Journal of Alzheimer's disease reports最新文献

{"title":"Integrating repetitive transcranial magnetic stimulation and Mediterranean diet for cognitive and anxiety improvement in early Alzheimer's disease: A case report and literature review.","authors":"Yumei Liu, Lin Zhu, Zian Pei, Zhifan Zhou, Xiaolin Su, Huixia Ren, Shuhan Fan, Xiaoyong Lan, Chongyuan Lian, Xue Shi, Yi Guo","doi":"10.1177/25424823251377988","DOIUrl":"10.1177/25424823251377988","url":null,"abstract":"<p><p>A 52-year-old male with early-stage Alzheimer's disease and long-standing anxiety received 30 repetitive transcranial magnetic stimulation sessions over 8 months and 20-month Mediterranean diet intervention. Neuropsychological assessments [Montreal Cognitive Assessment (MoCA), Mini-Mental State Examination (MMSE), Clinical Dementia Rating, Hamilton Anxiety Rating Scale (HAMA), Hamilton Depression Rating Scale (HAMD), Pittsburgh Sleep Quality Index) and resting-state electroencephalogram (rsEEG) were conducted at baseline, during treatment, and at 6-month follow-up. After treatment, MoCA and MMSE scores improved by 6 and 5 points; HAMA and HAMD scores declined by 7 and 3 points. rsEEG showed progressive increases in individual alpha peak frequency (8.69 to 10.22 Hz), enhancement of alpha power, and reduction in theta power. Cerebrospinal fluid amyloid-β₄₂ levels also normalized. The patient reported marked mental well-being.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"9 ","pages":"25424823251377988"},"PeriodicalIF":2.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441292/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088277","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":"Brexpiprazole: Pioneering medication for managing agitation in Alzheimer's disease.","authors":"Ayesha Shaukat, Rumaisa Riaz, Nawal Khaliq, Zubayer Shams, Aymar Akilimali","doi":"10.1177/25424823251379881","DOIUrl":"10.1177/25424823251379881","url":null,"abstract":"<p><p>Alzheimer's disease poses intricate challenges, affecting cognition and behavior, notably marked by agitation. The FDA's approval of brexpiprazole, an atypical antipsychotic, stands as a milestone, representing the first treatment for Alzheimer's-related agitation. brexpiprazole's modulation of serotonin-dopamine activity has proven effective in clinical trials, reducing agitation as measured by CMAI scores. Gradual dosage escalation is recommended, with potential side effects including nasopharyngitis, urinary tract infections, dizziness, somnolence, headache, and insomnia. Also useful for schizophrenia and treatment-resistant depression, providing ongoing treatment and potential well-being enhancement by managing agitation and other symptoms.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"9 ","pages":"25424823251379881"},"PeriodicalIF":2.8,"publicationDate":"2025-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441263/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145088282","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":"Effects of a person-centered music-based intervention in the rehabilitation of older adults with mild to moderate dementia.","authors":"Sara Santini, Alessandra Merizzi, Maria Joao Azevedo, Sandra Costa, Ioana Caciula, Mirko Di Rosa, Sabrina Quattrini","doi":"10.1177/25424823251367291","DOIUrl":"10.1177/25424823251367291","url":null,"abstract":"<p><strong>Background: </strong>With the progressive population aging, dementia is reaching epidemic dimensions worldwide. Non-pharmacological music-based interventions can have a positive impact on the rehabilitation of older adults with dementia. Nevertheless, there are few longitudinal cross-national studies testing their impact.</p><p><strong>Objectives: </strong>This pilot study aims at shedding light on the effects of the SOUND person-centered music-based intervention on well-being, cognition, executive functions and mood of older adults with mild-moderate dementia in three European countries.</p><p><strong>Methods: </strong>An original intervention consisting in 12 sessions of active and passive music activities (singing, rhythmic exercises with Orff's tools, narratives elicited by music, etc.), led by a trained facilitator, was implemented in Italy, Portugal and Romania with 41 older adults with mild-moderate dementia attending elder facilities. Data on well-being, cognition, executive functions and mood of participants were collected before, at the end and two weeks after the intervention through psychometric tools. Temporal comparisons were assessed by T-test for paired samples.