Journal of Alzheimer's Disease最新文献

{"title":"Racial and ethnic differences in cardiometabolic predictors of white matter hyperintensities burden among males: The HABS-HD study.","authors":"Cellas A Hayes, Raymond Jones, Roland J Thorpe","doi":"10.1177/13872877251365128","DOIUrl":"10.1177/13872877251365128","url":null,"abstract":"<p><p><b>Background:</b> Cardiometabolic conditions accelerate white-matter hyperintensity (WMH) accumulation-a vascular injury marker linked to increased Alzheimer's disease risk-yet how these relationships vary by race and ethnicity in males is poorly understood. <b>Objective:</b> To quantify racial ethnic-specific associations between cardiometabolic risk factors, blood-pressure indices, and WMH volume in Non-Hispanic White (NHW), Non-Hispanic Black (NHB), and Hispanic males. <b>Methods:</b> We analyzed 1378 males (558 NHW, 375 NHB, 445 Hispanic) from the Healthy Aging Brain Study-Health Disparities. Five binary exposures (hypertension, diabetes, dyslipidemia, obesity, tobacco dependence), four continuous blood-pressure metrics (systolic, diastolic, pulse, mean arterial pressure), and a principal-component cardiometabolic score were regressed on log-transformed, intracranial volume-adjusted WMH volume in race-stratified models. <b>Results:</b> Hispanic males exhibited the broadest vulnerability: hypertension, diabetes, and tobacco dependence each predicted higher WMH (β range 0.60-0.77, <i>p</i> ≤ 0.002), and the composite score had the strongest association (β = 0.26, 0.13-0.39, <i>p</i> < 0.001). Additionally, every 10-mm Hg rise in systolic, diastolic, pulse, or mean arterial pressure further increased WMH in Hispanic males (e.g., systolic β = 0.18, 0.11-0.26), an effect absent in NHW and NHB males. <b>Conclusions:</b> Cardiometabolic and hemodynamic drivers of WMH differ markedly across racial and ethnic groups of males, with Hispanic males showing the most pervasive risk profile, NHB males selective associations, and NHW males limited links. Tailored vascular-risk interventions may be essential to curb WMH-related pathways to Alzheimer's disease in racially and ethnically diverse male populations.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1067-1079"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12342656/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144784277","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}

{"title":"Valuation of cognition bolt-ons for EQ-5D-5L in Japan: A comparative analysis of scaling factor and conventional models.","authors":"Ataru Igarashi, Aureliano Paolo Finch, Zhihao Yang, Yukinori Sakata, Mie Azuma-Kasai, Kiyoyuki Tomita, Mika Ishii, Manabu Ikeda","doi":"10.1177/13872877251365548","DOIUrl":"10.1177/13872877251365548","url":null,"abstract":"<p><p>BackgroundA cognition bolt-on version for EQ-5D is needed to comprehensively assess health states of the general population.ObjectiveTo experimentally evaluate the valuation methods of the EQ-5D-5L bolt-ons using scaling factor and conventional models, we used the cognition bolt-on version of the Japanese EQ-5D-5L (EQ-5D-5L + C) and two previously developed cognition dimensions Remembering things and Thinking clearly.MethodsEligible participants, recruited from the general Japanese population, included adults living in three cities. Interviews were conducted from June to August 2023. Participants were randomized to Arms 1 (EQ-5D-5L + C), 2 (EQ-5D-5L + Remembering things), and 3 (EQ-5D-5L + Thinking clearly). Preferences were collected using a composite time trade-off (cTTO). The \"1-cTTO\" data were modeled using the scaling factor model, with EQ-5D-5L disutility weights estimated from the existing value sets. We also fitted the data into the conventional main-effects additive model. Both models used a tobit model and maximum likelihood estimation. Model performance was assessed using indices of fit.ResultsOverall, 864 individuals participated in the study. Addition of cognition dimensions to EQ-5D-5L expanded the scaling factor model coefficients in all arms. The observed mean and predicted \"1-cTTO\" values of the scaling factor model were not largely different in all three arms. The mean absolute errors of the scaling factor and conventional models were 0.0720 and 0.1305, 0.0748 and 0.0885, and 0.0985 and 0.0685 in Arms 1, 2, and 3, respectively.ConclusionsThe performance of the two models did not appear greatly different. Further experimental valuation studies using the scaling factor model and cognition items are warranted.