Alzheimer disease and associated disorders最新文献

{"title":"Enhanced Screening for Preclinical Cognitive Vulnerability Using Target-Specific Dwelling Time in the Digital Trail Making Test Part A-A Pilot Study.","authors":"Shigeya Tanaka, Tetsuya Yamagami","doi":"10.1097/WAD.0000000000000767","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000767","url":null,"abstract":"<p><strong>Background: </strong>Community-based cognitive screening requires efficient, low-burden tools. We examined \"dwelling time\" (time spent by the pen-tip on a specific target) during the digital Trail Making Test (TMT)-A as a potential marker for early cognitive changes.</p><p><strong>Method: </strong>In this cross-sectional study, we included 91 community-dwelling older adults (mean age 74.4 y) classified into low Memory Performance Index (MPI) (preclinical decline, score <50.2, n=35) and normal groups (n=56). Using a tablet and stylus, dwelling times during digital TMT-A were analyzed, focusing on 5 high-interference targets most strongly associated with MPI.</p><p><strong>Results: </strong>The low MPI group had significantly longer dwelling times at the identified targets. In regression models, the sum of these dwelling times independently predicted MPI (β=-0.200, P=0.020), whereas conventional total completion time did not (β=-0.132, P=0.157). Adding this dwelling time metric to a demographic-based model improved the area under the curve (AUC) from 0.818 to 0.845.</p><p><strong>Conclusions: </strong>For preclinical stages, dwelling time at specific targets is a more sensitive marker of cognitive decline than total completion time. This digital pen-tip behavioral analysis provides a quick, accurate, and low-stress screening tool for preclinical cognitive vulnerability in primary care.</p>","PeriodicalId":520551,"journal":{"name":"Alzheimer disease and associated disorders","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149303809","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":"Using the 4Cs of Primary Care to Ensure Timely Diagnosis of Alzheimer Disease.","authors":"Raj C Shah, Soo Borson, José A Luchsinger","doi":"10.1097/WAD.0000000000000759","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000759","url":null,"abstract":"<p><strong>Background: </strong>Disease-modifying treatment is available for patients diagnosed with early symptomatic Alzheimer disease [AD, mild cognitive impairment (MCI), and mild dementia]. Recognition and diagnosis of MCI and dementia occur every day in the primary care setting, but diagnostic challenges and delays are common. Over 90% of MCI cases are missed, and more than half of AD diagnoses occur when the disease is in the moderate or advanced stage, when crises and emergencies are more likely to occur.</p><p><strong>Discussion: </strong>Diagnostic delays limit opportunities to organize and implement proactive, comprehensive patient care and treatment and to prepare individuals and caregivers for the long-term implications of progressive dementia. With the advent of new diagnostic methods, including blood-based biomarkers, AD can now be diagnosed with greater precision and ease at a lower cost. Given the expected increase in prevalence of AD in the next 2 decades and the growing shortage of geriatricians and memory disorders specialists, the role of the PCP in diagnosing AD will be of even greater importance. However, many PCPs do not feel confident or equipped to recognize and diagnose patients with early symptomatic AD. To empower PCPs as key participants in diagnosis, we propose an approach aligned with the fundamental strengths of primary care, codified in the 4Cs (first contact, comprehensiveness, coordination, and continuity of care).</p><p><strong>Conclusion: </strong>Using the 4Cs framework, PCPs can increase the rate of timely diagnosis of symptomatic AD and be afforded more time to provide comprehensive care, using proactive rather than reactive management strategies throughout the diagnostic process.</p>","PeriodicalId":520551,"journal":{"name":"Alzheimer disease and associated disorders","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149291856","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":"Neuropathological Correlates of Apathy Progression in Alzheimer Disease and Related Dementias: A Longitudinal NACC Cohort Study.","authors":"Yumeng Ada Qi, Terry E Goldberg, Hyun Kim, Davangere P Devanand, Seonjoo Lee","doi":"10.1097/WAD.0000000000000754","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000754","url":null,"abstract":"<p><strong>Objective: </strong>Apathy is disabling in Alzheimer disease (AD) and related dementias, but its progression across neuropathologies remains unclear. This cohort study examined longitudinal apathy-neuropathology associations.