Journal of Alzheimer's Disease最新文献

{"title":"Research progress on terpenoids alleviating Alzheimer's disease through the Keap1/Nrf2/ARE pathway by exerting antioxidant effects and promoting mitophagy.","authors":"Wanting Zhang, Shan Wang, Xingchun Gou","doi":"10.1177/13872877261480043","DOIUrl":"https://doi.org/10.1177/13872877261480043","url":null,"abstract":"<p><p>The exact initiating causes of Alzheimer's disease (AD) remain inconclusive. Meanwhile, the causal sequence and interactions within its pathological network are still poorly understood, which limits the efficacy of single treatment strategies and impedes drug development. Oxidative stress, identified as a central intersection point within this network, drives the deposition of amyloid-β protein, excessive tau phosphorylation, neuroinflammation, and mitochondrial damage, creating a self-perpetuating cycle. Consequently, oxidative stress has become a focal point for multi-target interventions. This review systematically investigates the evidence of terpenoids in cellular and animal models, elucidating their protective effects via a dual antioxidant mechanism. Firstly, terpenoids activate the Keap1/Nrf2/ARE pathway, leading to the upregulation of antioxidant genes and reduced free radical generation. Secondly, they enhance PINK1/Parkin-mediated mitophagy, facilitating the clearance of damaged organelles and preventing the release of reactive oxygen species. The review also delves into the positive feedback regulatory network involving molecules like Nrf2 and key proteins of mitophagy, such as p62/SQSTM1, offering a detailed mechanistic insight into the synergistic effects of terpenoids. This study underscores the significance of natural terpenoids, with their unique regulatory role in oxidative stress, as a promising candidate library for Alzheimer's drug development due to their diverse structures, clear mechanisms, and high safety profile. Additionally, it establishes a theoretical and experimental basis for the development of novel intervention strategies targeting multiple pathways with a single drug.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877261480043"},"PeriodicalIF":3.4,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865257","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":"Mid-life candidate vascular plasma biomarkers are associated with MRI markers of vascular brain injury and amyloid- and tau-PET in cognitively healthy adults.","authors":"Martin D Mulligan, Ruiqi Wang, Qiong Yang, Alexa S Beiser, Pauline Maillard, Claudia Satizabal, Saptaparni Ghosh, Jeremy Tanner, Keith A Johnson, Charles DeCarli, Russell P Tracy, Daniel Levy, Emelia J Benjamin, Georges El Fakhri, Ramachandran S Vasan, Sudha Seshadri, Emer R McGrath","doi":"10.1177/13872877261480733","DOIUrl":"https://doi.org/10.1177/13872877261480733","url":null,"abstract":"<p><p>BackgroundIdentifying candidate biomarkers for preclinical dementia could improve our understanding of underlying biological pathways leading to vascular brain injury (VBI) and neurodegeneration.ObjectiveTo identify plasma protein markers of MRI markers of VBI and amyloid- and tau-PET burden in cognitively healthy adults.Methods125 plasma proteins were measured in dementia-free Framingham third Generation cohort participants between 2002-2005 (mean age 46 [SD 8]) with available MRI brain (n = 1039), ¹¹C-Pittsburgh Compound-B (PiB)- (n = 279), and/or ¹⁸F-Flortaucipir (FTP)-PET (n = 239) performed ∼13-15 years after blood sampling. Outcomes included white matter hyperintensities, peak width of skeletonized mean diffusivity, and free water); precuneus-, posterior cingulate- and frontal, lateral and retrosplenial cortices-Aβ deposition; and global- and entorhinal cortex-tau.ResultsGrowth differentiation factor-15 (GDF-15) was associated with increased VBI (p ≤ 0.02), while soluble receptor for advanced glycation end products (sRAGE) and insulin-like growth factor 1 (IGF-1) were associated with reduced VBI (p ≤ 0.04). Plasma tau, renin, and ApoB were associated with increased Aβ deposition (p ≤ 0.02), while sRAGE was associated with reduced Aβ deposition in all regions (p ≤ 0.03). Brain natriuretic peptide (NT-proBNP) and purine nucleoside phosphorylase (PNP) were associated with increased tau deposition (p ≤ 0.02), while low density lipoprotein cholesterol (LDL-C) and GDF-15 were associated with reduced tau deposition (p ≤ 0.04).ConclusionsCandidate vascular plasma proteins measured in dementia-free, asymptomatic adults at late mid-life were associated with subsequent neuroimaging markers of VBI and tau and amyloid deposition. Our findings highlight potential novel candidate vascular biomarkers for preclinical dementia but will require validation.