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1209-1216"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144955013","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":"Caregiver experiences after the death of a person with dementia with Lewy bodies: A mixed-methods analysis.","authors":"Melissa J Armstrong, Easton Wollney, Zhigang Li, Yunfeng Dai, Brian LaBarre, Tingchang Wang, Kaitlin Sovich, Hannah F Jury, James E Galvin, Adolfo M Henriquez, Susan M Maixner, Henry L Paulson, Julie A Fields, Angela Lunde, Bradley F Boeve, Carol Manning, Angela S Taylor, Zachary G Baker","doi":"10.1177/13872877251365218","DOIUrl":"10.1177/13872877251365218","url":null,"abstract":"<p><p>BackgroundDementia with Lewy bodies (DLB) is a common degenerative dementia, but no studies investigate bereaved caregiver experiences.ObjectiveTo investigate the experiences of caregivers three months after the death of persons with DLB using a mixed-methods approach.MethodsDyads of individuals with moderate-advanced DLB and their primary informal caregivers were followed prospectively every 6 months until the person with DLB died. Caregivers completed a study visit with questionnaires and a semi-structured interview ∼3 months later. Spearman correlation coefficients and Wilcoxon rank-sum tests evaluated the relationships of post-death measures with pre-death patient and caregiver variables. Thematic analysis was used to analyze the interviews.ResultsSeventy-three caregivers completed visits (mean 3.5 months post-death). Most of the caregivers were women (82.2%) and spouses (76.7%) or adult children (17.8%). Over 40% had scores indicating risk for clinical depression. Post-death caregiver experiences (depression, quality of life, grief, resilience) correlated with pre-death caregiver experiences. Post-death experiences did not associate with patient characteristics, disease-related symptoms, or healthcare services used in the last 6 months of life. Trajectories for caregiver measures from pre- to post-death visits varied widely. Interview themes included grief and sadness, anger, guilt and regret, relief, appreciation/gratitude, and adjusting to a new normal.ConclusionsThe finding that pre-death caregiving experiences have the strongest association with post-death experiences emphasizes the critical importance of accessible and evidence-based caregiver support before and after the death of a person with DLB. Research is needed to develop interventions for current and bereaved caregivers of individuals with DLB.Trial registration informationNCT04829656 (submitted 2021-03-22).</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1097-1113"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12412333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144846576","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}

{"title":"National Alzheimer's Coordinating Center cerebral neuropathology and cognitive function in atrial fibrillation.","authors":"Kathryn A Wood, Xinyue Chen, Yi-An Ko, Whitney Wharton, Marla Gearing","doi":"10.1177/13872877251364508","DOIUrl":"10.1177/13872877251364508","url":null,"abstract":"<p><p>Many studies have shown a relationship between atrial fibrillation (AF) and dementia or Alzheimer's disease (AD). The National Alzheimer's Coordinating Center (NACC) brain autopsy cohort was used to explore neuropathology in AF (N = 3558) using logistic and ordinal logistic regression. AF was significantly associated with differences in CERAD neuritic plaque density (estimated difference 0.76, 95% CI = [0.63, 0.92]). Subjects with AF had higher Braak and NIA/Reagan Scores, indicating worse neuropathology in AF; this was not significant however, after multiple testing adjustment. These findings suggest that the association between AF and higher dementia risk is unlikely mediated by primary dementia-related mechanisms.