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

{"title":"Beyond recognition: Refining the assessment of public knowledge and risk perception in dementia prevention.","authors":"Zhiyan Xie, Jun Su, Tao Liao","doi":"10.1016/j.tjpad.2026.100602","DOIUrl":"10.1016/j.tjpad.2026.100602","url":null,"abstract":"","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 8","pages":"100602"},"PeriodicalIF":7.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147983289","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":"Efficacy and safety of donanemab in the European eligible population: TRAILBLAZER-ALZ 2 post-hoc analyses.","authors":"Frank Jessen, Grazia Dell'Agnello, Jennifer A Zimmer, Christophe Sapin, Sascha Dichter, Erin Doty, Stéphane Epelbaum, Cynthia D Evans, Paula M Hauck, Rashna Khanna, Dawn A Brooks, John R Sims, Federica Agosta","doi":"10.1016/j.tjpad.2026.100605","DOIUrl":"10.1016/j.tjpad.2026.100605","url":null,"abstract":"<p><strong>Background: </strong>In the European Union (EU), donanemab is indicated in adults with early symptomatic Alzheimer's disease who are apolipoprotein E ε4 non-carriers or heterozygotes. Among these, patients without superficial siderosis at baseline, uncontrolled hypertension, or anticoagulant use are eligible.</p><p><strong>Objective: </strong>To assess efficacy and safety of donanemab in the EU-eligible population.</p><p><strong>Methods: </strong>A post-hoc conservative hybrid imputation method was implemented for clinical efficacy analyses during the TRAILBLAZER-ALZ 2 placebo-controlled period. In the 78-week long-term extension (LTE) participants in the early-start (randomised to donanemab) and delayed-start (randomised to placebo with donanemab initiation during the LTE) groups were compared to a propensity-weighted external control. Participants were switched to placebo after meeting amyloid-based treatment course completion criteria.</p><p><strong>Results: </strong>By 76 weeks, donanemab-treated participants in the EU-eligible population had a mean Clinical Dementia Rating Scale (CDR)-Sum of Boxes change from baseline difference from placebo of -0.7 points (95% confidence interval, -1.0, -0.4) and a 40.3% lower risk of disease progression to the next stage (per CDR-Global score). Treatment benefit increased over 154 weeks for non-carriers and heterozygotes, including those meeting treatment course completion criteria by 52 or 76 weeks. In the placebo-controlled period, 119 (19.5%) and 49 (8.0%) donanemab-treated eligible participants experienced amyloid-related imaging abnormalities-edema/effusion and infusion-related reactions, respectively. Safety findings were similar among donanemab-treated participants in the placebo-controlled period and LTE delayed-start group.</p><p><strong>Conclusions: </strong>Consistent with previous TRAILBLAZER-ALZ 2 and LTE findings, donanemab significantly slowed disease progression compared to controls with a manageable safety profile in non-carriers and heterozygotes.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 8","pages":"100605"},"PeriodicalIF":7.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13234467/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148043983","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":"Sex differences in subjective cognition among middle-aged and older Hispanic/Latino adults: Findings from the HCHS/SOL and SOL-INCA.","authors":"Ariana M Stickel, Wassim Tarraf, Sayaka Kuwayama, Ammie Xie, Rachel Membreno, Carolina L Costa, Carlos E E Araujo Menendez, Zvinka Z Zlatar, Krista M Perreira, Haibo Zhou, Martha Daviglus, Amber Pirzada, Paola Filigrana, Bonnie E Levin, Linda C Gallo, Hector M González, Sarah J Banks","doi":"10.1016/j.tjpad.2026.100637","DOIUrl":"10.1016/j.tjpad.2026.100637","url":null,"abstract":"<p><strong>Introduction: </strong>Sex differences in subjective cognitive decline (SCD) exist, yet the extent to which these differences generalize to underrepresented groups is unknown. Therefore, we investigated relationships between sex and SCD among Hispanic/Latino adults.</p><p><strong>Method: </strong>Participants were 5985 Hispanic/Latino adults from the Study of Latinos - Investigation of Neurocognitive Aging. We performed survey-adjusted linear regressions to test the associations between sex (male/female) with SCD and modifications by cardiovascular disease (CVD) risk, social and language acculturation. SCD was measured using the Everyday Cognition 12-item questionnaire, including executive functioning, memory, language, and visuospatial domains.</p><p><strong>Result: </strong>Overall, females reported more SCD in language and visuospatial domains. This was less pronounced for 1) language SCD at lower levels of CVD risk, and 2) visuospatial SCD with higher language acculturation.</p><p><strong>Discussion: </strong>Hispanic/Latina females self-reported more cognitive decline than males, but these differences were less pronounced in the context of lower CVD risk and higher language acculturation.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 8","pages":"100637"},"PeriodicalIF":7.