The Journal of Prevention of Alzheimer's Disease最新文献

{"title":"Prevalence of dementia and BPSD in community-dwelling older adults with advanced care needs: a nationwide survey in Taiwan.","authors":"Kai-Ming Jhang, Yu-Chun Tung, Wen-Fu Wang, Hsiang-Ju Chung, Hui-Yi Liao, Ling-Chun Huang, Chih-Cheng Hsu, Yuan-Han Yang","doi":"10.1016/j.tjpad.2026.100656","DOIUrl":"10.1016/j.tjpad.2026.100656","url":null,"abstract":"<p><strong>Background: </strong>Caring for people with both dementia and advanced care needs is complex. This study aimed to elucidate the prevalence of dementia and behavioral and psychological symptoms of dementia (BPSD) in patients receiving advanced care, including tube feeding, respiratory care, subcutaneous injection, urinary catheter, stoma care or enema, wound care, pain care, or dialysis.</p><p><strong>Methods: </strong>This study was a nationwide, population-based, cross-sectional survey. A total of 11,297 participants were enrolled between September 2020 and June 2022 using a multistage stratified systematic sampling design. Dementia diagnosis was made by subspecialists during in-home visit or by expert consensus. The presence of BPSD and the use of specific advanced care services were collected by trained interviewers.</p><p><strong>Results: </strong>Overall, 732 (6.5%) participants received at least one item of advanced care and 975 (8.6%) were diagnosed with dementia. Participants receiving advanced care had a higher prevalence of dementia (18.0%vs. 8.0%, p < 0.0001). Subjects receiving stoma or enema care (OR=4.92, 95% CI=2.29-10.59, p < 0.0001), tube feeding (OR=3.20, 95%CI=1.99-5.15, p < 0.0001), dialysis (OR=2.97, 95% CI=1.80-4.92, p < 0.0001), urinary catheterization or intermittent catheterization (OR=2.20, 95% CI=1.32-3.67, p = 0.003), and respiratory care (OR=2.01, 95% CI=1.14-3.57, p = 0.017) had a significantly higher risk of dementia. For BPSD, day-night confusion (42.0%vs. 27.9%, p = 0.002) and care-resistant behaviors (19.8%vs. 12.0%, p = 0.019) were significantly more prevalent in participants receiving advanced care.</p><p><strong>Conclusions: </strong>This study found that patients receiving advanced care had a significantly higher prevalence of dementia and BPSD in Taiwanese population. Healthcare professionals should be vigilant regarding potential comorbid dementia in patients receiving advanced care and provide more patient-centered approaches or non-pharmacological interventions to alleviate BPSD and reduce care partner's loading.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 9","pages":"100656"},"PeriodicalIF":7.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499164/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148765612","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oxidation over omega-3: Reinterpreting the paradoxical link between fish oil supplements and accelerated cognitive decline.","authors":"Dong'e Huang, Munan Lin, Junqing Dong","doi":"10.1016/j.tjpad.2026.100660","DOIUrl":"10.1016/j.tjpad.2026.100660","url":null,"abstract":"<p><p>Liao et al. (2026) recently reported an association between omega-3 supplementation and accelerated cognitive decline, mediated by FDG-PET hypometabolism. While clinically provocative, this observational finding warrants cautious interpretation. This Letter critiques four methodological limitations: (1) exposure misclassification, as ADNI's binary supplement variable ignores oxidation state and formulation (pharmacy grade vs. oxidized OTC fish oil); (2) residual confounding, since propensity score matching cannot adjust for subtle preclinical worry or lifestyle factors driving supplement initiation; (3) mechanistic overreach, as FDG hypometabolism reflects composite metabolic/inflammatory processes, not isolated synaptic dysfunction; and (4) context dependency, where effects likely hinge on baseline omega-3 status and individual oxidative load. We propose actionable refinements: biomarker-anchored dose modeling (serum EPA+DHA), negative-control sensitivity analyses, partial volume-corrected FDG mediation, and CSF synaptic marker integration. Rather than a universal \"harm\" signal, this paradoxical association should be framed as hypothesis generating, urging personalized prevention strategies over blanket clinical warnings.To the Editor.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 9","pages":"100660"},"PeriodicalIF":7.