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877261480733"},"PeriodicalIF":3.4,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865181","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":"Depressive symptoms and low cognitive performance in Chinese older adults: A severity-graded epidemiological analysis and a BARNN-inspired prospective risk-prediction framework with strict participant-level temporal validation.","authors":"Qiang Zhang, Xiao Cai, Yifan Zhao, Xinsong Ren, Dongwei Yan","doi":"10.1177/13872877261482053","DOIUrl":"https://doi.org/10.1177/13872877261482053","url":null,"abstract":"<p><p>BackgroundLate-life depression is robustly associated with subsequent cognitive impairment, yet the dose-response gradient and temporally validated, uncertainty-aware prediction tools remain understudied in Chinese older adults.ObjectiveTo characterize the severity-graded epidemiological association between depressive symptoms and low cognitive performance, and to develop and validate a prospective risk-prediction framework with explicit uncertainty estimation.MethodsWe analyzed 31,570 observations from 12,494 participants aged ≥45 years in the China Health and Retirement Longitudinal Study (2011-2020). Depressive symptoms were measured with the 10-item Center for Epidemiologic Studies Depression Scale (CESD-10); low cognitive performance was defined as total cognition score < 10. Layer 1 reported severity-graded prevalence and adjusted odds ratios. Layer 2 implemented a BARNN-inspired prospective state-transition predictor via a diverse tree ensemble, yielding predictive probability and epistemic uncertainty. Both layers used strict participant-level temporal validation.ResultsClinically significant depressive symptoms (CESD-10 ≥ 10) were associated with twofold higher odds of low cognitive performance (OR = 2.07, 95% CI 1.97-2.18), with a monotonic dose-response gradient across severity tiers (20.8% to 46.0%, p < 0.001). In prospective validation, the ensemble achieved comparable discrimination (AUC-ROC 0.838 versus 0.839 for logistic regression, P = 0.85) but superior calibration (Brier score 0.099 versus 0.126), plus per-sample uncertainty estimates and an explicit algorithmic deferral tier. The frozen four-tier rule produced a steep risk gradient (Low 5.8%, Moderate 24.9%, High 63.0%; OR high versus low=27.8).ConclusionsDepressive symptom severity shows a robust graded association with low cognitive performance in Chinese older adults. The framework supports reliable ordinal risk stratification with algorithmic deferral, providing a transferable template for population-level cognitive monitoring.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877261482053"},"PeriodicalIF":3.4,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865217","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":"A hippocampal vascular-glymphatic model of brain maintenance and cognitive resilience in Alzheimer's disease and post-stroke dementia.","authors":"Álvaro Ruiz-García, Blanca Díaz-Benito, Mariana Muñoz-García","doi":"10.1177/13872877261483191","DOIUrl":"https://doi.org/10.1177/13872877261483191","url":null,"abstract":"<p><p>Individuals with comparable burdens of brain pathology often follow markedly different cognitive trajectories. This heterogeneity is captured by three partly dissociable constructs-brain reserve, cognitive reserve, and brain maintenance-here grouped under the superordinate term cognitive resilience. Cognitive reserve has traditionally been indexed by education, occupational complexity, and lifelong cognitive engagement, yet its biological substrates remain incompletely defined. We propose that hippocampal vascular supply and perivascular (glymphatic) and meningeal lymphatic clearance, modulated by blood-brain barrier integrity and neuroinflammatory