Journal of Alzheimer's Disease最新文献

{"title":"Alzheimer's disease prediction and prevention in a public health perspective: Ethical considerations and collaborations beyond the biomedical paradigm.","authors":"Dorothee Horstkötter","doi":"10.1177/13872877241308299","DOIUrl":"https://doi.org/10.1177/13872877241308299","url":null,"abstract":"<p><p>The prevention of dementia is increasingly a task for public health promotion and aims at the general public. This likewise holds for potentially modifiable lifestyle risk factors and biomarkers indicating susceptibility. This commentary argues that from a public health ethical perspective, there is a significant overlap between the implications and requirements of the biomedical domain and lifestyle approaches. What's more, once public awareness of Alzheimer's disease prevention or risk reduction is further established, the public will likely intermix options and advice. Public health ethical recommendations should pro-actively reflect on upcoming questions, concerns, and remedies, combine but not separate both domains and anticipate their conceivable interactions.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877241308299"},"PeriodicalIF":3.4,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impacts of adapted dance on mood and physical function among persons living with Alzheimer's disease.","authors":"Crystal G Bennett, Rodney P Guttmann, Madeleine E Hackney, Raid Amin, Savannah Weaver","doi":"10.1177/13872877241298529","DOIUrl":"https://doi.org/10.1177/13872877241298529","url":null,"abstract":"<p><strong>Background: </strong>Most individuals living with Alzheimer's disease and related dementias (ADRD) experience one or more neuropsychiatric symptoms, such as agitation which negatively impacts their quality of life. Adapted dance integrates recorded music and movement that is appropriate for people with cognitive limitations. Adapted dance may be an enjoyable activity for persons living with ADRD and may provide psychological and physical benefits.</p><p><strong>Objective: </strong>The purpose of this pilot study was to assess the feasibility of an adapted dance intervention with persons with ADRD and the impacts of 12 weeks of adapted dancing on agitation, balance, gait, lower extremity strength, and caregiver burden.</p><p><strong>Methods: </strong>This study used an experimental design with repeated measures. Participants with ADRD were randomly assigned to a usual care or adapted line dance group that met 60 min twice a week. At pre-test, 4-, 8-, and 12 weeks of intervention, measures were collected for agitation, balance, gait, lower extremity strength, and caregiver burden.</p><p><strong>Results: </strong>The sample consisted of 4 males and 12 females (n = 16) with ADRD whose age ranged from 69-97 years. Twelve weeks of adapted line dance was found acceptable by ADRD participants. Participants attended ≥90% of dance sessions and did not experience loss of balance or fall. ADRD participants danced an average of 70 min per week. Both groups had improvements in agitation from baseline to 12 weeks.</p><p><strong>Conclusions: </strong>Twelve weeks of adapted dance was shown to be feasible and enjoyable for persons living with ADRD. Clinicians should consider adapted dance as part of an exercise prescription.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877241298529"},"PeriodicalIF":3.4,"publicationDate":"2024-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142882107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multimodal neuroimaging biomarkers and subtle cognitive decline in a population-based cohort without dementia.","authors":"Andrea M Weinstein, Fang Fang, Chung-Chou H Chang, Ann Cohen, Brian J Lopresti, Charles M Laymon, Neelesh K Nadkarni, Howard J Aizenstein, Victor L Villemagne, M Ilyas Kamboh, C Elizabeth Shaaban, Marissa A Gogniat, Minjie Wu, Thomas K Karikari, Mary Ganguli, Beth E Snitz","doi":"10.1177/13872877241303926","DOIUrl":"https://doi.org/10.1177/13872877241303926","url":null,"abstract":"<p><strong>Background: </strong>The relationship between subtle cognitive decline and Alzheimer's disease (AD) pathology as measured by biomarkers in settings outside of specialty memory clinics is not well characterized.</p><p><strong>Objective: </strong>To investigate how subtle longitudinal cognitive decline relates to neuroimaging biomarkers in individuals drawn from a population-based study in an economically depressed, small-town area in southwestern Pennsylvania, USA.