</p><p><strong>Methods: </strong>We analyzed 1488 participants from the National Alzheimer's Coordinating Center with autopsy-confirmed neuropathology and at least 2 caregiver-reported Neuropsychiatric Inventory Questionnaire assessments. Generalized linear mixed models tested associations between apathy and AD, Lewy body disease, frontotemporal lobar degeneration (FTLD), hippocampal sclerosis (HS), cerebrovascular disease, and cerebral amyloid angiopathy. Time was modeled as years to death, including pathology-by-time interactions. Models were adjusted for age at death, sex, and Neuropsychiatric Inventory Questionnaire total score excluding apathy. Sex-stratified analyses were conducted.</p><p><strong>Results: </strong>Apathy prevalence increased over time across all pathology groups. FTLD [odds ratio (OR) = 2.11, 95% CI: 1.32-3.39] and HS (OR = 2.23, 95% CI: 1.38-3.60) were consistently associated with higher odds of apathy. No pathology-by-time interaction was significant. Among males, FTLD (OR = 2.58, 95% CI 1.40-4.77), HS (OR = 2.48, 95% CI 1.29-4.77), and Lewy body disease (OR = 1.64, 95% CI 1.03-2.61) were significantly associated with apathy, while only HS (OR = 2.18, 95% CI 1.06-4.47) remained significant in females.</p><p><strong>Conclusion: </strong>Apathy severity varied by neuropathologies but progressed similarly over time. The elevated burden in FTLD and HS, particularly among males, underscores the importance of stratified approaches to early detection and intervention targeting apathy in AD and related dementias.</p>","PeriodicalId":520551,"journal":{"name":"Alzheimer disease and associated disorders","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149291749","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":"The Utility and Feasibility of a Caregiver Tool for the Management of Neuropsychiatric Symptoms of Dementia in Long-Term Care: The Baycrest Quick-Response Caregiver Tool.","authors":"Robert Madan, Anna Berall, Jon Parr Vijinski, Sayem Borhan, Kenneth Schwartz","doi":"10.1097/WAD.0000000000000753","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000753","url":null,"abstract":"<p><strong>Background: </strong>Neuropsychiatric symptoms of dementia (NPS) are common and have significant negative impacts. Behavioral interventions are the first line for the management of NPS. The Baycrest Quick-Response Caregiver Tool (BQRCT) is a novel intervention that assists caregivers in managing NPS in real time. The current study examined the utility and feasibility of the tool for health care professionals in long-term care (LTC).</p><p><strong>Methods: </strong>Participants completed an online training module, and immediate pre/post and follow-up surveys after 4 weeks. Survey data included face-valid Likert questions for program impact, feasibility questions, and the Pearlin Caregiver Competence Scale.</p><p><strong>Results: </strong>Ninety-six participants completed the immediate pre post survey, and 52 completed the follow-up survey at 4 weeks posttraining. The BQRCT-LTC was found to be useful, easy to understand, and implement. The overwhelming majority of participants would recommend the tool to other LTC staff. At the 4-week follow-up, there was a significant improvement on the Pearlin Caregiver Competence Scale, increasing from a mean score of 13.92 (SD=2.21) at pre to a mean score of 14.56 (SD=1.73) at the 4-week follow-up, with a mean difference of 0.64 (SD=2.22, P=0.044).</p><p><strong>Conclusion: </strong>The BQRTC-LTC was found to be feasible and useful in the LTC setting. After 4 weeks, the tool increased caregiver competence in a group of experienced staff in LTC. Future studies may consider measuring the tools impact on the frequency and severity of NPS.</p>","PeriodicalId":520551,"journal":{"name":"Alzheimer disease and associated disorders","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149291810","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":"Affective Reserve: Expanding Reserve Theory Beyond Cognition.","authors":"Elisa Di Rosa","doi":"10.1097/WAD.0000000000000768","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000768","url":null,"abstract":"<p><p>If cognitive systems can build reserve, why should affective systems not do the same? Despite decades of research on brain reserve and cognitive reserve, substantial interindividual variability in affective and cognitive trajectories across the lifespan remains unexplained. Building on the original conceptualization of affective reserve (AR), the present paper further develops AR as a distinct reserve mechanism that extends reserve theory beyond cognition to affective functioning. AR is proposed as a higher-order capacity built and strengthened across the lifespan through the engagement in meaningful and adaptive life experiences that promote the development and the employment