Injury in Starting and Replacement Players from Five Professional Men's Rugby Unions.

OBJECTIVES: The aim of this study was to compare the incidence, severity, and burden of injury in starting and replacement players from professional men's teams of five rugby unions. METHODS: Match injuries of greater than 24 h time-loss (including data on the severity, match quarter, event, body region) and player minutes of match exposure data were collated for all starting and replacement players in the men's English Premiership, Welsh Pro14 (both 2016/17-2018/19 seasons), and Australian, New Zealand, and South African Super Rugby (all 2016-2018 seasons) teams. Injury incidences and mean injury burden (incidence × days missed) were calculated, and rate ratios (RRs) (95% confidence intervals [CIs]) were used to compare injury incidence and burden between starting (reference group) and replacement players. RESULTS: Overall injury incidence was not different between starters and replacements for all injuries (RR = 0.98, 95% CI 0.88-1.10), nor for concussions (RR = 0.85; 95% CI 0.66-1.11). Mean injury burden was higher for replacement players (RR = 1.31, 95% CI 1.17-1.46). Replacement injury incidence was lower than the starters in the third (RR = 0.68, 95% CI 0.51-0.92) and fourth (RR = 0.78, 95% CI 0.67-0.92) match quarters. Injury incidence was not different between starters and replacements for any match event or body region, but compared with starters, replacements' injury burden was higher in lower limbs (RR = 1.24, 95% CI 1.05-1.46) and in the tackled player (RR = 1.30, 95% CI 1.01-1.66). CONCLUSION: This study demonstrated a lower injury incidence in replacement players compared with starters in the second half of matches, with a higher injury burden for replacement players due to higher mean injury severity.

Estimating Maturity Status in Elite Youth Soccer Players: Evaluation of Methods.

PURPOSE: To evaluate the concordance of predicted maturity status classifications (pre-, circa- or post-peak height velocity) relative to observed age at PHV in youth soccer players. METHODS: Longitudinal height records for 124 male soccer players were extracted from academy records spanning the 2000-2022 seasons. Age at PHV for each player was estimated with the Super-Imposition by Translation and Rotation (SITAR) model. Players were classified as pre-, circa- or post-PHV using both ±1 year and ± 0.5 year criteria to define the circa-PHV interval. Maturity status was estimated with several prediction protocols: maturity offset (Mirwald, Moore-1, Moore-2), maturity ratio (Fransen), percentage of predicted adult height (PAH%) using the Khamis-Roche (KR) and Tanner-Whitehouse-2 (TW2-RUS) equations using several bands: 85%-96%, 88%-96%, 88%-93%, and 90%-93% for the circa-PHV interval, and visual evaluation of individual growth-curves alone or with PAH% based on KR and TW2-RUS. Concordance of maturity status classifications based on complete growth curves and predicted estimates of maturity status was addressed with percentage agreement and Cohen's kappa. RESULTS: Visual evaluation of the growth curves had the highest concordance (≈ 80%) with maturity status classifications (pre-, circa-, post-PHV) based on longitudinal data for individual players. Predicted maturity offset with the Mirwald, Moore-1 and Fransen equations misclassified about one- third to one-half of the players, while concordance based on PAH% varied with the band used, but not with the method of height prediction. CONCLUSIONS: Visual assessment of the individual growth curves by an experienced assessor provides an accurate estimate of maturity status relative to PHV. Maturity offset prediction equations misclassifies the majority of players, while PAH% provides a reasonably valid alternative.

Injury Incidence, Severity and Type across the Menstrual Cycle in Female Footballers: A Prospective Three Season Cohort Study.