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"980-985"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760096","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":"Immune system-associated genes in patients with Alzheimer's disease.","authors":"Rui Yao, Ziyu Ouyang, Tianyan Xu, Yuan Zhu, Beisha Tang, Jinchen Li, Bin Jiao, Lu Shen, Shilin Luo, Xuewen Xiao","doi":"10.1177/13872877251364396","DOIUrl":"10.1177/13872877251364396","url":null,"abstract":"<p><p>BackgroundAlzheimer's disease (AD) has been linked to the immune system, but the role of immune-related genes in AD remains unclear.ObjectiveTo investigate the association between immune-related genes and AD risk systematically.MethodsWhole-genome sequencing (WGS) was performed on 1516 AD patients and 2010 controls. Genetic analysis of 8260 immune-related genes was conducted using PLINK 1.9 for common variants (MAF ≥ 0.01) and SKAT-O test for rare variants (MAF < 0.01). Molecular docking and RNA-seq were used to investigate the effects of <i>SAMD9</i> variants on protein function and their role in immune system and AD pathogenesis. In a subset of 184 AD patients and 118 controls, the relationship between polygenic risk scores (PRS) and plasma biomarkers was examined.ResultsSignificant associations were observed between common variants in <i>APOE</i> and <i>ABCA7</i> and AD. Two rare missense variants in <i>SAMD9</i> (F222L, I1389T) were suggestively linked to AD. Molecular docking and RNA-seq indicated that <i>SAMD9</i> F222L is a loss-of-function variant, affecting immune-related pathways. A rare missense variant in <i>HRH1</i> was associated with the plasma Aβ₄₂/Aβ₄₀ ratio. PRS of immune-related genes correlated with AD biomarkers (NfL, ptau181, ptau217, ptau231, and GFAP).ConclusionsCommon variants in <i>APOE</i> and <i>ABCA7</i>, along with rare missense variants in <i>SAMD9</i> and <i>HRH1</i>, are linked to AD. The <i>SAMD9</i> F222L variant was associated with altered immune-related gene expression, suggesting a potential link to AD pathogenesis. Immune-related gene PRS correlates with AD biomarkers, highlighting the immune system's role in AD in the Chinese population.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1129-1142"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144789217","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":"Autoimmune antibodies and systemic inflammatory markers are prevalent and associated with cognition in individuals aged 90.","authors":"Ghasem Farahmand, Anne-Marie C Leiby, Jiaxin Yu, Aanan Ramanathan, Rojan Javaheri, Claudia H Kawas, Davis C Woodworth, Maria M Corrada, Tianchen Qian, S Ahmad Sajjadi","doi":"10.1177/13872877251365560","DOIUrl":"10.1177/13872877251365560","url":null,"abstract":"<p><p>BackgroundWhile recent studies have found associations between markers of autoimmunity/inflammation and cognitive performance in individuals aged 60-90, these findings remain unexplored in individuals aged 90 and above.ObjectiveTo examine the prevalence of autoimmune antibodies and raised inflammatory markers and their associations with cognition in participants aged 90 + .MethodsWe included participants with serological testing from The 90+ Study, a community-based longitudinal study in southern California. For measures of autoimmunity, we evaluated antinuclear, antineutrophil cytoplasmic (ANCA), rheumatoid factor, double stranded DNA, antithyroglobulin, and thyroid peroxidase antibodies. For inflammatory markers, we examined interleukin-6 (IL-6) and erythrocyte sedimentation rate (ESR). To examine the relationship between autoimmune antibodies and inflammatory markers with cognitive performance, we ran linear mixed effects models.ResultsAmong 201 participants (mean age 94.8 years, 56.7% female, 93.5% white, and 4.5% with rheumatologic illness), autoimmune antibodies were positive in 70.2%. Also, among 142 participants with test results, elevated inflammatory markers were detected in 76.8%. Linear mixed effects model analyses revealed an association between higher levels of ANCA (<i>p</i> = 0.04), IL-6 (<i>p</i> = 0.01), and ESR (<i>p</i> = 0.01) and lower global cognitive scores. In a subset of participants with amyloid PET (<i>n</i> = 173), results remained significant even after accounting for amyloid burden.ConclusionsAutoimmune antibodies and raised inflammatory markers were highly prevalent in a community cohort of individuals aged 90 + . Our results suggest that increased prevalence of autoimmunity and inflammation might be associated with worse cognitive performance in this age group, independent of amyloid.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1217-1225"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799126","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}