</p><p><strong>Results: </strong>The SOUND intervention significantly improved participants' well-being, cognition and executive functions over time and remained stable at the follow-up at cross-national level. The potential of the intervention on mood is not clear due to depression and anxiety increasing among Romanian participants.</p><p><strong>Conclusions: </strong>Cross-national, longitudinal, multidisciplinary mixed-method studies demonstrating the effects of music-based rehabilitative interventions for older adults with mild-moderate dementia are encouraged to shape innovative treatments as well as to identify possible adverse effects on participants' mood linked to scarcity of coping capabilities as source of distress in older individuals.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"9 ","pages":"25424823251367291"},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082746","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":"Exploration of the potential role of plasma lipoprotein molecules in late-onset Alzheimer's disease among the Chinese population.","authors":"Shitao Wang, Guoshuai Luo, Qingqing Zhao, Shangrong Zhang, Zongyou Li, Jinghong Lu, Fei Wang, Daliang Sun, Hui Xu","doi":"10.1177/25424823251378973","DOIUrl":"10.1177/25424823251378973","url":null,"abstract":"<p><strong>Background: </strong>Evidence suggests that lipoprotein metabolism play a crucial role in Alzheimer's disease (AD). However, their involvement in late-onset AD (LOAD) remains unclear.</p><p><strong>Objective: </strong>This study aimed to uncover potential associations between lipoprotein metabolism and clinical LOAD diagnosis, cognitive function, and treatment.</p><p><strong>Methods: </strong>We performed a lipidomic analysis of plasma samples from 46 individuals with LOAD and 16 healthy controls to investigate the potential association between lipoprotein profiles, LOAD diagnosis and cognitive function. Then, we conducted a protein-protein interaction analysis to explore the potential therapeutic role of lipoprotein molecules in LOAD.</p><p><strong>Results: </strong>Our findings revealed that ApoA2 and HDL ApoA2 may be negatively associated with LOAD risk (odds ratio [OR] = 0.798, 95% confidence interval [CI] = 0.654-0.973, p = 0.026; OR = 0.785, 95% CI = 0.634-0.972, p = 0.026, respectively), while LDL-3 triglycerides showed a potential positive association (OR = 6.051, 95% CI = 1.789-20.470, p = 0.004). Additionally, HDL-4 ApoA1 may be positively correlated with cognitive function in LOAD (p = 0.047, r² = 0.087). Moreover, our findings suggest that ApoA2 may interact with targets of approved AD drugs.</p><p><strong>Conclusions: </strong>This study identifies potential key lipoprotein alterations associated with LOAD diagnosis and cognitive function, emphasizing the role of lipidomic insights in understanding and treating LOAD.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"9 ","pages":"25424823251378973"},"PeriodicalIF":2.8,"publicationDate":"2025-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437157/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145082712","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":"Comorbidities and apolipoprotein E genotypes of patients with mild cognitive impairment in transition to Alzheimer's disease.","authors":"Mingfei Li, Ying Wang, Lewis Kazis, Jiaying Weng, Weiming Xia","doi":"10.1177/25424823251353209","DOIUrl":"10.1177/25424823251353209","url":null,"abstract":"<p><strong>Background: </strong>Three common chronic diseases in the elderly: diabetes, hypertension, and hypercholesterolemia, associate with mild cognitive impairment (MCI) and Alzheimer's disease (AD).</p><p><strong>Objective: </strong>We will examine the association of apolipoprotein E (<i>APOE</i>) ε4 allele, diabetes, hypertension, and hypercholesterolemia (in combination) with the transition of MCI to AD.</p><p><strong>Methods: </strong>We examine patients from the National Alzheimer's Coordinating Center database from June 2005 to May 2021. AD converted from MCI, stable MCI, and non MCI/AD control subjects were analyzed using Cox proportional hazard models with propensity score weights on matching demographic information and medications prescribed at baseline.