tone, constitute one biological substrate of resilience. We make its conceptual placement explicit: these processes operate predominantly as substrates of brain maintenance (efficient clearance limiting amyloid-β and tau accumulation) and brain reserve (a redundant hippocampal arterial supply buffering partial vascular compromise), rather than of cognitive reserve sensu stricto. We hypothesize, as an inference requiring direct testing rather than an established mechanism, that vascular architecture and clearance capacity are mechanistically coupled through perfusion and arterial pulsatility, rather than acting as independent parallel contributors. Preserved blood-brain barrier integrity and a regulated neuroinflammatory tone are proposed to sustain this axis, whereas their disruption, through astrocytic aquaporin-4 mislocalization, microglial activation, and barrier breakdown, accelerates cognitive decline. We additionally outline one speculative pathway by which cerebral perfusion may contribute directly to cognitive reserve. Consistent with a Hypothesis article, the model is framed as a small set of constrained, falsifiable predictions-distinguishing established, inferred, and speculative links-and as a research roadmap for Alzheimer's disease and post-stroke dementia, identifying modifiable targets (cerebral perfusion, sleep, vascular risk control) and reframing cognitive resilience as biologically grounded and potentially actionable.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877261483191"},"PeriodicalIF":3.4,"publicationDate":"2026-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148865249","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":"Multistrain probiotics modulate tau pathology and preserve visuospatial cognition in early cognitive impairment: A double-blind, randomized, placebo-controlled trial.","authors":"Eun Hyun Seo, Sarang Kang, Seung-Gon Kim, Ja-Hae Kim, Hye-Jung Yoon, Kyu Yeong Choi, Hyung-Jun Yoon, Kun Ho Lee, Kang-Ho Choi","doi":"10.1177/13872877261477084","DOIUrl":"https://doi.org/10.1177/13872877261477084","url":null,"abstract":"<p><p>BackgroundThe gut-brain axis is increasingly implicated in Alzheimer's disease (AD) pathogenesis.ObjectiveTo investigate whether a multistrain probiotic supplement is associated with changes in AD-related plasma biomarkers and cognitive function in older adults with early cognitive impairment.MethodsIn this randomized, double-blind, placebo-controlled trial, eighty-seven participants from the Gwangju Alzheimer's Disease and Related Dementias cohort were randomized to receive a multistrain probiotic (n = 40) or placebo (n = 47) for 24 weeks. Plasma phosphorylated tau 181 (pTau181), glial fibrillary acidic protein (GFAP), and neurofilament light chain (NfL) were evaluated at baseline and 24 weeks. Cognitive assessments included the Clinical Dementia Rating Sum of Boxes (CDR-SB), CERAD battery, Stroop test, and Rey-Osterrieth Complex Figure (ROCF). Analyses utilized linear mixed models and ANCOVA.ResultsCompared to placebo, the probiotic group exhibited a significant reduction in plasma pTau181 (p < 0.001). While GFAP and NfL remained stable with probiotics, the placebo group showed significant within-group increases (p = 0.014, p = 0.041). Clinically, the probiotic group demonstrated improved CDR-SB scores (p = 0.010), primarily driven by the memory domain. Probiotics were associated with improved performance in visuospatial construction tasks (Constructional Praxis, p = 0.036; ROCF copy, p = 0.027) and preserved constructional recall, whereas the placebo group exhibited significant decline (p = 0.025). No significant between-group differences were observed in Mini-Mental State Examination, verbal memory, or executive scores.ConclusionsMultistrain probiotics modulated plasma tau and neuroinflammatory biomarkers, and selectively preserved visuospatial cognition in this study. These findings suggest the potential role of microbiota-targeted interventions as a non-pharmacological adjunct for early cognitive impairment, although further studies are required to confirm underlying mechanisms.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877261477084"},"PeriodicalIF":3.