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

{"title":"Trends in cognitive impairment among older adults in China from 2002 to 2022: Evaluating the impact of the COVID-19 pandemic.","authors":"Lei Feng, Kaisy Xinhong Ye, Qiushi Feng, Yan Mo, Zuqi Cai, Chunbo Li, Jintai Yu, Bin Li, Andrea B Maier, Yi Zeng, Zhenglian Wang","doi":"10.1016/j.tjpad.2025.100370","DOIUrl":"https://doi.org/10.1016/j.tjpad.2025.100370","url":null,"abstract":"<p><strong>Background: </strong>Cognitive impairment is a growing public health concern, particularly in aging populations. While trends in CI prevalence in China were studied up to 2018, no previous research has explored how the COVID-19 pandemic has affected these trends.</p><p><strong>Objectives: </strong>This study aims to extend the analysis to 2022, examining the impact of the pandemic on cognitive impairment prevalence.</p><p><strong>Participants: </strong>The Chinese Longitudinal Healthy Longevity Survey (CLHLS) data across multiple waves (2002 to 2022) was used (n=64,872).</p><p><strong>Measurements: </strong>Cognitive impairment was assessed using a Chinese version of the Mini-Mental State Examination (MMSE). The rural/urban-sex-single age-specific prevalence of cognitive impairment across different waves were estimated using the DemoRates R package. Cognitive impairment trends before and after the onset of the COVID-19 pandemic were compared to identify any significant changes.</p><p><strong>Results: </strong>In 2018 and previous waves, an average of 16,191 participants per wave were surveyed (four waves), with a cognitive impairment prevalence of 4.3%. In 2022, post-COVID-19, the survey included 14,022 participants and showed a significant increase in CI prevalence to 6.8%. The observed trends were independent of gender, age group, and residential environment (P-trend < 0.001). However, a significant decrease in mean calf circumference, increase in proportion of overweight participants, and increases in daily fruit and vegetable intake and regular physical activity were notable after the pandemic.</p><p><strong>Conclusion: </strong>The study suggests that the COVID-19 pandemic may have contributed to the observed increase in cognitive impairment prevalence in China, underscoring the importance of further research into the long-term cognitive effects of global health crises. These findings highlight the need to strengthen healthcare systems to support cognitive health in an aging population, while considering both pandemic-related and ongoing factors in the management of cognitive impairment.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100370"},"PeriodicalIF":7.8,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of circulating c-reactive protein levels with central Alzheimer's disease biomarkers.","authors":"Hye Ji Choi, Min Soo Byun, Dahyun Yi, Hyejin Ahn, Gijung Jung, Sangyong Park, Joon Hyung Jung, Musung Keum, Bo Kyung Sohn, Yu Kyeong Kim, Hongyoon Choi, Yun-Sang Lee, Jun-Young Lee, Koung Mi Kang, Chul-Ho Sohn, Yen-Ning Huang, Andrew J Saykin, Kwangsik Nho, Dong Young Lee","doi":"10.1016/j.tjpad.2025.100368","DOIUrl":"https://doi.org/10.1016/j.tjpad.2025.100368","url":null,"abstract":"<p><strong>Background: </strong>C-reactive protein (CRP) is well-known marker of inflammation and immune response. Its potential role in Alzheimer's disease (AD) pathophysiology remains unclear, particularly in relation to central AD biomarkers, including beta-amyloid (Aβ), tau, and neurodegeneration.</p><p><strong>Objectives: </strong>To investigate the associations between circulating CRP levels and central AD biomarkers-including Aβ deposition, tau, and AD-signature neurodegeneration-in nondemented older adults.</p><p><strong>Design, setting, participants: </strong>This cross-sectional observational study analyzed data from a Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer Disease conducted from 2014 to 2020. A total of 417 nondemented older adults underwent comprehensive evaluations, including blood sampling and multimodal neuroimaging for measuring of Aβ and AD-signature neurodegeneration. A subset of participants (N = 123) also underwent tau positron emission tomography (PET) scan.