</p><p><strong>Results: </strong>With MCI time of diagnosis as the index date, MCI patients with diabetes and hypertension carried a higher risk of developing AD (HR = 1.17, 95%CI (1.04, 1.31), p = 0.01) compared to MCI patients with a single condition. A similar observation was found among MCI patients with diabetes and hypercholesterolemia (HR = 1.20, 95%CI (1.07, 1.36), p = 0.002). Compared to MCI patients who had a single condition and without <i>APOE</i> ε4 allele, MCI patients with <i>APOE</i> ε4/4 and both diabetes and hypertension have a significantly higher risk of AD onset (HR = 7.6, 95%CI (5.02, 11.5), p < 0.0001). Those with <i>APOE</i> ε3/4 also have a significantly high risk (HR = 2.3, 95%CI (1.92, 2.75), p < 0.0001). Comparable outcomes were found among those with diabetes and hypercholesterolemia.</p><p><strong>Conclusions: </strong>The combination of diabetes with hypertension or hypercholesterolemia have a significant association with the progression of MCI to AD, and <i>APOE</i> ε4 allele enhances the association of these selected comorbidities in promoting this conversion.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"9 ","pages":"25424823251353209"},"PeriodicalIF":2.8,"publicationDate":"2025-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12432309/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066523","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":"Using machine learning to identify risk factors for Alzheimer's disease among older adults in the United States: The role of chronic and behavioral health.","authors":"Md Roungu Ahmmad, Emran Hossain, Md Tareq Ferdous Khan, Sumitra Paudel","doi":"10.1177/25424823251377691","DOIUrl":"10.1177/25424823251377691","url":null,"abstract":"<p><strong>Background: </strong>The interactions between behavioral disturbances, chronic diseases, and Alzheimer's disease (AD) risk are not fully understood, particularly in the context of the COVID-19 pandemic.</p><p><strong>Objective: </strong>This study aimed to identify key demographic, behavioral, and health-related predictors of AD using machine learning approaches.</p><p><strong>Methods: </strong>We conducted a cross-sectional analysis of 3257 participants from the National Health and Aging Trends Study (NHATS) and its COVID-19 supplement. Predictors included demographic, behavioral, and chronic disease variables, with self-reported physician-diagnosed AD as the outcome. LASSO and random forest (RF) models identified significant predictors, and regression tree analysis examined interactions to estimate individual AD risk profiles and subgroups.</p><p><strong>Results: </strong>Stroke, diabetes, osteoporosis, depression, and sleep disturbances emerged as key predictors of AD in both LASSO and RF models. Regression tree analysis identified three risk subgroups: a high-risk subgroup with a history of stroke and diabetes, showing a 68% AD risk among females; an intermediate-risk subgroup without stroke but with osteoporosis and positive COVID-19 status, showing a 30% risk; and a low-risk subgroup without stroke or osteoporosis, with the lowest risk (∼10%). Female patients with both stroke and diabetes had significantly higher AD risk than males (68% versus 10%, p = 0.029). Among patients without stroke but with osteoporosis, COVID-19 positivity increased AD risk by 20% (30% versus 10%, p = 0.006).</p><p><strong>Conclusions: </strong>Machine learning effectively delineates complex AD risk profiles, highlighting the roles of vascular and metabolic comorbidities and the modifying effects of sex, osteoporosis, and COVID-19. These insights support targeted screening and early intervention strategies to improve outcomes in older adults.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"9 ","pages":"25424823251377691"},"PeriodicalIF":2.8,"publicationDate":"2025-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12423528/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145066543","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":"Apolipoprotein E4 allele, antibodies against periodontal microorganisms, and cognition in older adults.","authors":"Anwar T Merchant, Longgang Zhao, Eric Mishio Bawa, Amirhossein Fakhre Yaseri, Matthew Lohman, Jiajia Zhang, Alyssa Clay-Gilmour, Roger D Newman-Norlund, Julius Fridriksson","doi":"10.1177/25424823251370770","DOIUrl":"10.1177/25424823251370770","url":null,"abstract":"<p><strong>Background: </strong>The presence of the apolipoprotein E4 (<i>APOE4</i>) allele and periodontal disease are independently correlated with higher levels of amyloid-β and inflammation in the brain, worse cognition, and Alzheimer's disease.