Young Hee Jung, Eun Seong Lee, Yu Jeong Park, Seungyun Lee, Su Jin Chung, Jin Ju Lim, Seon Wook Kim, Ho Jin Kang, Jae Seon Eo, Kyungmi Oh, Seong-Beom Koh, Hyeon Soo Kim, Sung Hoon Kang
{"title":"Association of plasma irisin levels with amyloid burden in the Alzheimer's disease spectrum.","authors":"Young Hee Jung, Eun Seong Lee, Yu Jeong Park, Seungyun Lee, Su Jin Chung, Jin Ju Lim, Seon Wook Kim, Ho Jin Kang, Jae Seon Eo, Kyungmi Oh, Seong-Beom Koh, Hyeon Soo Kim, Sung Hoon Kang","doi":"10.1002/dad2.70418","DOIUrl":"10.1002/dad2.70418","url":null,"abstract":"<p><strong>Introduction: </strong>This study investigated the association between plasma myokines, including irisin, and cerebral amyloid burden across the Alzheimer's disease (AD) continuum.</p><p><strong>Methods: </strong>A total of 100 participants were classified into four groups: amyloid-negative cognitively unimpaired (A- CU), amyloid-positive CU (A+ CU), A+ mild cognitive impairment (MCI), and A+ dementia of the Alzheimer's disease type (DAT). All participants underwent neuropsychological testing, brain magnetic resonance imaging, amyloid positron emission tomography, and plasma myokine assessment. Multivariable linear regression and mediation analyses were performed adjusting for covariates.</p><p><strong>Results: </strong>Irisin levels were significantly lower in all AD continuum groups compared to A- CU participants (<i>p</i> < 0.001), while brain-derived neurotrophic factor (BDNF) and fibroblast growth factor 21 (FGF21) showed no group differences. Higher irisin levels were associated with lower amyloid burden (<i>r</i> = -0.24, <i>p</i> = 0.019). Mediation analysis demonstrated that amyloid burden mediated the relationship between irisin and cognitive outcomes, whereas no such effects were observed for BDNF or FGF21.</p><p><strong>Discussion: </strong>Irisin may play a key role in the muscle-brain axis by linking amyloid pathology to cognitive decline in AD.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70418"},"PeriodicalIF":4.4,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364751/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450521","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}
Matti J Matheson, Rene Labounek, Adam D Block, Corey Strong, Ann J Robertson, Adam Hansen, Meghan Kremer, Ashley J Petersen, Annamarie Hill, Breton M Asken, Igor Nestrasil, Christophe Lenglet, Danni Li, J Neil Henderson, William G Mantyh
{"title":"<i>APOE ε4</i> and Alzheimer's disease biomarkers in an American Indian community.","authors":"Matti J Matheson, Rene Labounek, Adam D Block, Corey Strong, Ann J Robertson, Adam Hansen, Meghan Kremer, Ashley J Petersen, Annamarie Hill, Breton M Asken, Igor Nestrasil, Christophe Lenglet, Danni Li, J Neil Henderson, William G Mantyh","doi":"10.1002/dad2.70421","DOIUrl":"10.1002/dad2.70421","url":null,"abstract":"<p><strong>Introduction: </strong> Apolipoprotein E (<i>APOE</i>) <i>ε4</i>'s effect on Alzheimer's disease (AD) depends on ancestry and environmental risk factors. The <i>APOE</i> <i>ε4</i>-AD link in American Indian (AI) populations appears attenuated, with current understanding largely informed by a single research study. This study seeks to extend this evidence in an AI population in Minnesota.</p><p><strong>Methods: </strong>Cross-sectional analysis of <i>APOE</i> <i>ε4</i>, medical comorbidities, and AD plasma biomarkers with 182 tribal elders.</p><p><strong>Results: </strong>Median age was 67; 70% were female; median Mini-Mental State Examination score was 29. Age-, sex-, and chronic kidney disease-adjusted log odds ratios with 95% confidence intervals for <i>APOE</i> <i>ε4</i> carrier status on amyloid beta 42/40, tau phosphorylated at threonine 217 (p-tau217), and glial fibrillary acidic protein (GFAP) were 0.86 (0.80 to 0.94), 1.04 (0.87 to 1.25), and 1.00 (0.86 to 1.16).</p><p><strong>Conclusion: </strong>Compared to non-Hispanic White populations, <i>APOE</i> <i>ε4</i> has an attenuated effect on p-tau217 or GFAP in AI tribal elders. Limitations of this study include survival bias and race-associated differences in social determinants of health that can influence the observed results.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70421"},"PeriodicalIF":4.4,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358808/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438876","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}