of adaptive coping and emotion regulation strategies, and that may involve supportive social relationships. AR is proposed as a higher-order capacity built and strengthened across the lifespan through engagement in meaningful and adaptive life experiences that promote the development and employment of adaptive coping and emotion regulation strategies, and that may involve supportive social relationships. Therefore, AR is hypothesized to constitute an integrated and cumulative affective resource that contributes to resilience and helps explain individual differences in mental health trajectories, beyond what can be explained by cognitive reserve. Given the interdependence of affective and cognitive systems, AR may indeed contribute to both affective and cognitive trajectories and potentially influence the clinical expression of age-related neuropathology and dementia. The present framework specifies the developmental basis and conceptual boundaries of AR, distinguishing it from related constructs including cognitive reserve, emotional reserve, motivational reserve, emotional intelligence, and resilience, and derives testable predictions for future empirical research. By extending reserve theory from cognition to affective functioning, this framework provides a basis for investigating whether cumulative affective system adaptability might represent a previously underexplored source of interindividual variability in mental health, aging, and brain health.</p>","PeriodicalId":520551,"journal":{"name":"Alzheimer disease and associated disorders","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149291807","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":"Estimated Pulse Wave Velocity and Risk of Alzheimer Disease: A Prospective Cohort Study of 14,602 Older Adults From 2 Population-Based Cohorts.","authors":"Jie Ren, Haoyu Feng, Qingqing Liu","doi":"10.1097/WAD.0000000000000760","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000760","url":null,"abstract":"<p><strong>Background: </strong>Arterial stiffness may contribute to Alzheimer disease (AD) pathogenesis. Estimated pulse wave velocity (ePWV) is a noninvasive marker of arterial stiffness, yet its longitudinal association with AD remains unclear.</p><p><strong>Methods: </strong>This prospective cohort study included 14,602 participants aged 45 years or older without baseline AD from HRS (2010 to 2020) and ELSA (2004 to 2018). ePWV was calculated using the Greve formula. Cox models estimated HRs for AD per 1 m/s increase in ePWV, with sequential adjustments. Restricted cubic splines examined dose-response relationships.</p><p><strong>Results: </strong>Over median follow-ups of 8.2 years (HRS) and 10.2 years (ELSA), 203 and 136 incident AD cases occurred. In fully adjusted models, each 1 m/s increment in ePWV was associated with 39% (HR=1.39) and 63% (HR=1.63) increased AD risk, respectively. Positive dose-response associations were observed without clear threshold effects. Subgroup analyses showed consistent results across most strata.</p><p><strong>Conclusions: </strong>Elevated ePWV is independently associated with increased AD risk, suggesting its potential as a risk stratification tool for AD prevention.</p>","PeriodicalId":520551,"journal":{"name":"Alzheimer disease and associated disorders","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149280547","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":"Plasma Phosphorylated Tau 217 Reshapes Diagnostic Classification in a Real-World Memory Clinic Cohort.","authors":"Nora Maerean, Sofia Litchev, George R Jackson, Joseph S Kass, Valory N Pavlik, Chi-Ying R Lin","doi":"10.1097/WAD.0000000000000761","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000761","url":null,"abstract":"<p><strong>Background: </strong>Plasma phosphorylated tau-217 (ptau217) accurately identifies Alzheimer disease (AD), but its impact on real-world clinical diagnosis remains unclear. We evaluated the effect of plasma ptau217 on diagnostic reclassification in a memory disorders clinic.</p><p><strong>Methods: </strong>We retrospectively reviewed 100 patients evaluated for memory impairment. Initial clinical diagnoses were established based on clinical evaluation, neuropsychological testing, and brain MRI without plasma biomarker results. Follow-up diagnoses were assigned after the availability of plasma ptau217 results. Diagnostic reclassification was assessed using binary (ptau217 > 0.18) and higher threshold (ptau217 > 0.325) classification schemes. McNemar tests evaluated reclassification patterns, with subgroup analyses by apolipoprotein E (APOE) ε4 carrier status.