</p><p><strong>Objective: </strong>To assess whether the presence of the <i>APOE4</i> allele modifies the relationship between IgG antibodies against periodontal microorganisms and cognitive function in older adults participating in the NHANES III study.</p><p><strong>Methods: </strong>This cross-sectional analysis was conducted among participants of the third National Health and Nutrition Examination Survey (NHANES III) (1988 to 1994), aged 60 years and older, with measurements of IgG antibodies against 19 periodontal microorganisms and <i>APOE4</i> alleles (N = 1644).</p><p><strong>Results: </strong>Approximately 77.5% of participants carried no <i>APOE4</i> allele, 20.0% had one allele, and 2.6% were homozygous. Mean cognitive scores were 16.1, 16.0, and 15.3 for non-carriers, heterozygous, and homozygous <i>APOE4</i> allele carriers, respectively (p = 0.01). Antibody groups were not correlated with <i>APOE4</i> carrier status. The Orange-Blue cluster (antibodies against <i>E. nodatum, A. naeslundii</i>) was correlated with cognitive score (Spearman r = 0.08, p < 0.001), but not other antibody groups. In the multivariable-adjusted models, <i>APOE4</i> alleles did not modify the associations between antibody clusters and cognitive score (p-interaction > 0.05).</p><p><strong>Conclusions: </strong>Mean cognitive scores were lower among <i>APOE4</i> carriers. The <i>APOE4</i> allele did not modify associations between groups of IgG antibodies against periodontal microorganisms and cognition among older aged adults without cognitive impairment. These findings need to be verified in larger prospective studies.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"9 ","pages":"25424823251370770"},"PeriodicalIF":2.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413519/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016851","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":"Persistence with antidementia therapy in Germany: A retrospective cohort study of 567,815 patients.","authors":"Miriam Guba-Menzel, Felix S Hussenoeder, Karel Kostev","doi":"10.1177/25424823251372924","DOIUrl":"10.1177/25424823251372924","url":null,"abstract":"<p><strong>Background: </strong>Despite the availability of these therapies, maintaining long-term adherence remains a significant challenge.</p><p><strong>Objective: </strong>This retrospective cohort study aimed to investigate 12-month and 5-year persistence with antidementia drug therapy in Germany and to examine the association between demographic and clinical variables and the risk of therapy discontinuation.</p><p><strong>Methods: </strong>Patients aged 60 years or older from the IQVIA Longitudinal Prescription Database who received an initial prescription for antidementia therapy between 2016 and 2023 (index date) were included. Time to discontinuation was estimated using the Kaplan-Meier method, and a multivariable Cox proportional hazards model was used to assess associations between predefined variables and the risk of discontinuation.</p><p><strong>Results: </strong>The study included 567,815 patients (mean age: 80.2 years, 59.1% female). Five years after the index date, 19.8% of dementia patients were still receiving therapy, with a 12-month persistence rate of 53.1%. Cox regression models conducted for the total population revealed that younger age (<70 versus ≥90 years; HR: 1.21; 95% CI: 1.19-1.23; 71-80 years versus ≥90 years; HR: 1.13; 95% CI: 1.11-1.14) was significantly associated with an increased risk of therapy discontinuation. Initiating therapy with memantine was associated with a slightly lower risk of discontinuation compared to donepezil (HR: 0.87; 95% CI: 0.86-0.87).</p><p><strong>Conclusion: </strong>In this study, half of the patients discontinued antidementia therapy within one year and 80% within five years. Younger age was linked to a higher risk of therapy discontinuation, while memantine therapy was associated with improved persistence, potentially reflecting better adherence among patients with more advanced dementia.