Maurizio Giorelli, Claudia Ada Di Paola, Rosangela Vallarelli, Francesco Negri, Rosalba Morgese, Rosario Francesco Balzano, Pasquale Di Fazio, Daniela Tatò, Cataldo Procacci, Gianluca Masi, Federica Lucia Carpagnano, Tiziana Dimatteo
{"title":"Preparedness and quality of dementia care in an Italian health authority when introducing anti-Aβ therapies.","authors":"Maurizio Giorelli, Claudia Ada Di Paola, Rosangela Vallarelli, Francesco Negri, Rosalba Morgese, Rosario Francesco Balzano, Pasquale Di Fazio, Daniela Tatò, Cataldo Procacci, Gianluca Masi, Federica Lucia Carpagnano, Tiziana Dimatteo","doi":"10.1002/dad2.70403","DOIUrl":"10.1002/dad2.70403","url":null,"abstract":"<p><strong>Introduction: </strong>We aimed to assess dementia care organizations within a southern Italian local health authority (Azienda Sanitaria Locale di Barletta Andria Trani) and to propose an equitable implementation framework for anti-amyloid therapies.</p><p><strong>Methods: </strong>We performed a retrospective analysis of dementia-related outpatient activity in 2024 patients across 18 district clinics (primary care clinics) and three specialized centers for cognitive disorders and dementia (specialized memory centers), integrating booking, clinical, imaging, and prescribing data.</p><p><strong>Results: </strong>Among 1158 initial evaluations, specialized memory centers showed substantially higher quality indicators than district clinics: Mini-Mental State Examination documentation (80.0% vs. 6.6%, <i>p</i> < 0.001), full clinical documentation (95.5% vs. 10.0%), higher use of magnetic resonance imaging and amyloid positron emission tomography, and 5-fold higher rate of prescribing acetylcholinesterase inhibitors. Validated radiological scoring and biomarker facilities (cerebrospinal fluid, apolipoprotein E genotyping) were largely unavailable.</p><p><strong>Discussion: </strong>Major organizational gaps limit readiness for disease-modifying Alzheimer's disease therapies. A four-tier hub-and-spoke model may improve equity, efficiency, and safe implementation.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70403"},"PeriodicalIF":4.4,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13364749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148450438","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}
Catarina Tristão-Pereira, Daniel Vasquez, Jorge Alcina, Ana Baena, David Aguillon, Paula Ospina Lopera, Natalia Londono, Claudia Ramos, Lusiana Martinez, Sergio Alvarez, Monica Vidal, Isabela Gonzalez, Vincent Malotaux, Bing He, Averi Giudicessi, Liliana Ramirez-Gomez, Jennifer Gatchel, Zahinoor Ismail, Yakeel T Quiroz
{"title":"Associations among mild behavioral impairment, cognition, and brain pathology in preclinical autosomal dominant Alzheimer's disease.","authors":"Catarina Tristão-Pereira, Daniel Vasquez, Jorge Alcina, Ana Baena, David Aguillon, Paula Ospina Lopera, Natalia Londono, Claudia Ramos, Lusiana Martinez, Sergio Alvarez, Monica Vidal, Isabela Gonzalez, Vincent Malotaux, Bing He, Averi Giudicessi, Liliana Ramirez-Gomez, Jennifer Gatchel, Zahinoor Ismail, Yakeel T Quiroz","doi":"10.1002/dad2.70424","DOIUrl":"10.1002/dad2.70424","url":null,"abstract":"<p><strong>Introduction: </strong>The Mild Behavioral Impairment Checklist (MBI-C) captures neuropsychiatric symptoms in individuals at risk of dementia. In this study, we examined MBI-C scores in autosomal dominant Alzheimer's disease (ADAD).</p><p><strong>Methods: </strong>We included 83 cognitively unimpaired presenilin-1 E280A mutation carriers and 114 non-carriers with MBI-C, obfjective cognition, and subjective cognitive decline (SCD) assessments. Study sub-samples underwent neuroimaging to assess Alzheimer's disease (AD) pathology and neurodegeneration.</p><p><strong>Results: </strong>MBI-C total scores were greater in carriers than non-carriers (<i>r</i> <sub>rb </sub>= 0.19 [95% confidence interval (CI) 0.05, 0.31], <i>P </i>= 0.009), driven by impulse dyscontrol symptoms. Elevated MBI-C scores were associated with higher study partner-reported SCD scores (β = 0.28 [95% CI 0.07, 0.050], <i>P </i>= 0.008) and with greater neocortical amyloid beta (β = 0.46 [95% CI 0.17, 0.075], <i>P </i>= 0.003) among carriers.</p><p><strong>Discussion: </strong>Our study reveals that mild behavioral impairment symptoms may emerge before cognitive decline in ADAD and supports the MBI-C as a tool for detecting early behavioral changes linked to AD pathology and identifying at-risk individuals for clinical trials and early intervention.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70424"},"PeriodicalIF":4.4,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13358810/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438856","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}