</p><p><strong>Measurements: </strong>The primary outcomes were A/T/N biomarkers of AD, including brain Aβ and tau deposition measured via amyloid and tau PET, as well as AD-signature neurodegeneration measured by fluorodeoxyglucose (FDG)-PET. Associations between CRP levels and these biomarkers were analyzed while adjusting for CRP-decreasing allele scores, as well as other confounders, including age, sex, vascular risk score, body mass index, nonsteroidal anti-inflammatory drug (NSAID) usage, smoking status, and APOE ε4 carrier status.</p><p><strong>Results: </strong>The mean (SD) age of participants was 70.57 (8.00) years, with 179 (42.9 %) females. Circulating CRP levels showed non-linear associations with A/T/N biomarkers of AD, showing a U-shaped relationship with Aβ and tau deposition and an inverted U-shaped association with neurodegeneration. Threshold effect analyses revealed that CRP was inversely associated with Aβ deposition (B = -0.081; 95 % CI, -0.153 to -0.007; p = 0.031) below 0.63 mg/L, after adjusting for all confounding variables. In contrast, higher CRP levels were associated with lower cerebral glucose metabolism in AD-signature regions, indicative of greater AD-related neurodegeneration, when above 2.15 mg/L (B = -0.056; 95 % CI, -0.112 to -0.001; p= 0.042).</p><p><strong>Conclusions: </strong>Our study revealed differential associations between circulating CRP levels and central AD biomarkers that varied according to the CRP concentration. Further studies are necessary to elucidate the mechanisms underlying the inverse relationship between circulating CRP and brain Aβ within the clinically normal range, as well as potential aggravating effects of elevated CRP on Aβ-independent neurodegeneration.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100368"},"PeriodicalIF":7.8,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145087458","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clarifying what BP Predicts: Commentary on CSF Aβ42/40, p-tau181, and centiloid in unimpaired populations.","authors":"Shaoxiang Huang, Xueyu Wang, Peili Zhang","doi":"10.1016/j.tjpad.2025.100372","DOIUrl":"https://doi.org/10.1016/j.tjpad.2025.100372","url":null,"abstract":"","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100372"},"PeriodicalIF":7.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145081608","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Folic acid supplementation improves cognition function in participants with cerebral small vascular disease-related cognitive impairment: a randomized controlled trial.","authors":"Yinyue Liu, Zili Yu, Zhengjun Cai, Li Zhao, Yu Wang, Yajie Guo, Xiaonan Su, Yuli Miao, Bin Yi, Yanhong Wang, Xumei Zhang","doi":"10.1016/j.tjpad.2025.100369","DOIUrl":"https://doi.org/10.1016/j.tjpad.2025.100369","url":null,"abstract":"<p><strong>Background: </strong>The potential improvement of cognitive function through folic acid (FA) supplementation in patients with vascular cognitive impairment (VCI) remains unclear, and no randomized controlled trials (RCTs) have been conducted specifically in populations with cerebral small vessel disease-related cognitive impairment (CSVD-CI).</p><p><strong>Objective: </strong>This study aimed to explore the effects of FA supplementation on cognitive function and angiogenesis-related indicators in patients with CSVD-CI.</p><p><strong>Design: </strong>Double-blinded, parallel group, randomized controlled trial, with a six-month follow-up period.</p><p><strong>Setting: </strong>Department of neurology and neurosurgery in Shanxi, China.</p><p><strong>Participants: </strong>220 CSVD-CI patients.</p><p><strong>Interventions: </strong>The intervention consisted of FA tablets (0.4 mg/tablet) administered orally at a dose of two tablets daily for six months, while the placebo tablets were identical in appearance and administration but lacked FA.</p><p><strong>Measurements: </strong>The primary outcome was the Montreal Cognitive Assessment (MoCA) score at six months assessed in the intention-to-treat (ITT) population. Secondary outcomes included Mini-Mental State Examination (MMSE) score, Trail Making Test (TMT), Tinetti Performance Oriented Mobility Assessment (POMA), and five-level EuroQol five-dimensional questionnaire (EQ-5D-5 L).