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13380711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148424467","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":"Clinical and biological relevance of objectively-defined subtle cognitive decline in Alzheimer's disease: a narrative review of neuroimaging, biomarker, and clinical progression studies.","authors":"Amanda I Gonzalez, Jairo E Martinez, Averi Giudicessi, Meredith Rowe, Vivian Ku, Catarina Tristão-Pereira, Bing He, Vincent Malotaux, Yakeel T Quiroz","doi":"10.1016/j.tjpad.2026.100604","DOIUrl":"10.1016/j.tjpad.2026.100604","url":null,"abstract":"<p><p>Preclinical Alzheimer's Disease stages represent possible targets for disease-modifying intervention as well as opportunity for early identification of risk for future decline. Recent research has explored the use of objectively-defined subtle cognitive decline (Obj-SCD), an emerging classification that may identify individuals at risk for neurodegeneration before the onset of mild cognitive impairment (MCI). The Edmonds/Thomas actuarial Obj-SCD criteria (> 1 SD below expectations, single cognitive test impaired per domain) aims to capture those who exhibit minimal cognitive difficulties that do not meet a MCI or dementia diagnosis. Given the novelty of the Obj-SCD classification, this narrative review provides an overview of neuroimaging, biomarker, and clinical progression studies to evaluate its biological and clinical significance. Using fluid-based biomarkers, neuroimaging, and longitudinal designs, studies have indicated that the Obj-SCD classification has the potential to capture AD-related pathological changes detectable before the clinical onset of MCI. In particular, recent studies indicate a unique pathological profile of Obj-SCD, differentiating it from the cognitively unimpaired and MCI stages. Studies comparing Obj-SCD and subjective cognitive complaints show that the Obj-SCD criteria may be more closely associated to early AD pathology. While the existing literature is limited, findings uphold Obj-SCD as a sensitive classification able to identify individuals at risk for future cognitive impairment. Studies on Obj-SCD indicate utility in research settings, although it faces challenges regarding its clinical implementation and effectiveness.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 8","pages":"100604"},"PeriodicalIF":7.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13213860/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147975655","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":"Bidirectional causal relationships between plasma proteins, neuroimaging metrics and risk of Alzheimer's disease.","authors":"Xu Xu, Lintong Li, Wei Huang, Ying Yang, Xu Li, Pei Wang, Mengmeng Zhao, Huiliang Zhang, Chaoming Yuan","doi":"10.1016/j.tjpad.2026.100619","DOIUrl":"10.1016/j.tjpad.2026.100619","url":null,"abstract":"<p><strong>Background: </strong>Changes in neuroimaging metrics are among the first detectable pathophysiological alterations in Alzheimer's disease (AD). Proteins are closely linked to fluctuations in neuroimaging metrics. Therefore, the analysis of the proteomic signature associated with neuroimaging metrics holds significant promise for uncovering therapeutic targets that contribute to AD.</p><p><strong>Methods: </strong>GWAS data concerning the Brain Imaging Data Structure (BIDs). The AD cohort comprised a total of 401,661 individuals diagnosed with AD, alongside 10,520 control participants. For a bidirectional MR analysis involving neuroimaging metrics, proteomics, and AD, the methods utilized included inverse variance weighted (IVW), MR Egger, weighted median, weighted mode, and the Wald ratio approaches.</p><p><strong>Results: </strong>We identified 12 neuroimaging metrics that demonstrate significant relevance to AD (thickness of the left total hemisphere, volume of the right thalamus, and et al.). These metrics are structural magnetic resonance imaging (MRI) biomarkers that remain stable throughout the entire course of AD, from the preclinical stage through mild cognitive impairment (MCI) to dementia. Additionally, we found a substantial number of 1633 proteins that also show a noteworthy causal relationship with AD. Functional enrichment analysis indicated that these proteins were predominantly focused within various pathways linked to AD, encompassing those involved in the synaptic vesicle cycle, synaptic membranes, neurotransmitter release, and the activity of GABA receptors. In addition, our research indicates that the significant relationships observed between the identified proteins and AD are influenced by neuroimaging metrics. Notably, we found that these neuroimaging metrics play a crucial role in mediating a substantial 67% of the inverse relationship that exists between PTPRC and the phenotypic characteristics associated with AD.</p><p><strong>Conclusions: </strong>This study successfully establishes a connection between proteomic and neuroimaging metrics, as well as the AD that influence them. By creating this relationship, the research offers important information that aids in comprehending the intricate mechanisms involved in AD.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 8","pages":"100619"},"PeriodicalIF":7.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13273828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148219836","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":"Is it time to make brain health a vital sign?","authors":"Gregory Cooper","doi":"10.1016/j.tjpad.2026.100654","DOIUrl":"10.1016/j.tjpad.2026.100654","url":null,"abstract":"","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 8","pages":"100654"},"PeriodicalIF":7.