</p><p><strong>Methods: </strong>A subset of participants without dementia (N = 115, age 76.53 years ± 6.25) from the Monongahela Youghiogheny Healthy Aging Team (MYHAT) study completed neuroimaging including magnetic resonance imaging (MRI) measures of AD-signature region cortical thickness and white matter hyperintensities (WMH), Pittsburgh compound B (PiB)-positron emission tomography (PET) for amyloid-β (Aβ) deposition, and [¹⁸F]AV-1451-PET for tau deposition. Neuropsychological evaluations were completed at multiple timepoints up to 11 years prior to neuroimaging. Aβ positivity was determined using a regional approach. We used linear mixed models to examine neuroimaging biomarker associations with retrospective cognitive slopes in five domains and a global cognitive composite.</p><p><strong>Results: </strong>Among Aβ(+) participants (38%), there were associations between (i) tau Braak III/IV and language decline (p < 0.05), (ii) cortical thickness and both memory decline (p < 0.001) and global cognitive decline (p < 0.01), and (iii) WMH and decline in executive function (p < 0.05) and global cognition (p < 0.05). Among Aβ(-) participants, there was an association between tau Braak III/IV and decline on tests of attention/psychomotor speed (p < 0.05).</p><p><strong>Conclusions: </strong>These findings confirm an Aβ-dependent early AD biomarker pathway, and suggest a possible Aβ-independent, non-AD process underlying subtle cognitive decline in a population-based sample of older adults without dementia.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877241303926"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tele-neuropsychological multidomain assessment in Italian people with cognitive disorders: Reliability and user satisfaction.","authors":"Miriana Maria Bressan, Anna Maria Musso, Tommaso Bovi, Bruno Bonetti, Chiara Zucchella","doi":"10.1177/13872877241300186","DOIUrl":"https://doi.org/10.1177/13872877241300186","url":null,"abstract":"<p><strong>Background: </strong>Tele-neuropsychology has already been employed in neurocognitive disorders, however, in Italy, the evidence of its psychometric quality and satisfaction is still limited.</p><p><strong>Objective: </strong>This study aimed to: (1) evaluate the reliability of a standardized battery of neuropsychological screening and domain-specific tests delivered at home via videoconference to a sample of Italian people with cognitive disorders, compared with traditional face-to-face administration; (2) assess the feasibility and satisfaction about remote administration.</p><p><strong>Methods: </strong>This crossover study enrolled patients with subjective cognitive disorder, mild neurocognitive disorder, or dementia. All participants performed a brief neuropsychological screening assessment in face-to-face or remote mode. People with milder cognitive disorders (Mini-Mental State Examination ≥ 20) also performed an extended neuropsychological battery. After 15 days, each participant repeated the same assessment in the opposite mode. Finally, participants completed a satisfaction questionnaire.</p><p><strong>Results: </strong>114 participants were initially enrolled in the study and 100 individuals performed both face-to-face and remote assessments (14 dropouts). All neuropsychological tests showed agreement between the two modes of administration, except for the Digit Span Forward (<i>p </i>= 0.009) and oral-Symbol Digit Modalities Test (<i>p </i>< 0.001). According to Lin's concordance correlation coefficient (LCCCs), tests also showed good or excellent reliability (LCCCs between 0.609 and 0.964); only the Digit Span Backward and the Stroop test showed moderate reliability (LCCCs =0.514-0.441, respectively). Among 100 participants, 65 patients answered the satisfaction questionnaire, declaring high satisfaction for the remote evaluation.</p><p><strong>Conclusions: </strong>Tele-neuropsychology seems to work with in-home assessments among Italian patients with cognitive disorders and seems to be acceptable to them.</p><p><strong>Trial registration: </strong><i>ClinicalTrials.gov</i>, Identifier: NCT06078332 (October 17, 2023).</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877241300186"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142864274","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive function and its longitudinal predictability by intensity of physical activity in Chinese middle-aged and older adults.","authors":"Worku Animaw Temesgen, Ho Yu Cheng, Yuen Yu Chong","doi":"10.1177/13872877241305828","DOIUrl":"https://doi.org/10.1177/13872877241305828","url":null,"abstract":"<p><strong>Background: </strong>The aging population faces several health problems, including cognitive decline that can progress to Alzheimer's disease. Regular physical activity is widely recognized for its extensive benefits, including physical and mental health improvements especially for older adults.