PURPOSE: The aim of the study was to assess the influence of menstrual cycle phase on injury incidence, severity and type in elite female professional footballers over three seasons. METHODS: Time-loss injuries and menstrual cycle data were prospectively recorded for 26 elite female football players across three seasons. The menstrual cycle was categorised into four phases using a standardised model: menstruation (phase 1; P1), remainder of follicular phase (phase 2; P2), early luteal (phase 3; P3), and pre-menstrual phase (phase 4; P4). Injury incidence rates (IRR) and ratios (IIRR) were calculated for overall injuries, injury severity, type, contact vs non-contact and game/training. RESULTS: 593 cycles across 13,390 days were tracked during the study and 74 injuries from 26 players were eligible for analysis. When comparing IRR between phases (reference: P1), overall injury rates were highest in P4 (IIRR: 2.30 [95% CI: 0.99-5.34; p = 0.05]). When examining rates by injury severity and type, IRR were also highest in P4 for ≤7 days' time-loss (4.40 [0.93-20.76; p = 0.06]), muscle-specific (6.07 [1.34-27.43; p = 0.02]) and non-contact (3.05 [1.10-8.50; p = 0.03]) injuries. Muscle-specific (IIRR P3:P1: 5.07 [1.16-22.07; p = 0.03]) and ≤ 7 days' time-loss (4.47 [1.01-19.68; p = 0.05]) injury risk was also significantly higher in P3. Muscle injuries were the most prevalent sub-type (n = 41). No anterior cruciate ligament injuries were recorded across the monitoring period. CONCLUSIONS: Injury risk was significantly elevated during the luteal phase of the menstrual cycle (P3 and P4) among elite female professional footballers. Further research is urgently needed to better understand the influence of the menstrual cycle on injury risk and to develop interventions to mitigate risk.

The combined effects of growth and maturity status on injury risk in an elite football academy.

This study aimed to explore the interaction between growth rate on specific injury incidence and burden on pre-, circa- and post-peak height velocity (PHV) periods. Injury and stature data collected during the 2000-2020 seasons in an elite football academy were retrospectively analysed. Only players with height measurements from childhood until the attainment of adult height were included in the study (N = 84). Growth data were smoothed using a cubic spline to calculate daily growth rate and height. Growth rate was categorised into three groups: fast (> 7.2 cm/year), moderate (3.5-7.2 cm/year) and slow (< 3.5 cm/year). Percentage of observed adult height was used to classify players as pre-PHV (< 88%), circa-PHV (88-95%) or post-PHV (> 95%). Overall and specific injury incidence and burden and rate ratios for comparisons between growth rate groups were calculated on pre-, circa- and post-PHV periods, separately. Overall injury incidence and burden were greater in pre-PHV players with quicker growth rates compared to players growing moderately and slowly. All in all, players with more rapid growth-rates were at higher risk for growth-related injuries in all pre-, circa- and post-PHV periods. Post-PHV, the incidence and burden of joint/ligament injuries were 2.4 and 2.6-times greater in players growing slowly compared to players growing moderately. Practitioners should monitor growth rate and maturity status and consider their interaction to facilitate the design of targeted injury risk reduction strategies.

A similar injury profile observed in franchise men's and women's cricket in England and Wales: injury surveillance analysis from the first three 'The Hundred' competitions.

Objectives: To describe the injury profile of a novel format cricket competition ('The Hundred') and compare injury incidence and prevalence between the men's and women's competitions. Methods: Medical staff prospectively collected injury data from the eight men's and women's teams during the 2021-2023 competitions. Injury definitions and incidence calculations followed the international consensus statement. Results: In the men's competition, 164 injuries were recorded, compared with 127 in the women's competition. Tournament injury incidence was 36.6 (95% CI 31.4 to 42.7) and 32.5 (95% CI 27.3 to 38.7)/100 players/tournament in the men's and women's competition, respectively. Non-time-loss incidence (men's 26.6 (95% CI 22.2 to 31.8), women's 24.6 (95% CI 20.1 to 30.0)/100 players/tournament) was higher than time-loss incidence (men's 10.0 (95% CI 7.5 to 13.5), women's 7.9 (95% CI 5.6 to 11.3)/100 players/tournament). Injury prevalence was 2.9% and 3.6% in the men's and women's competitions, respectively. Match fielding was the most common activity at injury in both competitions. The thigh and hand were the most common body location time-loss injury in the men's and women's competitions, respectively. Conclusion: A similar injury profile was observed between the men's and women's competition. Preventative strategies targeting thigh injuries in the men's competition and hand injuries in the women's competition would be beneficial. Compared with published injury rates, 'The Hundred' men's presents a greater risk of injury than Twenty20 (T20), but similar to one-day cricket, with 'The Hundred' women's presenting a similar injury risk to T20 and one-day cricket. Additional years of data are required to confirm these findings.

English and Welsh men's domestic cricket injury risk by activity and cricket type: A retrospective cohort study from 2010 to 2019.

