intervention in AD.