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13495585/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148762214","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":"Feasibility of immersive 40 Hz gamma sensory stimulation in early-stage Alzheimer's disease.","authors":"Carolina Reis, Laura Hainke, Gabriel Headley, Sergi Navarro, Theodore P Zanto, Raphael Certain","doi":"10.1016/j.tjpad.2026.100679","DOIUrl":"10.1016/j.tjpad.2026.100679","url":null,"abstract":"<p><p>Alzheimer's disease (AD) remains in need of effective therapeutic strategies that are safe, scalable, and broadly accessible. Gamma sensory stimulation (GSS) is a non-invasive neuromodulation approach under investigation as a potential intervention for AD, supported by a favorable safety profile and emerging evidence of biological and clinical effects. This study evaluates the feasibility of delivering immersive GSS through virtual reality (VR) in individuals with early-stage AD. In this single-session, within-subject, sham-controlled early feasibility study, 11 participants with mild cognitive impairment due to AD or mild AD underwent immersive audiovisual stimulation delivered via VR while electroencephalography (EEG) was recorded. Participants engaged in three VR environments of increasing visual and cognitive complexity, in which audiovisual content was modulated at 40 Hz; two environments also included a sham condition. Primary outcomes were safety, tolerability, and 40 Hz neural responses. Secondary analyses compared neural responses and recall and recognition of encoded video-word pairs between 40 Hz and sham stimulation. All participants completed the session without serious adverse events or discontinuations. Stimulation-emergent symptoms were predominantly absent or mild. 40 Hz GSS elicited significantly stronger EEG responses at the stimulation frequency than both baseline and sham stimulation (p < 0.001), confirming target engagement. In exploratory analyses, items encoded during 40 Hz stimulation were better recalled and recognized than those encoded during sham stimulation (all FDR-adjusted p < 0.05). In this single-session study, immersive GSS was well tolerated and elicited frequency-specific 40 Hz EEG responses in individuals with early-stage AD, with no serious safety concerns identified, supporting the feasibility of this delivery approach. The encouraging acute neural and task-specific behavioral differences between 40 Hz and sham stimulation are hypothesis-generating and motivate controlled pilot studies evaluating the effects of repeated use on validated cognitive and functional outcomes.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 10","pages":"100679"},"PeriodicalIF":7.8,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13635571/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149064415","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":"Evoke (+) trials of semaglutide for early alzheimer's disease: Innovations, lessons, and implications.","authors":"Jeffrey L Cummings, Philip Scheltens","doi":"10.1016/j.tjpad.2026.100677","DOIUrl":"10.1016/j.tjpad.2026.100677","url":null,"abstract":"<p><p>The evoke and evoke+ trials for the treatment of early Alzheimer's disease (AD) with semaglutide were founded on the observation that semaglutide reduced the incidence of dementia in patients with type 2 diabetes. Non-clinical investigations support an effect of semaglutide on AD pathology. The evoke and evoke+ trials were large, well conducted, and innovative. These trials were negative, showing no clinical benefit of treatment with 14 milligrams of semaglutide for two years. Semaglutide produced a statistically significant and robust reduction in high sensitivity C-reactive protein consistent with suppression of peripheral inflammation. There was no effect on most plasma measures collected. CSF analyses showed nominally significant effects on biomarkers of the core biology of AD; YKL-40 and glial fibrillary acidic protein in CSF were decreased indicating a reduction in astroglial activation. The magnitude of these changes was small (7%-10%) and there was no correlative effect on AD progression. The discrepancy between observations in real world data and the trial outcomes indicates that treatment of symptomatic AD confirmed with biomarkers differs from treatment of patients with diabetes who were cognitively unimpaired and at risk for all cause cognitive decline. The evoke and evoke+ trials suggest that reduction in peripheral inflammation may be insufficient to produce beneficial clinical effects in AD. The results of the evoke(+) trials do not exclude the possibility that AD populations enriched for elevated levels of markers of peripheral inflammation or use of brain penetrant GLP-1 RAs could produce therapeutic benefit.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 10","pages":"100677"},"PeriodicalIF":7.8,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13634738/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149040888","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":"Autopsy findings in Alzheimer's disease clinical trial participants demonstrate a high frequency of off-target coexisting pathologic features.","authors":"E Pinar Coskun, Justin Barber, Lauren Bojarski, Christopher J McLouth, Erin L Abner, Linda J Van Eldik, Peter T Nelson, Gregory A Jicha","doi":"10.1016/j.tjpad.2026.100669","DOIUrl":"10.1016/j.tjpad.2026.100669","url":null,"abstract":"<p><strong>Background: </strong>Having multiple comorbid neuropathologic features may confound the results of interventional trials that were designed to target a specific pathophysiologic mechanism in Alzheimer's disease (AD) and or related dementias (ADRD). However, it is unknown what percentage of individuals undergoing AD/ADRD interventional studies have mixed pathologies.