OBJECTIVES: Explore whether injury profiles and mechanisms differ between red (First-Class multi-day) ball cricket and white (One-Day and Twenty20 limited over) ball cricket in elite men's domestic cricket from 2010 to 2019. DESIGN: Retrospective cohort analysis. METHODS: Injury incidence calculated according to the updated international consensus statement on injury surveillance in cricket, along with seasonal days lost and injury severity descriptive statistics. RESULTS: Across both cricket types, bowling resulted in the most seasonal days lost (mean 1942, 95 % confidence interval: 1799-2096) and highest mean injury severity (30 days, 95 % confidence interval: 28-33), with the lumbar spine the body region with the most seasonal days lost (mean 432 seasonal days; 95 % confidence interval: 355-525) from bowling. Injury incidence was higher in white ball compared to red ball cricket (per unit of time), with bowling (and its various phases) the most frequently occurring mechanism in both cricket types (white ball: 67.0 injuries per 1000 days of play [95 % confidence interval: 59.6-75.3]; red ball: 32.4 injuries per 1000 days of play [95 % confidence interval: 29.1-36.1]). When bowling, the abdomen and thigh were the body regions most injured from white (13.4 injuries per 1000 days of play [95 % confidence interval: 10.3-17.4]), and red ball (6.4 injuries per 1000 days of play [95 % confidence interval: 5.0-8.2]) cricket respectively. Overall, clear differences emerged in the nature and mechanism of injuries between red ball cricket and white ball cricket. CONCLUSIONS: Bowling presents the highest injury risk (across both cricket types), as well as highlighting the increased risk of injuries from diving during fielding and running between the wickets when batting, in shorter white ball cricket.

Sport-related major trauma incidence in young people and adults in England and Wales: a national registry-based study.

OBJECTIVES: Data on sport and physical activity (PA) injury risk can guide intervention and prevention efforts. However, there are limited national-level data, and no estimates for England or Wales. This study sought to estimate sport and PA-related major trauma incidence in England and Wales. METHODS: Nationwide, hospital registry-based cohort study between January 2012 and December 2017. Following Trauma Audit and Research Network Registry Research Committee approval, data were extracted in April 2018 for people ≥16 years of age, admitted following sport or PA-related injury in England and Wales. The population-based Active Lives Survey was used to estimate national sport and PA participation (ie, running, cycling, fitness activities). The cumulative injury incidence rate was estimated for each activity. Injury severity was described by Injury Severity Score (ISS) >15. RESULTS: 11 702 trauma incidents occurred (mean age 41.2±16.2 years, 59.0% male), with an ISS >15 for 28.0% of cases, and 1.3% were fatal. The overall annual injury incidence rate was 5.40 injuries per 100 000 participants. The incidence rate was higher in men (6.44 per 100 000) than women (3.34 per 100 000), and for sporting activities (9.88 per 100 000) than cycling (2.81 per 100 000), fitness (0.21 per 100 000) or walking (0.03 per 100 000). The highest annual incidence rate activities were motorsports (532.31 per 100 000), equestrian (235.28 per 100 000) and gliding (190.81 per 100 000). CONCLUSION: Injury incidence was higher in motorsports, equestrian activity and gliding. Targeted prevention in high-risk activities may reduce admissions and their associated burden, facilitating safer sport and PA participation.

Group brief cognitive behavioral therapy for suicide prevention compared to dialectal behavior therapy skills group for military service members: a study protocol of a randomized controlled trial.

BACKGROUND: Suicide is a pressing matter for the military. Not only does it pose a health risk, but suicide also compromises operational readiness. Despite provision of suicide prevention clinical best practices, the Department of Defense suffers several challenges (e.g., clinician shortages) limiting the agency's ability to effectively respond to service member suicide. Implementation of evidence-based suicide-specific group therapy is a possible solution to service member well-being needs and system challenges. Service members can also gain coping skills useful beyond managing suicidal thoughts and behaviors. METHODS: This 2-arm non-inferiority randomized controlled trial compares a group therapy format of Brief Cognitive Behavioral Therapy (i.e., G-BCBT) with Dialectical Behavior Therapy (DBT) Skills Group. Both therapies are delivered in-person at a United States Naval Medical Center. Participants (N = 136) are active-duty service members with recent suicidal thoughts or suicidal behavior. Evaluation features electronically delivered questionnaires at baseline, after each treatment session, and at 3- and 6-month follow-up. DISCUSSION: The primary outcome concerns G-BCBT impacts on suicidal ideation. Secondary outcomes of interest are suicide attempt, psychological distress (e.g., symptoms of depression, anxiety), and self-regulatory skills (e.g., emotion regulation). We also examine self-regulatory skills as treatment moderators. Clinical trial strengths and limitations are reviewed. TRIAL REGISTRATION: This study was registered at Clinicaltrials.gov (protocol NCT05401838).