{"title":"Determinants of burden among family caregivers of persons with dementia: Observational study using multiple monitoring methods.","authors":"Bomgyeol Kim, Jiyoung Shin, Kyung Hee Lee","doi":"10.1177/13872877251365642","DOIUrl":"10.1177/13872877251365642","url":null,"abstract":"<p><p>BackgroundSupporting persons with dementia and their caregivers is a global public health priority. However, current research typically relies on subjective caregiver reports, lacking the integration of objective physiological indicators.ObjectiveTo identify the determinants of caregiver burden among family caregivers of persons with dementia, guided by a biopsychosocial framework.MethodsSeventy-five dyads of persons with dementia and their caregivers participated in this study. The determinants of caregiver burden, including biological, psychological, and social factors, were assessed using sweat patches, actigraphy, and surveys, and analyzed using hierarchical multiple regression analysis.ResultsThe mean caregiver burden score was 42.32. Hierarchical multiple regression analysis showed that psychological factors explained 39.3% of the variance in caregiver burden. A 17.5% increase was observed by the addition of biological factors, accounting for 56.8% of the variance. Among the biological factors, high level of pro-inflammatory cytokine tumor necrosis factor-α in persons with dementia was significantly associated with increased caregiver burden. In contrast, long total sleep time was associated with decreased caregiver burden. Amidst psychological factors, not only increased depressive symptoms but also severe behavioral and psychological symptoms of dementia in individuals with dementia were significantly associated with increased caregiver burden.ConclusionsThese findings highlight the importance of tailored interventions that address both biological and psychological factors to reduce caregiver burden and improve care outcomes. Additionally, by alleviating caregiver burden, these interventions may also support ageing-in-place, allowing persons with dementia to remain in familiar environments within their communities.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1285-1293"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816715","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":"Surgical advances in the treatment of Alzheimer's disease: A comprehensive review.","authors":"Fei Xie, Yongqiang Ye, Jianqiang Hao, Hongbin Liu, Seidu A Richard, Sen He","doi":"10.1177/13872877251364397","DOIUrl":"10.1177/13872877251364397","url":null,"abstract":"<p><p>Alzheimer's disease (AD), a progressive neurodegenerative disorder, represents a significant global health challenge with profound implications for patients and their families. Despite decades of intensive research efforts, no curative treatment for AD currently exists. In recent years, surgical interventions have emerged as a promising therapeutic avenue, offering potential for disease modification and symptom management. This comprehensive review critically evaluates the evolving landscape of surgical approaches in AD treatment, encompassing deep brain stimulation, focused ultrasound, gene therapy delivery systems, neural grafting techniques, and lymphatic-venous anastomosis. We systematically analyze the neurobiological mechanisms, clinical efficacy, safety profiles, and technical challenges associated with these interventions. Drawing upon an extensive review of 112 recent studies, this article provides a rigorous assessment of the current state of surgical therapies for AD, while identifying key knowledge gaps and future research directions that could advance the field toward more effective therapeutic strategies.