David Wilson, Karen Copeland, Lindsey Mette, Meenakshi Khare, Matt Polak, Jorge Marques Signes, Tim Skelton
{"title":"Comparison of a multi-analyte algorithmic immunoassay blood test with immunoprecipitation mass spectrometry for the detection of amyloid pathology.","authors":"David Wilson, Karen Copeland, Lindsey Mette, Meenakshi Khare, Matt Polak, Jorge Marques Signes, Tim Skelton","doi":"10.1002/dad2.70420","DOIUrl":"10.1002/dad2.70420","url":null,"abstract":"<p><strong>Introduction: </strong>Alzheimer's blood-based biomarker (BBM) tests using single biomarkers or ratios are well characterized, but head-to-head comparisons of multi-analyte algorithmic tests on shared cohorts are lacking. We compared a five-biomarker algorithmic immunoassay (LucentAD Complete) with an algorithmic immunoprecipitation mass-spectrometry (IP-MS) benchmark on a shared plasma cohort.</p><p><strong>Methods: </strong>Symptomatic individuals (<i>n</i> = 192) with longitudinal samples from Alzheimer's Disease Neuroimaging Initiative (ADNI) were analyzed versus amyloid positron emission tomography (PET). Cross-sectional (<i>n</i> = 115) and longitudinal (<i>n</i> = 179; 12-year span) cohorts representing disease progression were used.</p><p><strong>Results: </strong>The immunoassay amyloid risk score demonstrated a 0.94 area under the curve (AUC) and 92%-93% accuracy, achieving performance parity with IP-MS metrics on shared samples. The two-cutoff design yielded an intermediate zone of 10.4%-12.8%.</p><p><strong>Discussion: </strong>These results establish diagnostic parity between algorithmic immunoassay and algorithmic IP-MS assay. In addition, providing individual biomarker results alongside a validated risk score offers a more granular foundation for comprehensive management than amyloid status alone, supporting premium reimbursement for multi-analyte algorithmic BBMs in clinical practice.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70420"},"PeriodicalIF":4.4,"publicationDate":"2026-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13351331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148425412","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}
Jonas Alexander Jarholm, Sandra Tecelão, Bjørn-Eivind Kirsebom, Mostafa Mehdipour Ghazi, Lene Pålhaugen, Berglind Gísladóttir, Fernando Gonzalez-Ortiz, Mehdi Sadat Akhavi, Einar Hopp, Anders Martin Fjell, Santiago Timón-Reina, Mads Nielsen, Kaj Blennow, Dag Aarsland, Atle Bjørnerud, Per Selnes, Tormod Fladby
{"title":"Independent prognostic value of peak width of skeletonized mean diffusivity on clinical progression in Alzheimer's disease.","authors":"Jonas Alexander Jarholm, Sandra Tecelão, Bjørn-Eivind Kirsebom, Mostafa Mehdipour Ghazi, Lene Pålhaugen, Berglind Gísladóttir, Fernando Gonzalez-Ortiz, Mehdi Sadat Akhavi, Einar Hopp, Anders Martin Fjell, Santiago Timón-Reina, Mads Nielsen, Kaj Blennow, Dag Aarsland, Atle Bjørnerud, Per Selnes, Tormod Fladby","doi":"10.1002/dad2.70416","DOIUrl":"10.1002/dad2.70416","url":null,"abstract":"<p><strong>Introduction: </strong>Peak width of skeletonized mean diffusivity (PSMD) is a candidate magnetic resonance imaging marker for global white matter integrity. We investigated the value of PSMD in predicting clinical progression in amyloid-positive and amyloid-negative individuals.</p><p><strong>Methods: </strong>PSMD, cognition, and amyloid status were measured in 254 subjects from the Dementia Disease Initiation (DDI) cohort and 211 subjects from the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort. Survival analysis was conducted on 166 DDI subjects and validated in 178 ADNI subjects using Clinical Dementia Rating scale.</p><p><strong>Results: </strong>High PSMD amyloid-positive individuals had an increased risk of clinical progression relative to those with low PSMD, driven by independent additive effects of amyloid pathology and PSMD. Higher PSMD was predominantly associated with slower processing speed and reduced executive function, but not with memory performance.</p><p><strong>Discussion: </strong>Combining PSMD with amyloid status may improve the prediction of clinical progression in Alzheimer's disease, particularly in relation to executive and processing speed domains.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70416"},"PeriodicalIF":4.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344884/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413803","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}
