Vanja Petrović, Emilie T Reas, Raylene A Reimer, Cindy K Barha
{"title":"Role of previous parity in the relationship between lifetime physical activity and later life cognition: The Rancho Bernardo study.","authors":"Vanja Petrović, Emilie T Reas, Raylene A Reimer, Cindy K Barha","doi":"10.1177/13872877261477010","DOIUrl":"10.1177/13872877261477010","url":null,"abstract":"<p><p>BackgroundParity history influences dementia risk and cognitive aging, and recent evidence suggests it may also influence the association between physical activity and cognition in later life.ObjectiveTo examine associations between total lifetime and life-stage-specific physical activity and later life cognition in postmenopausal females with differing parity histories.MethodsThis cross-sectional analysis using data from the Rancho Bernardo Study included 867 postmenopausal females with complete data, categorized into three parity groups (number of pregnancies >6-months): nulliparous, 1-2 pregnancies, and grand-multiparous (≥3 pregnancies). Cognitive outcomes included executive functions and memory. Physical activity was assessed using a self-report questionnaire capturing retrospective activity during adolescence, age 30, age 50, and current activity in later life. Covariates included age, education, health composite score, body mass index, and hysterectomy status. Linear models examined associations between physical activity and domain-specific later life cognitive outcomes stratified by parity.ResultsGreater total lifetime physical activity was associated with higher executive functions in nulliparous and grand-multiparous females. Moderate activity in nulliparous females and high activity in grand-multiparous females during adolescence and at age 30 were associated with higher executive functions. High physical activity at age 50 and currently was associated with higher executive functions in nulliparous females.ConclusionsThe findings suggest the relationship between self-reported physical activity and cognition was strongest in the two groups at greater risk for cognitive decline and Alzheimer's disease, the nulliparous and grand-multiparous groups. Further research is needed to understand the mechanisms driving parity differences.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1370-1383"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13583069/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148722359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michelle A Spratt, Millen S Khangura, Ambika Manhapra, Audrey Gao, Nicole H Siegel, Vasiliki Poulaki, Steven Ness, Manju L Subramanian
{"title":"The association between retinal vascular occlusions and dementia using TriNetX.","authors":"Michelle A Spratt, Millen S Khangura, Ambika Manhapra, Audrey Gao, Nicole H Siegel, Vasiliki Poulaki, Steven Ness, Manju L Subramanian","doi":"10.1177/13872877261481012","DOIUrl":"10.1177/13872877261481012","url":null,"abstract":"<p><p>BackgroundRetinal vascular occlusions have been associated with higher incidence of dementia and may serve as clinical indicators for underlying cognitive disease.ObjectiveThis study investigated whether retinal vascular occlusion and their subtypes are linked to increased risk of dementia, including all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD).MethodsParticipants age 65 and over were categorized into eight groups using the TriNetX global database: 1) Retinal vascular occlusion, 2) Retinal artery occlusions (RAO), 3) Retinal vein occlusions (RVO), 4) Central retinal artery occlusions (CRAO), 5) Branch retinal artery occlusions (BRAO), 6) Central retinal vein occlusions (CRVO), 7) Branch retinal vein occlusions (BRVO), and 8) No retinal vascular occlusions. Groups were propensity score matched 1:1 for demographic and clinical covariates. Outcomes include the risk of all-cause dementia, AD, and VaD, assessed using Cox proportional hazard ratios with 95% confidence intervals. Kaplan-Meier analysis evaluated time to dementia onset.ResultsThe TriNetX database identified 21,367 individuals with retinal vascular occlusion who were followed for an average of 6.29 years. Participants with retinal vascular occlusions, RVOs, or BRVOs demonstrated higher risk of all-cause dementia and VaD. There were no increased associations for retinal vascular occlusions and AD.ConclusionsRetinal vascular occlusions and RVOs were associated with an increased risk of all-cause dementia and VaD, but not AD. No associations were found with RAOs. Retinal vein occlusions may serve as a potential clinical marker for underlying neurodegenerative disease and emphasize the need for careful monitoring in patients with retinal vascular occlusions.