</p><p><strong>Results: </strong>MoCA and MMSE scores improved significantly in the FA group compared to placebo (both P < 0.05). Additionally, the FA group had statistically significant increases in serum folate and decreases in serum homocysteine (Hcy) (both P < 0.001). Matrix metalloproteinase-9 (MMP-9) expression decreased significantly in the FA group compared with placebo (P < 0.05).</p><p><strong>Conclusions: </strong>FA improved cognitive outcomes in CSVD-CI, accompanied by a reduction in serum Hcy levels and MMP-9 expression. Early FA supplementation could help prevent vascular-related cognitive decline in CSVD-CI patients.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100369"},"PeriodicalIF":7.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145058623","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alzheimer's disease prevention by flavonols and their analogs.","authors":"George Uhl, Balaji Kannan, Joungil Choi, Ian Henderson","doi":"10.1016/j.tjpad.2025.100361","DOIUrl":"https://doi.org/10.1016/j.tjpad.2025.100361","url":null,"abstract":"<p><p>Four studies now document reduced incidence of Alzheimer's disease (AD) or dementia diagnoses in aging individuals who report higher dietary intake of flavonols (or their glycosides) years prior to diagnosis vs those with lower intake. These effects are large, almost 50 %, for individuals at higher genetic risk for AD, providing a robust gene x environment interaction. They display a specific structure-activity relationship. These benefits are driven by modest-to-moderate differences in the quantity of flavonol (glycoside) consumed. These data contrast with the failure of late life supplementation with flavonol-rich ginko extract to alter progression to AD in groups of individuals who are not selected for genotype or dietary pattern. Studies of mouse AD models support benefits of the flavonol quercetin. In vitro and in vivo results add the receptor type protein tyrosine phosphatase PTPRD to the list of oxidative and other targets or mechanisms to which flavonol benefits are attributed. The magnitude of flavonol protection for individuals who would otherwise be especially vulnerable to AD, the ease of supplementation strategies with currently-available nutraceuticals and the opportunities for development of improved flavonol analogs all support further exploration of flavonol-based strategies for reducing the incidence of AD with aging.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100361"},"PeriodicalIF":7.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pulse pressure as a predictor of Alzheimer's disease biomarkers and cognitive decline: The moderating role of APOE ε4.","authors":"Joon Hyung Jung, Nayeong Kong, Seunghoon Lee","doi":"10.1016/j.tjpad.2025.100363","DOIUrl":"https://doi.org/10.1016/j.tjpad.2025.100363","url":null,"abstract":"<p><strong>Background: </strong>Elevated pulse pressure (PP), indicative of arterial stiffness, has been implicated in cognitive impairment and Alzheimer's disease (AD) pathology. However, its role in preclinical AD and interactions with genetic risk factors like apolipoprotein E ε4 (APOE4) remain unclear.</p><p><strong>Objectives: </strong>To investigate the association between baseline PP and AD biomarkers (amyloid-beta (Aβ) and tau) and cognitive decline, and to determine whether APOE4 carrier status moderates these relationships.</p><p><strong>Design: </strong>Prospective cohort study and secondary analysis of the Anti-Amyloid Treatment in Asymptomatic Alzheimer's (A4) randomized clinical trial SETTING: Multicenter observational cohort and randomized clinical trial conducted at 67 sites across the United States, Canada, Australia, and Japan.</p><p><strong>Participants: </strong>This study included 1690 cognitively unimpaired older adults from the A4 and Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) studies. Participants underwent baseline PP assessment, Aβ and tau PET imaging, and cognitive testing with longitudinal follow-up over 240 weeks.</p><p><strong>Measurements: </strong>Blood pressure was measured at baseline, with PP calculated as the difference between systolic and diastolic pressures. AD pathologies were assessed through Aβ PET imaging using 18F-Florbetapir, and regional tau deposition in inferior temporal and meta-temporal regions using 18F-Flortaucipir PET imaging. Cognitive performance was measured using the Preclinical Alzheimer Cognitive Composite (PACC).