</p><p><strong>Objective: </strong>This study aimed to examine the prediction of physical activity intensities on cognitive function of older adults.</p><p><strong>Methods: </strong>Data from 8 years prospective survey among Chinese population aged 45 years and older is used. Cognitive function was measured by word recall, orientation, numeric subtraction, and copying a picture. Physical activity was assessed with three intensity levels. General estimating equations (GEE) with unstructured correlation matrix is used to test the prediction of physical activity intensity on cognitive function.</p><p><strong>Results: </strong>Cognitive function of participants significantly declined from 9.81 at baseline to 8.81 after 8 years. Moderate-intensity physical activity for 3 days/week was strongest positive predictor of cognitive function with a betta coefficient of 0.64. Light-intensity physical activity also positively predicted cognitive function, however vigorous physical activity for more than 3 days/week negatively predicted cognitive function.</p><p><strong>Conclusions: </strong>Cognitive function of the Chinese population is found to continuously decline after 60 years old age. Fortunately, this decline can be delayed with age-tolerable light to moderate-intensity physical activities.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877241305828"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploratory study of French healthcare workers' experiences of anosognosia in Alzheimer's disease and related disorders.","authors":"Julie Vignolo, Jean-Pierre Jacus, Thierry Darnaud, Christine Vanessa Cuervo-Lombard","doi":"10.1177/13872877241307045","DOIUrl":"https://doi.org/10.1177/13872877241307045","url":null,"abstract":"<p><strong>Background: </strong>Anosognosia or lack of insight is a common feature of Alzheimer's disease (AD) and associated disorders. It is an impairment in the ability to recognize the disease and related symptoms. Anosognosia is associated among patients with poor compensatory strategies, behavioral disorders, apathy and caregiver burden. Therefore, its early identification by healthcare workers is a major challenge in order to provide support for both patients and caregivers.</p><p><strong>Objective: </strong>To explore the knowledge, attitudes and experiences of French healthcare workers relating to anosognosia in AD and related disorders.</p><p><strong>Methods: </strong>An online self-completed questionnaire was created for the study. It was anonymous and divided into three dimensions: general knowledge, confidence, and subjective experiences of anosognosia. One hundred and eleven healthcare workers completed the questionnaire. Mann Whitney and Kruskal Wallis tests were used to determine the variables associated with the total knowledge and confidence scores. Ordinal logistic regressions were performed to explore the associations between subjective experiences and demographics.</p><p><strong>Results: </strong>The participants had moderate knowledge. Knowledge scores were influenced by their experience in the geriatric field, type of profession, workplaces and training. The areas where knowledge was poorest were anosognosia assessment and management. The participants with the lowest knowledge levels were those interacting the most with patients, especially at home. Overall, they identified difficulties related to anosognosia and did not seem confident about their ability to deal with this condition.</p><p><strong>Conclusions: </strong>This study determines specific areas for training on anosognosia, such as identification, assessment and management of this condition.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877241307045"},"PeriodicalIF":3.4,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854258","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Curation and validation of electronic medical record-based dementia diagnoses in the VA Million Veteran Program.","authors":"Victoria C Merritt, Rui Zhang, Richard Sherva, Monica T Ly, David Marra, Matthew S Panizzon, Debby W Tsuang, Richard L Hauger, Mark W Logue","doi":"10.1177/13872877241299130","DOIUrl":"https://doi.org/10.1177/13872877241299130","url":null,"abstract":"<p><strong>Background: </strong>The age distribution and diversity of the VA Million Veteran Program (MVP) cohort make it a valuable resource for studying the genetics of Alzheimer's disease (AD) and related dementias (ADRD).