</p><p><strong>Objective: </strong>To characterize the spectrum of coexisting neuropathologies in brains of AD/ADRD clinical trial participants to inform trial design and therapeutic strategies METHODS: Autopsied participants from the University of Kentucky Alzheimer Disease Research Center (UK-ADRC) community-based cohort who died between January 2005, and February 2024 were included and queried retrospectively for participation in therapeutic interventional trials. Of a total of 614 autopsied cases, 67had been enrolled in one of the following types of clinical trials: cognitively normal participants in prevention trials for AD/ADRD (designated group P; n = 21); interventions for mild cognitive impairment or early dementia (MCI/D; n = 26); and, interventions for vascular cognitive impairment (V; n = 20). The trial-engaged groups were compared to the trial-naïve group in terms of their demographic, clinical, and genetic characteristics. Pathological features (amyloid-β, tau, α-synuclein, TDP-43, and cerebrovascular disease) were assessed using consensus-based neuropathologic methods.</p><p><strong>Results: </strong>All interventions were designed to target only a single pathologic feature. The trial-engaged group did not differ significantly from those who were trial-naïve with respect to demographic, genetic (APOE), or clinical characteristics, except for a marginally higher level of education among trial participants (p=0.04). Pure on-target pathology (i.e., only one isolated pathology was found at autopsy that was the signature pathology targeted by the intervention) was only seen in 10, 23, and 29 % of the engaged participants of V, MCI/D and P trials respectively. Comorbid pathologies were common in all three groups. On average, the trial-engaged groups altogether had a mean of 2.54 pathologic features/person, whereas the MCI/D trial-engaged group had a mean of 3.2 pathologic features/person.</p><p><strong>Conclusion: </strong>Multi-etiology dementia was the norm rather than the exception for AD/ADRD trial participants. Recognizing the heterogeneity of multiple pathologies in clinical trial participants may enable the development of improved inclusion/exclusion criteria, as well as the rational use of antemortem biomarkers to stratify the likelihood of mixed comorbid pathologies that may be undesirable for single-target interventional studies. Further, multitargeted treatment strategies may be required in future trials of disease-modifying agents.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 10","pages":"100669"},"PeriodicalIF":7.8,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13599578/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148978079","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":"Prevalence, risk factors, and racial disparities in probable and possible dementia: the national health and aging trends study.","authors":"Young-Shin Lee, Juan A Cruz, Michelle Kabakibi, Alison Moore, Jung-Ah Lee, Hee-Jin Jun","doi":"10.1016/j.tjpad.2026.100676","DOIUrl":"10.1016/j.tjpad.2026.100676","url":null,"abstract":"<p><strong>Background: </strong>While global frameworks highlight modifiable risk factors for cognitive decline, evidence on how these risks affect diverse populations remains limited. This study determines the prevalence of probable and possible dementia, identifies primary predictors, and investigates risk variations across racial and ethnic groups in a nationally representative sample.</p><p><strong>Methods: </strong>Using a sample of 7,574 older adults from the 2023 National Health and Aging Trends Study (NHATS), cognitive status was classified as probable, possible, or no dementia. Survey-weighted multinomial logistic regression models with interaction terms examined conditional effects of age, health conditions, and sensory corrections across demographics.</p><p><strong>Results: </strong>Advanced age, low education, stroke, falls, and depression/anxiety were associated with higher Odds of possible and probable dementia (Prb-D), while female, vision and hearing aid use lowered Prb-D odds. Hispanic adults aged 85 and older faced a 60.2% predicted probability of Prb-D, compared to 35.1% for Non-Hispanic (NH) White adults. Low education disproportionately increased Prb-D prevalence, especially among Hispanics. Among hearing aid users, NH White and NH Black adults showed lower of Prb-D probability than non-users, whereas Hispanic users showed a higher probability. Chewing or swallowing problems severely escalated Prb-D probability for Hispanic adults (42.2%) compared to NH Whites (19.3%), and depression doubled the overall risk of Prb-D.</p><p><strong>Conclusion: </strong>The burden of cognitive decline is deeply unequal, proving standardized interventions insufficient for minority older adults. Addressing these disparities necessitates culturally responsive care pathways and the elimination of structural barriers, particularly inadequate insurance coverage for audiology and dental services.</p>","PeriodicalId":22711,"journal":{"name":"The Journal of Prevention of Alzheimer's Disease","volume":"13 10","pages":"100676"},"PeriodicalIF":7.8,"publicationDate":"2026-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13590080/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148956104","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}