</p><p><strong>Results: </strong>Higher baseline PP was significantly associated with increased Aβ (β = 0.078; p = 0.001), inferior temporal tau (β = 0.110; p = 0.032), and meta-temporal tau deposition (β = 0.116; p = 0.022). In longitudinal analyses, elevated PP predicted greater decline in PACC scores (β = -0.020; p < 0.001). APOE4 status moderated these associations, with significant effects of PP on tau deposition and cognitive decline observed exclusively among APOE4 carriers. Mediation analysis indicated that tau deposition significantly mediated the association between PP and cognitive decline (indirect effect β = -0.068; 95 % CI [-0.126, -0.011]).</p><p><strong>Conclusions: </strong>Elevated PP is associated with increased AD biomarker burden and accelerated cognitive decline in cognitively unimpaired older adults, particularly among APOE4 carriers. Our study suggests that arterial stiffness may contribute to AD pathogenesis and progression via tau pathology. These results highlight the potential of vascular health management as an early intervention target for AD prevention, especially in genetically at-risk populations.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100363"},"PeriodicalIF":7.8,"publicationDate":"2025-09-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145001420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tailoring multidomain intervention programs to reduce cognitive and physical decline in older adults: Examining rural-urban differences in a nationwide cluster-randomized controlled trial.","authors":"Min-Yin Ho, Wei-Ju Lee, Ko-Han Yen, Chih-Kuang Liang, Li-Ning Peng, Ming-Hsien Lin, Ching-Hui Loh, Fei-Yuan Hsiao, Liang-Kung Chen","doi":"10.1016/j.tjpad.2025.100231","DOIUrl":"10.1016/j.tjpad.2025.100231","url":null,"abstract":"<p><strong>Background: </strong>Frailty and cognitive impairment are major challenges in aging populations. Multidomain interventions targeting physical, cognitive, and nutritional health show promise; however, evidence on rural-urban differences in efficacy remains limited.</p><p><strong>Objectives: </strong>To evaluate the impact of rural-urban disparities on the clinical efficacy of a 12-month multidomain intervention for cognitive and physical outcomes in older adults.</p><p><strong>Design: </strong>Cluster-randomized controlled trial.</p><p><strong>Setting: </strong>Community clusters in five cities/counties across Taiwan.</p><p><strong>Participants: </strong>A total of 1082 adults aged ≥65 years from 40 community clusters were randomized to intervention or control groups.</p><p><strong>Intervention: </strong>The intervention group received a 12-month program including physical exercise (45 min/session), cognitive training (1 hour/session), and nutritional guidance (15 min/session). The control group received telephone-based health education. This trial was registered at ClinicalTrials.gov (NCT03056768) MEASUREMENTS: Outcomes included walking speed, grip strength, physical activity (METs), frailty (CHS score), and cognitive function (MoCA), assessed at baseline, 6, and 12 months.</p><p><strong>Results: </strong>Urban participants showed significantly greater gains in visuospatial/executive function at the 12 month (rural-urban difference 0.63, 95 % CI: 0.26 -1.03), and walking speed at the 12 month (rural-urban difference 0.12 m/s, 95 % CI: 0.05 - 0.19). Rural participants demonstrated better improvements in grip strength at the 12 month (rural-urban difference -2.59 kg, 95 % CI: -3.91 - -1.27) and language function (rural-urban difference -0.38, 95 % CI: -0.68 - -0.09). Frailty reduction was more pronounced in urban areas at the 12 month (-0.21, 95 % CI: -0.38 - -0.03, p = 0.025), but showed minimal change in the rural participants.</p><p><strong>Conclusion: </strong>Rural-urban disparities influence the effectiveness of multidomain interventions. Tailored strategies are needed to optimize health outcomes across diverse settings.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100231"},"PeriodicalIF":7.