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"9 ","pages":"25424823251372924"},"PeriodicalIF":2.8,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12413513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016875","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":"Adverse reproductive outcomes and future risk of incident dementia: The modifying effect of genetic susceptibility.","authors":"Qiaoqiao Xu, Chengzhe Tao, Sijia Dai, Zhixi Lu, Michael Aschner, Guangfeng Long, Shaojun Li, Cheng Xu","doi":"10.1177/25424823251370717","DOIUrl":"10.1177/25424823251370717","url":null,"abstract":"<p><strong>Background: </strong>Adverse reproductive outcomes (AROs) in women can lead to the occurrence of a variety of diseases later in life. However, research on AROs and dementia risk in women has not been reported.</p><p><strong>Objective: </strong>This study explored the effects of miscarriage and stillbirth on future dementia risk in women.</p><p><strong>Methods: </strong>The Cox proportional hazards model was used to clarify the association between miscarriage, stillbirth, and dementia risk. In this cohort, only women with a history of miscarriage and stillbirth were selected. A genetic risk score for dementia was constructed, and the combined effect of miscarriage, stillbirth, and the genetic risk score for dementia on the future risk of incident dementia was determined.</p><p><strong>Results: </strong>For each increase in the number of miscarriages and stillbirths, the risk of dementia increased by 5% and 22%, respectively. Compared to women who had a low genetic risk score, no miscarriages and at least one live-born infant, women with more than 3 miscarriages and a high genetic risk score had a significantly increased risk of dementia.</p><p><strong>Conclusions: </strong>Our results indicate that miscarriage and stillbirth are associated with an increased risk of dementia, especially in women with a high genetic risk score.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"9 ","pages":"25424823251370717"},"PeriodicalIF":2.8,"publicationDate":"2025-09-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12411706/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145016841","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":"Cost-benefit of dementia insurance for cognitively-unimpaired <i>APOE</i> ε4 homozygotes: A simulation study.","authors":"Kenichiro Sato, Saki Nakashima, Yoshiki Niimi, Ryoko Ihara, Takeshi Iwatsubo","doi":"10.1177/25424823251372925","DOIUrl":"10.1177/25424823251372925","url":null,"abstract":"<p><strong>Background: </strong>Dementia insurance, a private insurance product covering the first diagnosis of dementia of the insured, may be beneficial for asymptomatic individuals who recognize their own high genetic risk for Alzheimer's disease.</p><p><strong>Objective: </strong>We aimed to examine the cost-benefit of dementia insurance in cognitively unimpaired individuals, stratified by <i>APOE</i> ε4 genotype.</p><p><strong>Methods: </strong>A simulation study using 18 years of longitudinal data from National Alzheimer's Coordinating Center study to simulate the income and expenses of dementia insurance from the insured's perspective. Cognitively unimpaired participants at baseline (approximately n = 9000) were included, and the loss ratio (= total benefits gained / total premium paid) was calculated by <i>APOE</i> ε4 subgroup, applying the premium rates of actual insurance products in Japan.</p><p><strong>Results: </strong>For individuals aged 60 or older with ≥ 10-year follow-up, the estimated loss ratio was highest in <i>APOE</i> ε4 homozygotes. However, even for this group, the 95% confidence interval for the loss ratio was either below or included 1.0, indicating no clear financial gain. Their loss ratio was approximately 3 to 4 times higher than for ε4-negative individuals, and 2 times higher than for ε4-heterozygotes.</p><p><strong>Conclusions: </strong>Dementia insurance may be relatively more cost-beneficial for asymptomatic ε4-homozygotes in their 60 s or older compared to other genotypes over policy periods of 10 years or longer. However, it does not represent a clear financial gain for the insured, highlighting the need for careful consideration. Our study provides an important basis for further investigating the advantages and limitations of dementia insurance for individuals with high-risk gene.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"9 ","pages":"25424823251372925"},"PeriodicalIF":2.8,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12402658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144994527","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}