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1700-1708"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148873945","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":"The systemic Ben Brik score, MAROC 22: A mechanism-anchored bedside instrument for the surveillance of reversible cognitive burden in octogenarians-A single-center pilot.","authors":"Soufiane Ben Brik","doi":"10.1177/13872877261474889","DOIUrl":"10.1177/13872877261474889","url":null,"abstract":"<p><p>BackgroundCognitive decline in octogenarians is routinely attributed to irreversible neurodegeneration, yet a substantial fraction is driven by partly reversible physiological mechanisms. Oxidative and mitochondrial damage are among the earliest events in Alzheimer's disease pathology, upstream of amyloid deposition, and this framework has not been operationalized into a bedside instrument for the oldest-old.ObjectiveTo present the SBG-MAROC 22-a 310-point, 22-parameter, seven-pillar bedside matrix whose item weights are anchored to published hazard ratios for incident dementia-and to report preliminary single-center data on its feasibility and capacity to flag reversible contributors and acute decompensation.MethodsSingle-center, single-author, retrospective pilot. Forty-seven consecutive patients aged ≥ 80 years [mean age 83.7 ± 2.9 years; 55.3% female; baseline Montreal Cognitive Assessment (MoCA) 16.2 ± 4.1] were assessed with the SBG-MAROC 22 alongside the MoCA. A subgroup (n = 11) received the PD-GOLD protocol with MoCA reassessment at ∼45 days. No power calculation or concurrent control group; reporting followed STROBE.ResultsThe score showed a preliminary association with concurrent MoCA (r≈0.78), within-pilot inter-rater agreement (κ≈0.85), and at least one reversible contributor in 89.4% of patients. The treated subgroup gained a mean +6.0 MoCA points at 45 days (95% CI +3.0 to +9.0; prediction interval -3.1 to +15.1, crossing zero). An exploratory FXTAS-versus-Alzheimer's area under the curve was 0.92. All values are internal, uncontrolled pilot estimates, not validation.ConclusionsThe SBG-MAROC 22 is a clinically feasible, MRI-independent bedside instrument whose hypothesis-generating profile warrants independent, blinded, prospective multicenter validation before any clinical use. Claims of validated discrimination or therapeutic efficacy are not made.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1895-1904"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148663688","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}
Xin Yang, Xiangchun Xu, Ying Liu, Lei Shi, Feiying He
{"title":"Roles of smoke exposure and inflammatory biomarkers in cognitive function among older adults: Findings from two prospective cohort studies.","authors":"Xin Yang, Xiangchun Xu, Ying Liu, Lei Shi, Feiying He","doi":"10.1177/13872877261482025","DOIUrl":"10.1177/13872877261482025","url":null,"abstract":"<p><p>BackgroundMany studies have established associations between smoke exposure and both accelerated cognitive decline and systemic inflammation. However, their interrelationship remains unclear.ObjectiveThis study aims to provide novel insights into the tripartite relationships linking smoke exposure, inflammatory biomarkers, and cognitive function among older adults.MethodsThis study analyzed data from 2503 participants in the National Health and Nutrition Examination Survey (NHANES, 2011-2014) and 3263 participants in the China Health and Retirement Longitudinal Study (CHARLS, 2011-2012). Serum cotinine was mainly used to assess smoke exposure in NHANES, while self-reported smoking status was used in CHARLS. Cognitive function was assessed using standard cognitive tests in NHANES and CHARLS. Inflammatory biomarkers included NLR, SII, leukocyte, neutrophil and lymphocyte in NHANES and leukocyte in CHARLS. Linear regression, nonlinear threshold effect models, and mediation analysis examined associations and mediating effects.ResultsHigher cotinine was associated with lower cognitive scores in NHANES (<i>β</i> = -0.219, <i>p</i> < 0.001). In CHARLS, current smokers exhibited lower cognitive scores than never-smokers (<i>β</i> = -0.090, <i>p</i> = 0.004). Neutrophil and leukocyte showed linear relationship with cognitive function in NHANES, while other inflammatory indicators showed significant nonlinear threshold effects. Mediation analysis revealed that neutrophil and leukocyte partially mediated 7.39% and 9.75% of the smoke-cognitive decline association.ConclusionsSmoking is related to cognitive decline in older adults from two national cohorts, with neutrophil and leukocyte partly mediating this link in the U.S. cohort. Interventions for smoking cessation and inflammation reduction may help mitigate cognitive decline.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1772-1785"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148911806","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}