Sonal Sukreet, Michael C Donohue, Jennifer Ngolab, Alison Belsha, Jennifer Salazar, Paula Cohen, Sandhya Jaiswal, Veasna Tan, Neelum T Aggarwal, Jessica Alber, Ken Johnson, Gregory A Jicha, Christopher H van Dyck, Srinath Ramanan, James J Lah, Stephen Salloway, Steven R Verdooner, Michael S Rafii, Paul S Aisen, Reisa A Sperling, Robert A Rissman
{"title":"Relationships between longitudinal retinal amyloid imaging and amyloid PET in the A4 Trial.","authors":"Sonal Sukreet, Michael C Donohue, Jennifer Ngolab, Alison Belsha, Jennifer Salazar, Paula Cohen, Sandhya Jaiswal, Veasna Tan, Neelum T Aggarwal, Jessica Alber, Ken Johnson, Gregory A Jicha, Christopher H van Dyck, Srinath Ramanan, James J Lah, Stephen Salloway, Steven R Verdooner, Michael S Rafii, Paul S Aisen, Reisa A Sperling, Robert A Rissman","doi":"10.1002/dad2.70422","DOIUrl":"10.1002/dad2.70422","url":null,"abstract":"<p><strong>Introduction: </strong>Alzheimer's disease (AD) is associated with retinal amyloid-related changes, which may help identify amyloid positron emission tomography (PET) positive (+) individuals. Previously, in a small cross-sectional study, we reported higher retinal spot counts (RSCs) in preclinical amyloid PET (+) individuals screened for the Anti-Amyloid Treatment in Asymptomatic Alzheimer's Disease (A4) trial compared to control individuals enrolled in the Longitudinal Evaluation of Amyloid Risk and Neurodegeneration (LEARN) trial before drug treatment.</p><p><strong>Methods: </strong>Eligible volunteers had retinal scans 48 hours after consuming curcumin. Scans were processed and quantified via NeuroVision. Participants were grouped by amyloid status and treatment to assess the effect of solanezumab on RSC.</p><p><strong>Results: </strong>RSC did not differ significantly over time between groups and was not modified by treatment, diverging from the cross-sectional retinal amyloid findings observed in A4/LEARN.</p><p><strong>Discussion: </strong>Curcumin-based retinal amyloid labeling shows promise but needs standardized protocols and validation in larger cohorts to understand its relationship to amyloid PET.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70422"},"PeriodicalIF":4.4,"publicationDate":"2026-07-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13344897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148413820","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":"Longitudinal changes in DTI-ALPS and choroid plexus volume relative to CSF biomarkers during lecanemab treatment in mild cognitive impairment: A pilot study.","authors":"Toshiya Takahashi, Kaku Kimura, Shingo Takenaka, Sayaka Ono, Maya Fukui, Yasushi Okada, Tomohiko Asada, Kan Niimi, Akio Ikeda, Ryosuke Takahashi, Riki Matsumoto, Hidenao Fukuyama","doi":"10.1002/dad2.70375","DOIUrl":"10.1002/dad2.70375","url":null,"abstract":"<p><strong>Background: </strong>Lecanemab improves cerebrospinal fluid (CSF) biomarkers, but whether magnetic resonance imaging (MRI) proxies of CSF-interstitial fluid (ISF) exchange improve is unknown.</p><p><strong>Methods: </strong>This was a single-center prospective pilot (<i>n</i> = 8). The ALPS index was derived from diffusion tensor image analysis along the perivascular space (DTI-ALPS), and intracranial volume (ICV)-normalized choroid plexus (ChP) volume was segmented with FreeSurfer Sequence Adaptive Multimodal SEGmentation (SAMSEG). Baseline changes were tested with Wilcoxon signed-rank tests with Benjamini-Hochberg false discovery rate (FDR) control within prespecified MRI, CSF, and cognition endpoint families.</p><p><strong>Results: </strong>CSF Aβ42 and Aβ42/40 increased and tau phosphorylated at threonine 181 (p-tau181) decreased at 6 and 12 months (all <i>q</i> < 0.05); cognition showed no FDR-significant change. The ALPS index showed a downward tendency (9-month <i>q</i> = 0.010), and ChP/ICV increased at 6-12 months (all <i>q</i> = 0.010).</p><p><strong>Discussion: </strong>The ALPS index and ChP volume may be insufficient as stand-alone surrogate endpoints over 12 months. These findings suggest exploring complementary strategies targeting CSF-ISF exchange and clearance pathways and warrant larger controlled longitudinal studies.</p><p><strong>Clinical trial registration information: </strong>Not applicable (observational study).</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70375"},"PeriodicalIF":4.4,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336065/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438818","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}