</p><p><strong>Objective: </strong>We present and evaluate the performance of several International Classification of Diseases (ICD) code-based classification algorithms for AD, ADRD, and dementia for use in MVP genetic studies and other studies using VA electronic medical record (EMR) data. These were benchmarked relative to existing ICD algorithms and AD-medication-identified cases.</p><p><strong>Methods: </strong>We used chart review of n = 103 MVP participants to evaluate diagnostic utility of the algorithms. Suitability for genetic studies was examined by assessing association with <i>APOE</i> ε4, the strongest genetic AD risk factor, in a large MVP cohort (n = 286 K).</p><p><strong>Results: </strong>The newly developed MVP-ADRD algorithm performed well, comparable to the existing PheCode dementia algorithm (Phe-Dementia) in terms of sensitivity (0.95 and 0.95) and specificity (0.65 and 0.70). The strongest <i>APOE</i> ε4 associations were observed in cases identified using MVP-ADRD and Phe-Dementia augmented with medication-identified cases (MVP-ADRD <i>or</i> medication, p = 3.6 ×10^-290; Phe-Dementia <i>or</i> medication, p = 1.4 ×10^-290). Performance was improved when cases were restricted to those with onset age ≥60.</p><p><strong>Conclusions: </strong>We found that our MVP-developed ICD-based algorithms had good performance in chart review and generated strong genetic signals, especially after inclusion of medication-identified cases. Ultimately, our MVP-derived algorithms are likely to have good performance in the broader VA, and their performance may also be suitable for use in other large-scale EMR-based biobanks in the absence of definitive biomarkers such as amyloid-PET and cerebrospinal fluid biomarkers.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877241299130"},"PeriodicalIF":3.4,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142846765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differences in lean mass and sarcopenia between individuals with Alzheimer's disease and those without dementia: A systematic review and meta-analysis of observational studies.","authors":"Camila Cristine Gomes Nazareth, Ana Carolina Aparecida Marcondes Scalli, Marcos Paulo Braz de Oliveira, Antonio Felipe Souza Gomes, Sonia Brito-Costa, Guilherme Eustáquio Furtado, Natália Oiring de Castro Cezar","doi":"10.1177/13872877241299051","DOIUrl":"https://doi.org/10.1177/13872877241299051","url":null,"abstract":"<p><strong>Background: </strong>Studies have observed that individuals with Alzheimer's disease (AD) tend to have lower lean mass and higher rates of sarcopenia.</p><p><strong>Objective: </strong>This review aims to assess differences in lean mass, sarcopenia, and its components between individuals with AD and those without dementia (WD).</p><p><strong>Methods: </strong>Searches were conducted in the Medline, Web of Science, Embase, Scopus and Latin American and Caribbean Health Scientific Literature. Observational studies comparing lean mass, sarcopenia, and its components in the populations of interest were included. We used the Joanna Briggs Institute (JBI) scale to assess methodological quality. Mean differences (MD) and standardized mean differences were calculated for the meta-analyses.</p><p><strong>Results: </strong>Four studies with 2035 individuals found that those with AD had significantly lower upper and lower limb lean mass, and skeletal muscle mass index compared to WD individuals. AD individuals also had a higher sarcopenia prevalence (41.33% versus 20.66%) and significant reductions in handgrip strength, lower limb muscle strength, and gait speed compared to WD individuals. The JBI scale analysis showed high agreement among the studies (k = 1.00, p = 0.046).</p><p><strong>Conclusions: </strong>Individuals with AD have lower lean mass, higher rates of sarcopenia, and reduced muscle function compared to those without dementia. While the results suggest the need for early screening programs and integrated therapeutic interventions to improve clinical outcomes and quality of life for individuals with AD, it is important to consider that biases inherent in observational studies may compromise the quality of the evidence. Therefore, further research, preferably clinical trials, is needed to confirm these associations.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877241299051"},"PeriodicalIF":3.