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13519609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Increasing cardiovascular disease risk predicts faster cognitive decline: A Bayesian analysis of a cohort of adults in rural West Texas.","authors":"Chathurika S Dhanasekara, Chanaka N Kahathuduwa, Volker Neugebauer","doi":"10.1016/j.tjpad.2026.100651","DOIUrl":"10.1016/j.tjpad.2026.100651","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is a major risk factor for cognitive decline and dementia. We examined whether a higher atherosclerotic cardiovascular disease (ASCVD) risk is associated with faster cognitive decline in Project FRONTIER, a rural cohort.</p><p><strong>Methods: </strong>Participants were aged ≥40 years without baseline CVD and completed two study visits. Primary outcomes were the RBANS Total Score and its domains; secondary outcomes were Executive Interview 25, verbal fluency, Clock Drawing Test (CLOX), and Trail Making Test (TMT) A and B. Primary exposure was the 10-year ASCVD risk per AHA PREVENT equations. We fitted Bayesian mixed-effects models to estimate the interaction between time (in years) and ASCVD risk, adjusting for covariates using brms package in R.</p><p><strong>Results: </strong>We analyzed data of 383 participants (age 57.74 ± 11.4 years; 75.5 % female; 59.8 % Hispanic; median follow-up 3.00 years, IQR: 2.67-3.64). The time×ASCVD risk interaction for RBANS Total was credibly negative (β = -1.22 points/year per 10 % higher risk, 95 % CrI -1.87 to -0.58). Strongest domain-specific effects were for attention (β = -1.25; 95 % CrI -2.14 to -0.37) and delayed memory (β = -1.36; 95 % CrI -2.16 to -0.05). CLOX suggested a credibly negative interaction (β = -0.39; 95 % CrI -0.62 to -0.16), and TMT-A showed a credibly positive interaction (β = +2.85 s/year; 95 % CrI 1.28 to 4.41).</p><p><strong>Discussion: </strong>In this rural cohort, a higher 10-year ASCVD risk was associated with faster decline in global cognition, particularly attention and delayed memory, supporting the potential value of cardiovascular risk monitoring and modification to preserve cognitive function.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 9","pages":"100651"},"PeriodicalIF":7.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13475418/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148685860","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive social determinants of health and brain health in midlife.","authors":"Christina S Dintica, Julia Cheunkarndee, R Nick Bryan, Lenore J Launer, Kristine Yaffe","doi":"10.1016/j.tjpad.2026.100652","DOIUrl":"10.1016/j.tjpad.2026.100652","url":null,"abstract":"<p><strong>Background: </strong>Social determinants of health (SDOH) are increasingly recognized as important drivers of cognitive outcomes. However, most existing evidence focuses on individual SDOH components and older populations.</p><p><strong>Objectives: </strong>To develop a comprehensive SDOH index and examine its association with subsequent changes in cognitive function and structural brain measures in midlife.</p><p><strong>Design: </strong>Prospective cohort study with repeated measures of cognition and brain imaging.</p><p><strong>Setting: </strong>Community-based cohort from the Coronary Artery Risk Development in Young Adults (CARDIA) study.</p><p><strong>Participants: </strong>A total of 3488 participants with SDOH data in early midlife (mean age 40.0 ± 3.6 years); 645 participants had repeated brain magnetic resonance imaging (MRI) data.</p><p><strong>Measurements: </strong>A weighted aggregate SDOH index was constructed from 12 items across 5 domains: economic stability, community and social context, education, neighborhood and built environment, and health care access. Cognitive function was assessed using the Digit Symbol Substitution Test (DSST), Stroop Test, and Rey Auditory Verbal Learning Test (RAVLT). Brain MRI outcomes included white matter hyperintensities (WMHs) and total gray matter (GM) volume. Mixed linear regression models examined associations between SDOH quartiles and longitudinal cognitive and MRI outcomes, adjusting for demographics, vascular risk factors, depression, and intracranial volume (for MRI).</p><p><strong>Results: </strong>At baseline, participants in the most disadvantaged SDOH quartile performed worse across all cognitive tests compared with the least disadvantaged quartile (p < 0.001). Over time, the most disadvantaged quartile showed steeper decline in DSST performance (adj. mean change: -0.72, 95% CI: -0.93 to -0.52 vs. -0.55, 95% CI: -0.76 to -0.34, p = 0.013), greater WMH accumulation (ratio: 1.07, 95% CI: 1.05 to 1.09 vs. 1.04, 95% CI: 1.03 to 1.05, p = 0.007), and steeper decline in total GM volume (-2.02 cm³, 95% CI: -2.39 to -1.65 vs. -1.46 cm³, 95% CI: -1.71 to -1.20, p = 0.011) per 5-year interval compared to the least disadvantaged quartile.