Thomas J Littlejohns, Wenyu Liu, Carol Brayne, Julia Butt, Jennifer A Collister, Nita G Forouhi, Effrossyni Gkrania-Klotsas, Shabina Hayat, Katie Jeffery, Elżbieta Kuźma, Robert N Luben, Alexander J Mentzer, Julie Parsonnet, Nicholas Wareham, Tim Waterboer, David J Hunter
{"title":"<i>Helicobacter pylori</i>, herpes simplex virus-1, varicella-zoster virus, and dementia risk.","authors":"Thomas J Littlejohns, Wenyu Liu, Carol Brayne, Julia Butt, Jennifer A Collister, Nita G Forouhi, Effrossyni Gkrania-Klotsas, Shabina Hayat, Katie Jeffery, Elżbieta Kuźma, Robert N Luben, Alexander J Mentzer, Julie Parsonnet, Nicholas Wareham, Tim Waterboer, David J Hunter","doi":"10.1002/dad2.70414","DOIUrl":"10.1002/dad2.70414","url":null,"abstract":"<p><strong>Introduction: </strong><i>Helicobacter pylori</i> (<i>H. pylori</i>), herpes simplex-1 (HSV-1), and varicella-zoster virus (VZV) could increase dementia risk; however, evidence from large cohorts with long-term follow-up is scarce.</p><p><strong>Methods: </strong>Multivariable-adjusted Cox proportional-hazards models were used to investigate the association between <i>H. pylori</i>, HSV-1, and VZV seropositivity and dementia risk over 24 years in 8550 participants from the European Prospective Investigation into Cancer in Norfolk study in the United Kingdom.</p><p><strong>Results: </strong><i>H. pylori</i> (hazard ratio [HR] = 1.24, 95% confidence interval [CI]: 1.09 to 1.41), but not HSV-1 (HR = 1.03, 95% CI: 0.91 to 1.18) or VZV (HR = 1.01, 95% CI: 0.86 to 1.19), was associated with dementia risk. The <i>H. pylori</i>-dementia association remained robust among incident cases >15 years after blood draw (HR = 1.26, 95% CI: 1.06 to 1.48). Seropositive tertiles of the <i>H. pylori</i> antibodies CagA (<i>p </i>= 0.007) and GroEL (<i>p </i>= 0.001) demonstrated significant trends with dementia risk.</p><p><strong>Discussion: </strong><i>H. pylori</i> may represent a novel dementia prevention target, although early-life socioeconomic factors might confound the association.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70414"},"PeriodicalIF":4.4,"publicationDate":"2026-07-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13336066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148438881","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":"Obstacles and solutions for implementing amyloid-targeting treatments in Europe.","authors":"Anna Hofmann, Robert Perneczky","doi":"10.1002/dad2.70367","DOIUrl":"10.1002/dad2.70367","url":null,"abstract":"<p><p>Recent approvals of disease-modifying therapies by the European Medicines Agency mark a historic shift in the treatment landscape of Alzheimer's disease (AD) within the European Union that will challenge national health-care systems and require major adaptations and modernization. This Perspective article provides an overview of the major obstacles in Europe concerning successful implementation of amyloid-targeting treatments and offers potential solutions to overcome them. Major hurdles include a lack of recognition regarding the critical importance of an early, biomarker-based AD diagnosis; low acceptance of blood tests and digital cognitive screening tools; insufficient investment in magnetic resonance imaging capacities; and a fragmented infrastructure for clinical registries. We call on European clinicians, research institutions, and policy makers for a bold and coordinated action to urgently modernize diagnostic pathways and monitoring infrastructure to deliver novel AD treatments in a timely, safe, and equitable manner to all patients who may benefit.</p>","PeriodicalId":53226,"journal":{"name":"Alzheimer''s and Dementia: Diagnosis, Assessment and Disease Monitoring","volume":"18 3","pages":"e70367"},"PeriodicalIF":4.4,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322994/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148378031","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}
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