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836532","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between plant-based dietary patterns and cognitive function in middle-aged and older residents of China.","authors":"Jianying Peng, Xiaolong Li, Jie Wang, Fengping Li, Jianfeng Gao, Yan Deng, Benchao Li, Tingting Li, Yuanyuan Li, Sui Tang, Likang Lu, Peiyang Zhou, Shuang Rong","doi":"10.1177/13872877241300253","DOIUrl":"https://doi.org/10.1177/13872877241300253","url":null,"abstract":"<p><strong>Background: </strong>Plant-based diets may protect against cognitive impairment; however, observational data have not been consistent.</p><p><strong>Objective: </strong>This study aimed to evaluate the association between plant-based dietary patterns and cognitive function.</p><p><strong>Methods: </strong>The study recruited 937 participants who were asked to complete food frequency questionnaires to assess the quality of their plant-based diets using the overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI). Cognitive function evaluated using the Montreal Cognitive Assessment (MoCA) test. Logistic regression was used to explore the association between plant-based dietary patterns and the prevalence of mild cognitive impairment (MCI), while multiple linear regression was used to analyze the association between plant-based dietary patterns and cognitive scores.</p><p><strong>Results: </strong>The prevalence of MCI was 26% among the 937 participants. There was a significant association between higher uPDI scores and higher odds of MCI, with Quintile 4 compared with Quintile 1 showing an odds ratio of 2.21 (95% confidence interval 1.35, 3.60). Higher uPDI scores were associated with a lower total MoCA score and poorer performance in various cognitive domains. There were no significant associations between the PDI, the hPDI, and cognitive function. Consuming whole grains, nuts, and eggs once a week or more were associated with a lower risk of MCI, whereas frequently consumption of pickled vegetables was associated with an increased risk of MCI.</p><p><strong>Conclusions: </strong>Unhealthy plant-based diets were associated with cognitive impairment, while whole grains, nuts, and eggs may protect cognitive function; pickled vegetables are associated with cognitive impairment.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877241300253"},"PeriodicalIF":3.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836512","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of visit-to-visit blood pressure variability and time in target range in predicting risk for cognitive outcomes in the SPRINT trial.","authors":"Isabel J Sible, Daniel A Nation","doi":"10.1177/13872877241303378","DOIUrl":"https://doi.org/10.1177/13872877241303378","url":null,"abstract":"<p><strong>Background: </strong>Blood pressure (BP) variability (BPV) and time in target range (TTR) are emerging vascular risk factors for dementia, independent of traditionally targeted mean BP.</p><p><strong>Objective: </strong>Determine whether BPV or TTR is most strongly associated with cognitive risk.</p><p><strong>Methods: </strong>In this post hoc analysis of the SPRINT trial, 8034 participants underwent repeated BP measurement and cognitive testing at baseline and follow-up. Visit-to-visit BPV was calculated as average real variability. TTR was the percent of time in desired treatment arm target range (standard: 120-140 mmHg systolic BP; intensive: 110-130 mmHg systolic BP). Adjudicated clinical outcomes were no cognitive impairment, mild cognitive impairment (MCI), and probable dementia. We investigated a direct comparison of BPV and TTR in predicting cognitive risk, stratified by BP treatment group.</p><p><strong>Results: </strong>Elevated BPV was associated with increased risk for MCI (adjusted HR: 1.21 [95% CI 1.10, 1.33], <i>p </i>< 0.001) and MCI/dementia (HR: 1.17 [95% CI 1.07, 1.27], <i>p </i>< 0.001) in the standard group, and dementia (HR: 1.17 [95% CI 1.01, 1.36], <i>p </i>= 0.039) in the intensive group. Higher TTR was related to lower dementia risk (HR: 0.72 [95% CI 0.60, 0.86], <i>p </i>< 0.001) in the intensive group only.</p><p><strong>Conclusions: </strong>Visit-to-visit BPV outperformed TTR in predicting risk for MCI and MCI/dementia. TTR was more strongly associated with dementia risk under intensive treatment. Findings were independent of mean BP in a cohort with rigorously controlled BP and suggest newer aspects of BP control may be harnessed to further reduce cognitive risk.</p><p><strong>Clinical trial information: </strong>ClinicalTrials.gov; NCT01206062.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877241303378"},"PeriodicalIF":3.4,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142836523","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}