</p><p><strong>Conclusions: </strong>Greater social disadvantage in midlife is associated with worse baseline cognition and accelerated decline in cognitive function and brain integrity. These findings highlight the importance of SDOH as key determinants of brain health in midlife and suggest that strategies to mitigate social disadvantage may help preserve cognitive and brain health.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 9","pages":"100652"},"PeriodicalIF":7.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13487268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148707609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Do methodological limitations and confounding factors explain the apparent acceleration of cognitive decline in older adults taking omega-3 fatty acid supplements?","authors":"Simon C Dyall, Mélanie Plourde","doi":"10.1016/j.tjpad.2026.100661","DOIUrl":"10.1016/j.tjpad.2026.100661","url":null,"abstract":"<p><p></p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 9","pages":"100661"},"PeriodicalIF":7.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13507837/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148798096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From advice to agency: making brain health actionable and equitable for middle-aged adults with mild neurocognitive disorder.","authors":"Hermine Lenoir","doi":"10.1016/j.tjpad.2026.100667","DOIUrl":"10.1016/j.tjpad.2026.100667","url":null,"abstract":"","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 9","pages":"100667"},"PeriodicalIF":7.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13572748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901167","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What's good for the heart is good for the brain? Evidence from a rural cohort on the longitudinal relationship between atherosclerotic cardiovascular disease risk and cognitive decline.","authors":"Maileen G Ulep","doi":"10.1016/j.tjpad.2026.100672","DOIUrl":"10.1016/j.tjpad.2026.100672","url":null,"abstract":"","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 9","pages":"100672"},"PeriodicalIF":7.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13595204/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978065","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From regulatory approval to clinical practice: real-world eligibility for anti-amyloid monoclonal antibodies in an Italian dementia-care network.","authors":"Giovanna Zamboni, Manuela Tondelli, Giulia Vinceti, Chiara Gallingani, Zeno Bercini, Aurora Barbieri, Chiara Carbone, Najara Iacovino, Silvia Cossutti, Daniela Ballotta, Simone Salemme, Annalisa Chiari","doi":"10.1016/j.tjpad.2026.100655","DOIUrl":"10.1016/j.tjpad.2026.100655","url":null,"abstract":"","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 9","pages":"100655"},"PeriodicalIF":7.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13499131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148759707","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Risk of Dementia after initiation of GLP-1 RA versus long-acting insulin in patients with type 2 Diabetes mellitus.","authors":"Chien-Hung Lin, Peir-Haur Hung, Mu-Chi Chung, Laing-You Wu, Chi-Jung Chung","doi":"10.1016/j.tjpad.2026.100645","DOIUrl":"10.1016/j.tjpad.2026.100645","url":null,"abstract":"<p><strong>Background: </strong>Recent studies suggest a decreased risk of dementia in patients treated with glucagon-like peptide-1 receptor agonist (GLP-1 RA). In this study, we compare the risk of dementia associated with GLP-1 RA versus long-acting insulin in adults aged over 50 years with type 2 diabetes (T2DM) using real-world administrative data from a large Taiwan cohort DESIGN: A population-based retrospective cohort study SETTING: We analyzed 10,783 propensity score-matched pairs of adults with T2DM who initiated either GLP-1 RA or long-acting insulin from Taiwan's National Health Insurance Research Database (2011-2021).</p><p><strong>Measurements: </strong>Primary outcome was new-onset dementia; secondary outcomes included dementia requiring treatment and specific dementia subtypes (Alzheimer's disease, vascular dementia, and unspecified dementia). Hazard ratios (HRs) were estimated using Cox models.