Ramkrishna K Singh, Semere Bekena, Alexis I B Walker, Kaylin Taylor, Yiqi Zhu, Subrata Pal, Essa A Mohamed, Jean-Francois Trani, Ian Kaplan, Ganesh M Babulal
{"title":"Exploratory factor and network analysis of 43 inflammatory plasma biomarkers and cognitive performance in Black adults.","authors":"Ramkrishna K Singh, Semere Bekena, Alexis I B Walker, Kaylin Taylor, Yiqi Zhu, Subrata Pal, Essa A Mohamed, Jean-Francois Trani, Ian Kaplan, Ganesh M Babulal","doi":"10.1177/13872877261481701","DOIUrl":"10.1177/13872877261481701","url":null,"abstract":"<p><p>BackgroundSystemic inflammation has been implicated in cognitive aging and neurodegeneration; however, inflammatory biomarkers are expressed in coordinated patterns rather than as isolated markers.ObjectiveTo identify latent inflammatory biomarker groupings and evaluate their associations with cognitive performance among midlife and older adults.MethodsThis cross-sectional study included 334 participants from the Aging Research Characterizing Health Exposome via Social Drivers (ARCHES) study. Cognitive performance was assessed using the Preclinical Alzheimer Cognitive Composite (PACC). Plasma inflammatory biomarkers were quantified using the NuLISA™ multiplex immunoassay platform. Exploratory factor analysis (EFA) (minimum residual extraction, oblimin rotation) identified latent inflammatory factors, retaining biomarkers with loadings ≥0.40. Factor scores were evaluated in multivariable linear regression models adjusted for age, sex, education, and genotype status; sensitivity analyses adjusted for socioeconomic context, medication use, BMI, lifestyle factors, and clinical diagnoses. Age-stratified and nonlinear spline analyses were conducted.Results27 of 43 biomarkers formed an eight-factor structure explaining 43% of variance. Two factors were significantly associated with cognitive performance after FDR correction. Factor 4 (CCL4, CXCL1, S100A12) and Factor 5 (IL2, IL5, IL13, IL10, CSF2) were inversely associated with PACC scores. These associations remained consistent across sensitivity analyses. Age-stratified analyses showed that several inflammatory factors were associated with cognitive performance among participants aged 45-<65 years, whereas no factors remained significant among participants aged ≥65 years after FDR correction. Nonlinear modeling indicated a non-linear age-cognitive performance relationship.ConclusionsEFA identified clusters of correlated inflammatory biomarkers associated with cognitive performance in this cohort of midlife and older adults.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1758-1771"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880337","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}
Patrick Crowley, Mark R O'Donovan, Evelyn Flanagan, Rónán O'Caoimh
{"title":"Associations between sleep and cognition among middle-aged and older adults in Europe.","authors":"Patrick Crowley, Mark R O'Donovan, Evelyn Flanagan, Rónán O'Caoimh","doi":"10.1177/13872877261481093","DOIUrl":"10.1177/13872877261481093","url":null,"abstract":"<p><p>BackgroundThe Survey of Health, Ageing and Retirement in Europe (SHARE) is a longitudinal multi-country study of community-dwelling middle-aged and older adults including data on sleep and cognition.ObjectiveTo examine the cross-sectional association between sleep-related issues and cognition in the SHARE (pooling waves 8 and 9; 2019-2022).MethodsSubjective sleep data were obtained from SHARE waves 8 and 9. Objective data were available from wave 8. The SHARE Cognitive Instrument (SHARE-Cog) assessed cognition. Participants were divided into three groups: probable dementia, cognitive impairment no dementia (CIND), and normal cognition (NC). Survey-weighted generalized linear regression models were used to compare groups.Results88,889 interviews were included (55% females; mean age 68.88), categorized as: probable dementia 7%, CIND 12%, and NC 81%. While, in the unadjusted analysis, a characteristic 'inverted