Can we reduce injury risk during the adolescent growth spurt? An iterative sequence of prevention in male academy footballers.

Background: The adolescent growth spurt is associated with an increased risk of injury in young athletes.Aim: This study aimed to use an interdisciplinary collaboration between technical coaches, sports scientists, and medical staff to mitigate this risk.Subjects and methods: 77 male academy footballers were followed across two seasons. At-risk players were identified using somatic maturity status and growth rate in stature and the lower limbs, using thresholds of 88% to 92.8% of predicted adult stature, ≥7.2 cm/year, and ≥3.6 cm/year, respectively. During the 2019-20 season, players with symptoms of a growth-related injury or two of three risk factors were included in an intervention strategy that included modified training load, football-specific skills, balance, coordination and landing drills, and an individualised strength program.Results: For players with the three risk factors, there was a significant reduction in the incidence (rate ratio [RR] = 0.14 (5.2 per 1000h → 0.8 per 1000h, p = 0.05) and burden (RR = 0.08 (216 per 1000h → 17 per 1000h, p = 0.02) between the seasons. For players with ≤2 risk factors, there were no significant differences in injury risk between the baseline and intervention seasons.Conclusion: Overall, it may be possible to mitigate injury incidence and burden during the adolescent growth spurt in high-risk athletes.

Incidence of concussion in men's Super League, Championship, and Academy rugby league matches between 2016 and 2022.

OBJECTIVES: To quantify the incidence of concussion and compare between playing levels in male rugby league. DESIGN: Retrospective cohort. METHODS: Between 2016 and 2022, medically diagnosed concussions in Super League, Championship, and Academy competitions were reported to the Rugby Football League via club medical staff. Anonymised data were analysed using generalised linear mixed-effects models by season, month, and between competitions. RESULTS: Overall, 1403 concussions were identified from 104,209 player-match hours. Concussion incidence for Super League, Championship, and Academy was 15.5, 10.5, and 14.3 per 1000 player-match hours, respectively. Championship concussion incidence was significantly lower than the Super League (p < 0.001) and Academy (p < 0.001). No significant differences were identified between years for Super League (range: 13.3 to 18.8 per 1000 player-match hours) and Championship (range: 8.4 to 12.1 per 1000 player-match hours). In Academy (range: 9.6 to 20.5 per 1000 player-match hours), concussion incidence was significantly greater in 2021 compared to earlier years (2016, p = 0.01 and 2017, p = 0.03). No significant differences were identified between months for any competition. CONCLUSIONS: The incidence of concussion is greater in Super League and Academy compared to the Championship. Academy concussion incidence has increased over time. Different factors between and within competitions, such as changes to medical standards and knowledge, could have influenced the identification and diagnosis of concussion.

Rehearsal and Performance Volume in Professional Ballet: A Five-Season Cohort Study.

INTRODUCTION: Few studies have published data concerning the longitudinal rehearsal and performance demands experienced by professional ballet dancers. We aimed to describe the rehearsal and performance volumes undertaken across five professional ballet seasons and identify factors associated with inter-dancer and inter-production variation in dance hours. METHODS: Scheduling data were collected from 123 dancers over five seasons at The Royal Ballet. Linear mixed effects models were used to evaluate differences in: 1. weekly dance hours and seasonal performance counts across sexes, company ranks, and months; and 2. factors associated with the variation in rehearsal hours required to stage different productions. RESULTS: On average across the five seasons, a peak in performance volume was observed in December, whereas rehearsal hours peaked in October and November and between January and April. Differences in weekly dance hours were observed between company ranks (p < 0.001, range in means: 19.1 to 27.5 hours per week). Seasonal performance counts varied across company ranks (p < 0.001), ranging from 28 (95% CI: 22, 35) in principals to 113 (95% CI: 108, 118) in the rank of artist. Rehearsal durations were considerably greater in preparation for newly created ballets compared with existing ballets (77.8 vs. 37.5 hours). Rehearsal durations were also greater in preparation for longer ballets, with each additional minute of running time associated with a 0.43 hour increase in rehearsal duration (p < 0.001). Full-length ballets, however, were consistently the most time-efficient to stage due to their long performance runs compared with shorter ballets (16.2 vs. 7.4 performances). CONCLUSIONS: Training principles such as progressive overload and periodization should be implemented in professional ballet companies to manage the high and variable rehearsal and performance loads.