</p><p><strong>Results: </strong>Diagnosis reclassification occurred in 37.8% and 46.9% of patients using the lower and higher threshold, respectively (both P<0.001). With the higher threshold (ptau217 > 0.325), reclassification among APOE ε4 carriers was balanced (42% from AD to non-AD vs. 43% from non-AD to AD, P=0.096). In contrast, APOE ε4 noncarriers showed significantly greater reclassification from AD to non-AD than from non-AD to AD (66% vs.14%, P<0.001).</p><p><strong>Conclusions: </strong>Plasma ptau217 meaningfully influences diagnostic decisions in memory clinic practice and may be particularly valuable for refining diagnoses among APOE ε4 noncarriers.</p>","PeriodicalId":520551,"journal":{"name":"Alzheimer disease and associated disorders","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229819","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":"Comment on \"Alzheimer Disease Patients Who Survived COVID-19 Have Rapid Disease Progression and a Higher Risk of Death at 5-Year Follow-Up\".","authors":"Anderson M P da Silva, Diogo H Santos","doi":"10.1097/WAD.0000000000000765","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000765","url":null,"abstract":"","PeriodicalId":520551,"journal":{"name":"Alzheimer disease and associated disorders","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229781","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":"What Are We Measuring in Dementia? A Capability Perspective.","authors":"Tsuyoshi Okamura, Chiaki Ura","doi":"10.1097/WAD.0000000000000763","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000763","url":null,"abstract":"<p><p>Current dementia research and clinical practice primarily rely on cognitive and functional outcomes, which may not fully capture what matters most in the lives of people with dementia. Drawing on the capability approach, this paper proposes a shift in focus from deficits to what individuals are able to be and do. We argue that outcomes in dementia research can be understood hierarchically, from impairment and function to well-being and ultimately to capability. Using the example of the \"blank period\" following diagnosis in Japan, we illustrate how limited support may lead to a decline in quality of life, despite early diagnosis. In contrast, community-based and relational interventions may help sustain meaningful lives even in the presence of cognitive impairment. We further suggest that capability should be understood as dynamic and relational, emerging through interactions with others. This perspective offers an expanded ethical and practical framework for dementia care.</p>","PeriodicalId":520551,"journal":{"name":"Alzheimer disease and associated disorders","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229786","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 Age at Menarche and Education With Episodic Memory in Late-Life Women.","authors":"Erika A Pugh, Precious Peters, Victoria Castillo, Nallely Segura, Kazi Priyanka Silmi, Mackenzie Hoffman, Paris Adkins-Jackson, Leigh Johnson, Marybel R Gonzalez","doi":"10.1097/WAD.0000000000000755","DOIUrl":"https://doi.org/10.1097/WAD.0000000000000755","url":null,"abstract":"<p><strong>Background: </strong>Understanding how early-life reproductive timing and educational context shape cognitive aging is critical for addressing disparities in dementia risk among women. However, few studies have examined the relationship between menarcheal age and cognition in a diverse sample. This study examined associations among menarchal timing, education, and episodic memory performance in an ethnically and racially diverse sample of older women from the Health and Aging Brain Study-Health Disparities.</p><p><strong>Methods: </strong>Using linear regression models, we assessed whether age at menarche and education were associated with performance on 2 commonly used episodic memory measures. Ethnicity-stratified sensitivity analyses and exploratory longitudinal mixed-effects models were also conducted. The sample included 780 women aged 50 years and older, racialized as non-Hispanic White, Hispanic, and Black.</p><p><strong>Results: </strong>Earlier age at menarche and higher educational attainment were independently associated with better episodic memory performance, with more robust and consistent associations observed for Logical Memory II compared with the Spanish-English Verbal Learning Test.</p><p><strong>Conclusion: </strong>These findings suggest that early-life reproductive timing and educational attainment are meaningfully related to episodic memory performance, with test-specific and context-sensitive patterns. Incorporating age at menarche and educational context into life-course approaches to brain health may improve the measurement of heterogeneity in cognitive aging.</p>","PeriodicalId":520551,"journal":{"name":"Alzheimer disease and associated disorders","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149229811","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}