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"899-909"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144835146","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":"Longitudinal associations between plasma biomarkers and changes in naturalistic driving behaviors in older adults.","authors":"Chen Chen, Ganesh M Babulal","doi":"10.1177/13872877251365636","DOIUrl":"10.1177/13872877251365636","url":null,"abstract":"<p><p>BackgroundThe aging United States population is expected to significantly increase by 2050, along with Alzheimer's disease (AD), a leading cause of cognitive impairment among older adults. AD is associated with declines in driving abilities and compromised safety, yet early detection remains challenging. Plasma biomarkers like ptau₂₁₇ and Aβ_42/40 are potential tools for detecting preclinical AD, offering a less invasive and scalable alternative to traditional methods.ObjectiveThis study explored the relationship between plasma biomarkers (ptau₂₁₇ and Aβ_42/40) and longitudinal changes in naturalistic driving behaviors in older adults.MethodsParticipants were enrolled in longitudinal studies occurring in The DRIVES Project, which included older adults aged 65 and above who were cognitively normal at baseline. Longitudinal driving behaviors were captured daily using GPS-based data loggers, while plasma biomarkers were used to examine preclinical AD. Linear mixed-effects models assessed the relationship between preclinical AD and driving behaviors over a four-year period.ResultsParticipants with preclinical AD based on ptau₂₁₇ exhibited a decline in driving behaviors, including fewer long trips and visits to unique destinations, while driving more frequently per month. Preclinical AD based on Aβ_42/40 showed increased shorter trips and reduced entropy. Both plasma analytes were associated with longitudinal changes in driving behaviors, but no significant differences in adverse events were observed.ConclusionsPlasma analytes ptau₂₁₇ and Aβ_42/40, are associated with subtle changes in driving behaviors, offering a non-invasive tool for early detection of preclinical AD. Driving behaviors analysis could be integrated into clinical practice for earlier intervention and better management of AD progression.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1275-1284"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799162","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 relationships between cerebrospinal fluid neurofilament light chain and hippocampal atrophy with cognitive decline.","authors":"Ramkrishna K Singh, Semere Bekena, Nikitha Damera, Yiqi Zhu, Jean-Francois Trani, Ganesh M Babulal","doi":"10.1177/13872877251365219","DOIUrl":"10.1177/13872877251365219","url":null,"abstract":"<p><p>BackgroundIdentifying predictive biomarkers of cognitive decline is critical for timely intervention in early Alzheimer's disease and related dementia. Biomarkers such as cerebrospinal fluid (CSF) neurofilament light (NfL), and MRI-based hippocampal atrophy are potential indicators of neurodegeneration, but their long-term predictive value remains unclear.ObjectiveThis study examined 20-year longitudinal associations between CSF NfL, MRI-based hippocampal atrophy, and cognitive decline in cognitively normal older adults.MethodsA cohort of 279 cognitively normal adults aged ≥55 years was followed from 2003 to 2023 at the Knight ADRC. Participants underwent annual cognitive and neurological assessments, including Clinical Dementia Rating (CDR), CSF NfL quantification, and MRI-based hippocampal volumetry. Cognitive decline was defined as: (1) first progression (CDR ≥ 0.5) and (2) sustained progression (two consecutive CDRs ≥ 0.5). Analyses included Kaplan-Meier survival, Cox proportional hazards models, and linear mixed-effects (LME) models.ResultsParticipants had a mean age of 66.5 years (SD = 6.08); 58.4% were female. Mean follow-up was 11.41 years (SD = 3.5). First progression occurred in 71 participants (25.4%), and sustained progression in 35 (13%). Higher CSF NfL levels were associated with faster time to first (95% CI:0.2-1; p < 0.001) and sustained progression (95% CI:0.46-1; p = 0.008). Cox models showed increased risk of first progression (HR = 1.83; 95% CI: 1.11-3.01; p = 0.018) but not sustained (p = 0.093). LME models showed CSF NfL increase and hippocampal volume decline (p < 0.001) in both outcomes.ConclusionsCSF NfL is a strong predictor of cognitive decline and may serve as a screening biomarker for early dementia risk.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"1143-1153"},"PeriodicalIF":3.1,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144816716","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}