</p><p><strong>Results: </strong>Analysis of matched pairs identified 375 cases of newly diagnosed dementia. The incidence rate was 4.86 per 1,000 person-years in GLP-1 RA users versus 7.56 in insulin users. GLP-1 RA use was associated with significantly lower risk of overall dementia (HR 0.64, 95% CI 0.46-0.89, P=0.0072) and unspecified dementia (HR 0.41, 95% CI 0.24-0.68, P=0.0006), but not for Alzheimer's disease (HR 1.48, 95% CI 0.61-3.63, P=0.3867) or vascular dementia (HR 1.66, 95% CI 0.21-13.03, P=0.6324). Among GLP-1 RAs, both liraglutide (HR 0.40, 95% CI 0.20-0.80, P=0.0091) and dulaglutide (HR 0.42, 95% CI 0.19-0.92, P=0.0311) showed significant protective effects against unspecified dementia.</p><p><strong>Conclusions: </strong>GLP-1 RA use was associated with lower dementia risk versus long-acting insulin in T2DM patients, especially with liraglutide and dulaglutide. As observational, causality requires confirmation from randomized controlled trials.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 9","pages":"100645"},"PeriodicalIF":7.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476480/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148698015","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying generalization error in machine learning prediction of cognitive decline.","authors":"Roya Melanie Hüppi, Nicolas Langer, Bruno Hebling Vieira","doi":"10.1016/j.tjpad.2026.100646","DOIUrl":"10.1016/j.tjpad.2026.100646","url":null,"abstract":"<p><strong>Background: </strong>Predicting cognitive decline as a continuum, from healthy age-related decline to mild cognitive impairment and dementia, enables more precise individual-level predictions. However, the practical value of such models for early intervention and prevention depends on their ability to generalize to independent cohorts, a property that is often not evaluated.</p><p><strong>Objectives: </strong>This study investigated whether adding structural magnetic resonance imaging (MRI) to non-brain data improved machine learning predictions of continuous cognitive decline and analyzed the models' generalizability.</p><p><strong>Design: </strong>Multi-target random forest regression models predicted annual decline in the Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) and Mini-Mental State Examination (MMSE) using non-brain data, structural MRI data, or their combination from the Alzheimer's Disease Neuroimaging Initiative (ADNI; N = 1237) and Open Access Series of Imaging Studies (OASIS-3; N = 662) datasets. Cross-site generalizability was evaluated.</p><p><strong>Setting: </strong>Data from ADNI and OASIS-3 were used for this study.</p><p><strong>Participants: </strong>A total of 1899 participants who had demographic, clinical, and brain imaging data from a baseline session and clinical data from at least 2 follow-up sessions were included.</p><p><strong>Measurements: </strong>Baseline non-brain (demographics, clinical and neuropsychological scores, information on APOE genotype, cognitive diagnosis, health, and number of sessions before baseline) and/or structural MRI data were used to predict the yearly rate of change in CDR-SOB and MMSE scores.</p><p><strong>Results: </strong>Including structural MRI data improved prediction of CDR-SOB and MMSE change, reaching respective R² values of .41 and .33 in ADNI and .42 and .33 in OASIS-3. Model performance for across-dataset predictions was reduced (R² between .18 and .35), unexplained by distributional shifts of target variables. Models using only top predictive features performed similarly to full models when tested externally (R² between .18 and .34), suggesting predictor redundancy.</p><p><strong>Conclusions: </strong>Incorporating structural MRI data enhances within-dataset prediction of continuous cognitive decline, allowing for more precise individual-level prediction and advancing towards precision medicine. Even though external validation remains limited, quantifying the generalizability gap is a crucial step towards the responsible use of ML models in clinical intervention and prevention.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 9","pages":"100646"},"PeriodicalIF":7.8,"publicationDate":"2026-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13476611/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697879","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}