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840192","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":"<i>APOE</i> ε4 and peripheral metabolic network architecture in older adults.","authors":"Dae Jong Oh, Ji Won Han, Tae Hui Kim, Kyung Phil Kwak, Bong Jo Kim, Shin Gyeom Kim, Jeong Lan Kim, Seok Woo Moon, Joon Hyuk Park, Seung-Ho Ryu, Dong Woo Lee, Seok Bum Lee, Jung Jae Lee, Jin Hyeong Jhoo, Ki Woong Kim","doi":"10.1177/13872877261476718","DOIUrl":"https://doi.org/10.1177/13872877261476718","url":null,"abstract":"<p><p>BackgroundWhether apolipoprotein E (<i>APOE</i>) ε4 status shapes the organization of modifiable peripheral metabolic risk pathways for dementia prevention remains unclear. Most prior studies have focused on individual <i>APOE</i>-by-biomarker interactions rather than the broader conditional dependency structure among metabolic variables.ObjectiveWe aimed to examine whether <i>APOE</i> ε4 is conditionally connected to metabolic factors and whether network architecture differs by genotype.MethodsIn 2454 participants from the Korean Longitudinal Study on Cognitive Aging and Dementia with complete data on 13 variables, conditional dependency networks were estimated using graphical least absolute shrinkage and selection operator models and mixed graphical models. Network Comparison Tests were used to compare 12-node metabolic networks between ε4 carriers and non-carriers. Cox proportional hazards models evaluated whether hub biomarkers predicted incident cognitive impairment over a median follow-up of 7.4 years and whether associations differed by <i>APOE</i> genotype.Results<i>APOE</i> ε4 showed negligible conditional connectivity, with near-zero partial correlations in GLASSO (maximum |r| = 0.0114) and zero edge weights in mixed graphical models. The 12-node metabolic network did not differ significantly between carriers and non-carriers in either network structure (M = 0.1671, p = 0.45) or global strength (S = 2.3662, p = 0.46). Among 1922 baseline cognitively normal participants, 504 developed cognitive impairment during follow-up. Neither the <i>APOE</i> × homocysteine interaction (p = 0.921) nor the <i>APOE</i> × creatinine interaction (p = 0.402) was significant.Conclusions<i>APOE</i> ε4 was conditionally independent of the peripheral metabolic variables examined, with no major genotype-specific differences in network architecture. These findings highlight the importance of metabolic dementia prevention regardless of genotype, although interventional confirmation is warranted.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877261476718"},"PeriodicalIF":3.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840215","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":"Network-based statistical mapping of structural covariance alterations in pathologically confirmed argyrophilic grain disease and Alzheimer's disease: An exploratory pilot study.","authors":"Keita Sakurai, Daita Kaneda, Yuto Uchida, Haruto Shibata, Satoru Morimoto, Yoshio Hashizume","doi":"10.1177/13872877261480673","DOIUrl":"https://doi.org/10.1177/13872877261480673","url":null,"abstract":"<p><p>BackgroundAlthough neuroimaging differences from Alzheimer's disease (AD) in argyrophilic grain disease (AGD), a limbic-predominant 4-repeat tauopathy, have been evaluated, edge-wise alterations in structural similarity remain unexamined.ObjectiveAs an exploratory pilot study, to apply network-based statistics (NBS) to individualized structural covariance (ISC) matrices to identify morphological-similarity alterations in AGD and AD.MethodsWe analyzed 3D T1-weighted MRI from 13 pathologically confirmed AGD, 17 AD, and 18 healthy controls (HC). Gray-matter volumes from a 170-region atlas were used to compute ISC matrices. Between-group differences were assessed using NBS (threshold t = 3.5; 5000 permutations). Component strength was the sum of ISC edge weights within the significant component. Stability was assessed via leave-one-out analyses and bootstrap confidence intervals. Significant edges were mapped to Yeo 7 resting-state networks.ResultsAll three comparisons yielded a single significant component (HC versus AD: 340 edges; HC versus AGD: 80 edges; AGD versus AD: 39 edges). Component strength was higher in the group with less widespread morphological disruption (HC > AD; HC > AGD; AGD > AD), with non-overlapping bootstrap confidence intervals. Mapping to resting-state networks revealed widespread posterior cortico-limbic involvement in AD and a limbic-predominant pattern in AGD. In the AGD versus AD comparison, AD showed greater disruption within frontoparietal, somatomotor, and ventral attention systems. Component strength correlated positively with Mini-Mental State Examination scores (r = 0.48, <i>p</i> = 0.01).ConclusionsNBS applied to ISC matrices provides preliminary evidence of altered morphological similarity in AGD and AD, with AGD showing a limbic-predominant subnetwork and AD demonstrating broader posterior cortico-limbic involvement.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877261480673"},"PeriodicalIF":3.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840176","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 profiles in idiopathic normal pressure hydrocephalus and Alzheimer's disease.","authors":"Magnhild S Dejgaard, Per Kristian Eide, Gro Gujord Tangen, Eva Skovlund, Geir Selbæk, Torgeir Bruun Wyller","doi":"10.1177/13872877261478264","DOIUrl":"https://doi.org/10.1177/13872877261478264","url":null,"abstract":"<p><p>BackgroundIdiopathic normal pressure hydrocephalus (iNPH) and Alzheimer's disease (AD) are neurodegenerative disorders with partly overlapping clinical features. Since the treatment is different, we need better knowledge about how the cognitive profile differs between these conditions.ObjectiveWe aimed to compare the cognitive profile of iNPH patients with that of a large cohort of confirmed AD patients.MethodsPatients diagnosed with iNPH and accepted for shunt surgery were compared with patients with biomarker verified Alzheimer's disease in The Norwegian Register of Persons Assessed for Cognitive symptoms (NorCog). All patients underwent a standardized cognitive assessment with age and education adjusted z-scores. We used the Clinical Dementia Rating Scale (CDR) to adjust for disease severity. Since the cognitive score distributions were highly skewed, we used nonparametric analyses stratified by CDR stage combined with multinomial logistic regression.ResultsIn total, 276 iNPH patients were compared to 1113 AD patients. iNPH patients performed significantly poorer on phonemic fluency [median z-score difference (AD-iNPH) 0.30, 95% confidence interval (CI) 0.20 to 0.50], but significantly better on other cognitive tests, in particular immediate (median difference -0.35, 95% CI -0.49 to -0.20) and delayed recall (median difference -0.46, 95% CI -0.59 to -0.34). The differences persisted after adjustment for CDR and were most pronounced in early stages of the disease.ConclusionsiNPH seems to affect phonemic fluency more and memory less than AD. As the disease progresses, the cognitive profiles become more similar, and the conditions cannot be distinguished by cognitive tests.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877261478264"},"PeriodicalIF":3.4,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840237","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":"Comparing the associations between performance-based, participant-reported, and study partner-reported instrumental activities of daily living tasks and cognition in cognitively unimpaired adults.","authors":"Abigail T LaCasse, Catherine E Munro, Hannah Truitt, Madeline Yu, Claudia R Aibel, Onyinye J Udeogu, Rebecca E Amariglio, Dorene M Rentz, Gad A Marshall, Mark A Dubbelman","doi":"10.1177/13872877261478266","DOIUrl":"https://doi.org/10.1177/13872877261478266","url":null,"abstract":"<p><p>BackgroundAssessing instrumental activities of daily living (IADLs) is an integral diagnostic process for cognitive decline due to Alzheimer's disease (AD). While there are questionnaire-based and performance-based IADL measures, there is no clear consensus on the best methodology for a preclinical population.ObjectiveWe aimed to compare performance-based and questionnaire-based IADL measures and investigate whether IADL measures differently predict cognition.MethodsOne hundred and sixty-one cognitively unimpaired participants (mean age=70.69 ± 6.33 years; 62% female) completed performance-based IADL measures (i.e., Harvard Automated Phone Task [APT]; Czaja Functional Assessment Battery [CFAB]), questionnaire-based IADL measures (i.e., Cognitive Function Index [CFI]; The Alzheimer's Disease Cooperative Study Activities of Daily Living-Prevention Instrument [ADCS ADL-PI], also completed by study partners), and cognitive assessments. Separate cross-sectional linear regressions were used to determine (1) whether IADL questionnaires predicted performance-based measures, (2) whether IADL assessments predicted cognition.ResultsGreater impairment on participant self-reported questionnaires (CFI and ADCS ADL-PI) were associated with worse performance on the CFAB automated teller machine task (R² = 0.36, p = 0.010; R² = 0.44, p = 0.003). Worse performance on the APT primary care physician task and greater impairment on participant self-reported CFI were associated with worse executive functioning (R² = 0.13, p = 0.003; R² = 0.06, p = 0.035) and slower processing speed (R² = 0.15, p = 0.009; R² = 0.22, p < 0.001). Greater impairment on the participant self-reported CFI was the only assessment associated with worse memory scores (R² = 0.14, p = 0.005).ConclusionsAmong cognitively unimpaired older adults, few questionnaire-based IADL questionnaires were associated with performance-based measures. There was variability within and across IADL assessments' associations with cognition, suggesting that not all IADL assessments are interchangeable.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877261478266"},"PeriodicalIF":3.4,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148818324","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":"Dual eligibility and neuropsychiatric symptoms and treatment disparities among Medicare Part D beneficiaries with Alzheimer's disease and related dementias.","authors":"Sara Alsharayri, Sara Knox, Maxwell Cutty, Abe Mollalo","doi":"10.1177/13872877261478140","DOIUrl":"https://doi.org/10.1177/13872877261478140","url":null,"abstract":"<p><p>BackgroundNeuropsychiatric symptoms (NPS) are common and clinically consequential in Alzheimer's disease and related dementias (ADRD), yet their recognition and treatment may vary across socioeconomic groups. Dual-eligible Medicare-Medicaid beneficiaries represent a vulnerable population, but differences in NPS documentation and management remain unclear.ObjectiveTo examine whether dual eligibility is associated with differences in (1) documented NPS and (2) prescription fills among Medicare beneficiaries with ADRD who received home health (HH) care.MethodsWe conducted a cross-sectional study of 167,484 Medicare Part D beneficiaries with ADRD who received HH care and were identified using the Chronic Conditions Warehouse flag. Dual eligibility was the primary exposure. NPS were identified using diagnosis codes from medical claims. Prescription fills for NPS-related medications were identified using Medicare Part D prescription drug event data (≥2 prescription fills for anxiety-related medications and antidepressants). Logistic regression models estimated associations of dual eligibility with NPS documentation and prescription fills, adjusting for demographic characteristics, original Medicare entitlement, and comorbidity burden.ResultsDual-eligible beneficiaries comprised 30.7% of the cohort. Documented confusion and anxiety were the most prevalent symptoms. Dual-eligible beneficiaries had a higher prevalence of confusion (83.5% versus 82.0%) and anxiety (57.0% versus 53.2%) compared with Medicare-only beneficiaries. After adjustment, dual eligibility was associated with higher odds of documented confusion (aOR 1.18, 95% CI 1.14-1.22) and anxiety (aOR 1.19, 95% CI 1.15-1.22). Dual eligibility was also associated with slightly higher odds of anxiety-related prescription fills (aOR 1.21, 95% CI 1.17-1.26), whereas antidepressant prescription fills did not differ (aOR 1.00, 95% CI 0.95-1.05).ConclusionsDual eligibility was associated with modest differences in NPS documentation and prescription fills, suggesting differences in recognition and management of NPS among beneficiaries with ADRD.</p>","PeriodicalId":14929,"journal":{"name":"Journal of Alzheimer's Disease","volume":" ","pages":"13872877261478140"},"PeriodicalIF":3.4,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148793525","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}