U' shaped association was observed between sleep duration and cognition, only the association between cognition and longer sleep durations ≥10 hours remained statistically significant after adjusting for potential confounders. Cognitive impairment was significantly associated with subjective reports of recent trouble sleeping, weekly use of medication to aid sleep, and daytime napping, although only the association with daytime napping remained statistically significant after adjusting for potential confounders.ConclusionsThis analysis confirmed an association between sleep duration ≥10 hours and lower cognitive scores among community-dwelling middle-aged and older Europeans. Cognitive impairment was also significantly associated with daytime napping. Further research is required to understand the clinical significance of these findings and establish the underlying causal relationships.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1731-1744"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887630","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":"Reduced differentiation of personality in Alzheimer's disease-like dementia and associations between informant report of personality change and cognitive decline.","authors":"Silvia Gobbo, Daniele Romano","doi":"10.1177/13872877261469839","DOIUrl":"10.1177/13872877261469839","url":null,"abstract":"<p><p>BackgroundPersonality changes are documented in Alzheimer's disease (AD), but research has focused almost exclusively on how much traits change rather than how the underlying personality structure reorganizes. Recent evidence from healthy aging shows that personality traits can de-differentiate over time, suggesting a decline of coherence of traits with age. Whether such personality de-differentiation also occurs in neurodegeneration and how personality and cognitive changes relate remains unknown.ObjectiveThis study aimed to examine structural changes in personality traits in individuals with AD-like dementias, using the HEXACO personality model administered cross-sectionally to informants and to a control group of informants of healthy older adults, and explore dimensional changes in the relationship between reported changes in personality and cognition.Methods207 informants of persons with AD-like dementia and 201 informants of healthy older adults completed the Hexaco Adjective Scales, referring both to the present time and to perceived changes in personality, and a questionnaire (e-Cog) to assess cognitive changes.ResultsPrincipal component analysis revealed a simplified personality structure in persons with AD but not in healthy older adults, with Emotionality not emerging as an independent factor in persons with AD. Network analyses indicated significant links between personality trait changes and declines across cognitive domains that differed between the two groups.ConclusionsAD-like dementias are characterized by a reduced differentiation of personality structure paralleling the simplification of cognitive organization, with the strongest impact observed in the Emotionality domain. Personality changes also co-occur with perceived cognitive decline, underscoring the need to integrate personality assessment in evaluating dementia.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1320-1334"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148562122","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":"Retraction: Detection of Peri-Synaptic Amyloid-β Pyroglutamate Aggregates in Early Stages of Alzheimer's Disease and in AβPP Transgenic Mice Using a Novel Monoclonal Antibody.","authors":"","doi":"10.1177/13872877261474572","DOIUrl":"10.1177/13872877261474572","url":null,"abstract":"","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1493"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148648296","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}
Claudie Hooper, Emmanuel González, Leonor Nogueira, Julien Delrieu, Nicola Coley, Maria Soto, Bruno Vellas, Sophie Guyonnet