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144294879","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":"Comment by European Alzheimer's Disease Consortium (EADC) investigators on the negative recommendation of the CHMP on the marketing authorization of donanemab for early Alzheimer' s disease.","authors":"Frank Jessen, Javier Arbizu, Mercé Boada, Mircea Balasa, Karim Bennys, Marina Boban, Katharina Bürger, Andrea Chincarini, Annachiara Cagnin, Peter Paul De Deyn, Emrah Düzel, Sebastiaan Engelborghs, Michael Ewers, Lieza G Exalto, Wiesje M van der Flier, Juan Fortea, Kristian Steen Frederiksen, Giovanni B Frisoni, Lutz Frölich, Alejandro J Garza-Martinez, Timo Grimmer, Bernard Hanseeuw, Jakub Hort, Adrian Ivanoiu, Patrick G Kehoe, Sean P Kennelly, Silke Kern, Stefan Klöppel, Lenka Krajčovičová, Milica G Kramberger, Bernadette McGuinness, Patrizia Mecocci, Timo Jan Oberstein, Pierre-Jean Ousset, Claire Paquet, Robert Perneczky, Fabrizio Piazza, Domenico Plantone, Innocenzo Rainero, Guillaume Sacco, Eric Salmon, Isabel Santana, Nikolaos Scarmeas, Anja Schneider, Jonathan M Schott, Eino Solje, Elka Stefanova, Elisabeth Stögmann, Mélanie Strauss, Stanislav Sutovsky, Gunhild Waldemar, Bengt Winblad","doi":"10.1016/j.tjpad.2025.100259","DOIUrl":"10.1016/j.tjpad.2025.100259","url":null,"abstract":"","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100259"},"PeriodicalIF":7.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144609583","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":"Editorial: Brain-penetrant antibodies for Alzheimer's disease: The next generation?","authors":"C H van Dyck","doi":"10.1016/j.tjpad.2025.100314","DOIUrl":"10.1016/j.tjpad.2025.100314","url":null,"abstract":"","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100314"},"PeriodicalIF":7.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761422","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":"Associations of cardiovascular health assessed by life's crucial 9 with incident cardiovascular disease and dementia: A prospective cohort study.","authors":"Yiwen Dai, Yuling Liu, Yang Pan, Jingya Ma, Jie Liang, Wenya Zhang, Xuyang Diao, Menghan Zhu, Xinqing Yang, Darui Gao, Yanyu Zhang, Mengmeng Ji, Yichi Zhang, Wuxiang Xie, Fanfan Zheng","doi":"10.1016/j.tjpad.2025.100273","DOIUrl":"10.1016/j.tjpad.2025.100273","url":null,"abstract":"<p><strong>Background: </strong>The associations of the renewed cardiovascular health (CVH) assessed by Life's Crucial 9 (LC9), which consisted of Life's Essential 8 (LE8) and psychological health, with incident cardiovascular disease (CVD) and dementia remained unexplored.</p><p><strong>Objectives: </strong>This study aims to investigate the associations and determine whether LC9 has a higher discrimination ability than LE8 in predicting incident CVD and dementia.</p><p><strong>Design, setting, and participants: </strong>This study was a prospective population-based cohort study using data from the UK Biobank.</p><p><strong>Measurements: </strong>LC9 was assessed as American Heart Association recommended. Incident CVD and dementia were based on self-reported data, hospital inpatient records, and death register records.</p><p><strong>Results: </strong>Of 289,649 included participants, 137,480 (47.5 %) were male, and the mean age was 56.6 ± 8.1 years. Compared with participants having low LC9, those having moderate or high LC9 had lower risks of incident CVD (moderate: 0.46 [0.43-0.48]; high: 0.25 [0.23-0.27]; p for trend <0.001) and dementia (moderate: 0.57 [0.50-0.64]; high: 0.45 [0.39-0.52]; p for trend <0.001) after multivariate adjustment. Both the LE8 and LC9 achieved good discriminative performance for incident CVD (LE8 Harrell C-statistic= 0.7138 vs. LC9 Harrell C-statistic=0.7144, p = 0.136); the net reclassification improvement was estimated at 0.07 % (p = 0.749), and integrated discrimination improvement was estimated at 0.009 (p < 0.001). The results for dementia showed similar patterns.</p><p><strong>Conclusions and relevance: </strong>Optimal LC9 was associated with lower risks of incident CVD and dementia. Although psychological health is essential for preventing CVD and dementia, including it into CVH's evaluation criteria did not significantly improve CVH's predictive performance.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":" ","pages":"100273"},"PeriodicalIF":7.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413700/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144620649","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}