Professional male rugby union players' perceived psychological recovery and physical regeneration during the off-season.

We explored male professional rugby union players' experiences and perceptions of their mental and physical health and well-being across the northern hemisphere off-season. 34 professional male rugby union players participated in individual semistructured interviews (mean (SD) age=27.5 (4.3) years). Interviews were recorded, transcribed verbatim and analysed using reflexive thematic analysis. The off-season was characterised by three phases players undergo to preserve their mental and physical health and well-being to recover from the previous season and regenerate in preparation for the upcoming season. These included decompression from previous season, cognitive detachment from the rugby environment and preparation for preseason. Successful progression through all three phases was influenced by several variables (work and life demands, contextual factors, experience level). Recovery and regeneration strategies focused on physical distancing/getting away from the rugby environment to cognitively detach. Injured players appear an at-risk subgroup for threats to mental well-being (isolation, anxiety, reduced sense of achievement) as a result of reduced or minimal time away from the workplace due to treatment obligations. Younger professionals are a subgroup at risk of overtraining/injury due to inadequate rest, especially as this group are least likely to seek support/guidance. This study is the first investigation into male professional rugby union players' experiences and perceptions of their mental and physical health and well-being across the off-season period. It highlights the distinct phases players undertake to mentally recover and regenerate and the need to consider education and support for potential at risk subgroups.

Subjective Measures of Workload and Sleep in Australian Army Recruits; Potential Utility as Monitoring Tools.

INTRODUCTION: Subjective measures may offer practitioners a relatively simple method to monitor recruit responses to basic military training (BMT). Yet, a lack of agreement between subjective and objective measures may presents a problem to practitioners wishing to implement subjective monitoring strategies. This study therefore aims to examine associations between subjective and objective measures of workload and sleep in Australian Army recruits. MATERIALS AND METHODS: Thirty recruits provided daily rating of perceived exertion (RPE) and differential RPE (d-RPE) for breathlessness and leg muscle exertion each evening. Daily internal workloads determined via heart rate monitors were expressed as Edwards training impulse (TRIMP) and average heart rate. External workloads were determined via global positioning system (PlayerLoadTM) and activity monitors (step count). Subjective sleep quality and duration was monitored in 29 different recruits via a customized questionnaire. Activity monitors assessed objective sleep measures. Linear mixed-models assessed associations between objective and subjective measures. Akaike Information Criterion assessed if the inclusion of d-RPE measures resulted in a more parsimonious model. Mean bias, typical error of the estimate (TEE) and within-subject repeated measures correlations examined agreement between subjective and objective sleep duration. RESULTS: Conditional R2 for associations between objective and subjective workloads ranged from 0.18 to 0.78, P < 0.01, with strong associations between subjective measures of workload and TRIMP (0.65-0.78), average heart rate (0.57-0.73), and PlayerLoadTM (0.54-0.68). Including d-RPE lowered Akaike Information Criterion. The slope estimate between objective and subjective measures of sleep quality was not significant. A trivial relationship (r = 0.12; CI -0.03, 0.27) was observed between objective and subjective sleep duration with subjective measures overestimating (mean bias 25 min) sleep duration (TEE 41 min). CONCLUSIONS: Daily RPE offers a proxy measure of internal workload in Australian Army recruits; however, the current subjective sleep questionnaire should not be considered a proxy measure of objective sleep measures.

A multidimensional approach to identifying the physical qualities of male English regional academy rugby union players; considerations of position, chronological age, relative age and maturation.

Interpreting the physical qualities of youth athletes is complex due to the effects of growth, maturation and development. This study aimed to evaluate the effect of position, chronological age, relative age and maturation on the physical qualities of elite male academy rugby union players. 1,424 participants (n = 2,381 observations) from nine Rugby Football Union regional academies prospectively completed a physical testing battery at three time points, across three playing seasons. Anthropometrics, body composition, muscular power, muscular strength, speed, aerobic capacity and running momentum were assessed. Positional differences were identified for all physical qualities. The largest effect sizes were observed for the associations between chronological age (d = 0.65-0.73) and maturation (d = -0.77 to -0.69) and body mass related variables (i.e. body mass and running momentum). Relative strength, maximum velocity and aerobic capacity were the only models to include two fixed effects with all other models including at least three fixed effects (i.e. position and a combination of chronological age, relative age and maturation). These findings suggest a multidimensional approach considering position, chronological age, relative age and maturation is required to effectively assess the physical qualities of male age grade rugby union players. Therefore practitioners should use regression equations rather than traditional descriptive statistic tables to provide individualised normative comparisons thus enhancing the application of testing results for talent identification and player development.Highlights Practitioners should record and incorporate position, chronological age, relative age and maturation into the physical evaluation of elite academy rugby union players.The regression equations provided within this study offer highly generalisable comparative values that are specific to a players chronological and biological development.Through the use of enhanced player evaluation practitioners will be able to make more informed decisions surrounding talent identification and athlete development.