{"title":"Cross-sectional associations of loneliness with plasma p-tau217 and neurofilament light chain in dementia-free older adults in the INSPIRE-T baseline cohort.","authors":"Claudie Hooper, Emmanuel González, Leonor Nogueira, Julien Delrieu, Nicola Coley, Maria Soto, Bruno Vellas, Sophie Guyonnet","doi":"10.1177/13872877261482077","DOIUrl":"10.1177/13872877261482077","url":null,"abstract":"<p><p>BackgroundLoneliness is the subjective feeling of social isolation and evidence suggests that it increases the risk for cognitive decline and Alzheimer's disease (AD). However, studies examining the associations between loneliness and AD biomarkers are limited and inconclusive.ObjectiveWe sought to investigate the relationships between loneliness and plasma tau phosphorylated at threonine 217 (p-tau217) and plasma neurofilament light chain (NfL): peripheral biomarkers of central AD pathology.MethodsThis is a cross-sectional analysis of the 'INStitute for Prevention' 'healthy agIng' and 'medicine REjuvenative' 'Translational' (INSPIRE-T) baseline data. Participants were dementia-free (Mini-Mental State Exam score ≥ 24) community-dwellers aged ≥ 65 years (n = 434). Loneliness was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS<sup>®</sup>) Item Bank v2.0, Short Form 8a questionnaire and plasma p-tau217 and plasma NfL were measured using Lumipulse immunoassays. Multiple linear regression was conducted to evaluate the relationships between loneliness (exposure) and plasma biomarkers (outcomes).ResultsLoneliness was not associated with plasma p-tau217 (β = 0.00458 [95% CI: -0.00328, 0.01243], p = 0.253) or plasma NfL (β = 0.00138 [95% CI: -0.00418, 0.00693], p = 0.626) in multiple linear regression models adjusted for age, sex, education, cognitive performance, depressive score, eyesight, hearing, and apolipoprotein ε4 (<i>APOE</i> ε4) status (model 2). There was no significant moderating effect of sex, depression, eyesight, hearing or <i>APOE</i> ε4 on these associations.ConclusionsOur findings suggest that loneliness is not associated with plasma p-tau217 or plasma NfL in dementia-free older adults. Perspective studies are warranted to examine these associations further.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1823-1832"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13631390/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148880319","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Karina L M Sassi, Anika Thomson, Vanessa M Young, Natalia P Rocha, Antonio L Teixeira
{"title":"Mild behavioral impairment and risk of incident dementia: A systematic review and meta-analysis.","authors":"Karina L M Sassi, Anika Thomson, Vanessa M Young, Natalia P Rocha, Antonio L Teixeira","doi":"10.1177/13872877261480315","DOIUrl":"10.1177/13872877261480315","url":null,"abstract":"<p><p>BackgroundLate-life emergence of persistent behavioral changes has been recognized as a clinically meaningful sign of neurodegeneration. These neuropsychiatric symptoms, operationalized as mild behavioral impairment (MBI), represent a unique pathway through which early dementia symptoms may become observable. By capturing this neurobehavioral dimension of risk, MBI expands the traditional focus on cognitive decline and may provide a complementary framework for understanding the early manifestations of neurodegeneration.ObjectiveThis systematic review evaluated longitudinal evidence on the association between MBI and incident dementia, including conversion rates, dementia subtypes, domain-specific risk patterns, and biomarker correlates.MethodsWe systematically searched five databases up to November 2025. Eligible studies were longitudinal prospective or retrospective cohorts including adults ≥ 50 years without dementia at baseline, assessing MBI using ISTAART-aligned instruments and reporting incident dementia outcomes. Two reviewers independently screened studies and extracted data. Hazard ratios were synthesized using random-effects meta-analysis, with heterogeneity and publication bias formally assessed.ResultsDespite significant study heterogeneity, MBI was associated with increased risk of incident dementia. Alzheimer's disease was the most frequently reported outcome. Among different neurobehavioral domains, apathy and affective dysregulation emerged as particularly strong predictors of dementia risk. A few biomarker studies linked MBI to greater amyloid burden, elevated plasma phosphorylated tau, and structural brain changes, supporting a biological connection between MBI and early neurodegeneration.ConclusionsMBI seems to represent a clinically meaningful syndrome that identifies individuals at elevated risk for dementia. Future studies must confirm the clinical and epidemiological value of MBI and/or its subdomains, exploring their biological substrates.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1587-1601"},"PeriodicalIF":3.4,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13688341/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148900546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}