Longitudinal study of six seasons of match injuries in elite female rugby union.

ObjectiveTo establish match injury rates and patterns in elite female rugby union players in England. METHOD: We conducted a six-season (2011/2012-2013/2014 and 2017/2018-2019/2020) prospective cohort study of time-loss match injuries in elite-level female players in the English Premiership competition. A 24-hour time-loss definition was used. RESULTS: Five-hundred and thirty-four time-loss injuries were recorded during 13 680 hours of match exposure. Injury incidence was 39 injuries per 1000 hours (95% CIs 36 to 42) with a mean severity of 48 days (95% CIs 42 to 54) and median severity of 20 days (IQR: 7-57). Concussion was the most common specific injury diagnosis (five concussions per 1000 hours, 95% CIs 4 to 6). The tackle event was associated with the greatest burden of injury (615 days absence per 1000 hours 95% CIs 340 to 1112), with 'being tackled' specifically causing the most injuries (28% of all injuries) and concussions (22% of all concussions). CONCLUSIONS: This is the first multiple-season study of match injuries in elite women's rugby union players. Match injury incidence was similar to that previously reported within international women's rugby union. Injury prevention strategies centred on the tackle would focus on high-burden injuries, which are associated with substantial player time-loss and financial costs to teams as well as the high-priority area of concussions.

The influence of match exposure on injury risk in elite men's rugby union.

OBJECTIVES: To investigate the influence of previous season match exposure on injury incidence and burden in elite men's rugby union. DESIGN: A three-season (2016-17 to 2018-19) retrospective cohort design was used to collect and analyse injury and exposure data across English Premiership rugby union teams. METHODS: Generalised linear mixed-effects models were used to model the influence of match exposure (all match involvements, match involvements of ≥20 mins, and full-game equivalents) upon match and training injury incidence and burden in the following season. RESULTS: Involvement in ≥31 matches within a season was associated with substantially increased match and training injury burden in the following season. Match exposure was not clearly associated with injury incidence in the following season. The increased match injury burden associated with higher match involvements appeared to be driven by an increased risk for older (>26 y) Forwards, whilst the increased training injury burden associated with higher match involvements appeared to be driven by an increased risk for older (>26 y) Backs. CONCLUSIONS: The present study demonstrates that all match involvements, regardless of duration, should be considered when exploring associations between match exposure and injury risk. High match involvements (≥ 31 matches) are associated with elevated injury burden, in both matches and training, in the following season. The physical and psychological load of players with high previous-season match exposure should be carefully managed.

Characterizing Molecular and Synaptic Signatures in mouse models of Late-Onset Alzheimer's Disease Independent of Amyloid and Tau Pathology.

INTRODUCTION: MODEL-AD is creating and distributing novel mouse models with humanized, clinically relevant genetic risk factors to more accurately mimic LOAD than commonly used transgenic models. METHODS: We created the LOAD2 model by combining APOE4, Trem2*R47H, and humanized amyloid-beta. Mice aged up to 24 months were subjected to either a control diet or a high-fat/high-sugar diet (LOAD2+HFD) from two months of age. We assessed disease-relevant outcomes, including in vivo imaging, biomarkers, multi-omics, neuropathology, and behavior. RESULTS: By 18 months, LOAD2+HFD mice exhibited cortical neuron loss, elevated insoluble brain Aß42, increased plasma NfL, and altered gene/protein expression related to lipid metabolism and synaptic function. In vivo imaging showed age-dependent reductions in brain region volume and neurovascular uncoupling. LOAD2+HFD mice also displayed deficits in acquiring touchscreen-based cognitive tasks. DISCUSSION: Collectively the comprehensive characterization of LOAD2+HFD mice reveal this model as important for preclinical studies that target features of LOAD independent of amyloid and tau.