Journal of Alzheimer's disease reports最新文献

{"title":"Association of early-life caregiver mental health and education with incidence of mild cognitive impairment among the Chinese population: A longitudinal observational study.","authors":"Yan Wang, Chaofeng Fan","doi":"10.1177/25424823261450904","DOIUrl":"https://doi.org/10.1177/25424823261450904","url":null,"abstract":"<p><strong>Background: </strong>Mild cognitive impairment (MCI) is a critical prodromal stage of dementia, yet the role of early-life psychosocial determinants, particularly caregiver characteristics, remains underexplored.</p><p><strong>Objective: </strong>To investigate the associations of caregiver mental health and education with offspring MCI incidence, and to examine their joint effects.</p><p><strong>Methods: </strong>We utilized data from the China Health and Retirement Longitudinal Study (CHARLS), involving 8140 participants aged ≥45 years. The mental health (categorized as normal or abnormal) and educational level (categorized as illiterate, basic, or middle school and above) of the primary male and female caregivers were assessed retrospectively. MCI was diagnosed based on a comprehensive cognitive battery assessing orientation, episodic memory, and executive function, with scores standardized for age and education. Cox regressions were used to analysis.</p><p><strong>Results: </strong>Over a median follow-up of 9.0 years, 873 (10.72%) participants developed MCI. Abnormal caregiver mental health was associated with an approximately 18% higher risk of incident MCI in offspring (HR [95% confidence interval]: female caregiver: 1.17 [1.02-1.35]; male caregiver: 1.18 [1.02-1.37]). Compared to having an illiterate caregiver, having a male caregiver with a basic education was associated with a 23% lower risk of MCI (HR = 0.78 [0.67-0.91]); this association was not significant for female caregivers.</p><p><strong>Conclusions: </strong>Caregiver mental health and educational attainment are independently associated with the risk of MCI in their offspring during mid-to-late life. Interventions supporting caregiver well-being and education may contribute to dementia prevention strategies. These findings were derived exclusively from the Chinese population; caution should be taken when generalizing to other populations.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"10 ","pages":"25424823261450904"},"PeriodicalIF":2.8,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662357/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198513","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":"The role of thyroid hormones in Alzheimer's disease: Associations with cerebrospinal fluid biomarkers and diagnostic performance.","authors":"Yazhen Huang, Meina Quan, Qianqian Wang, Junhua Liang, Tingting Li, Wei Wang","doi":"10.1177/25424823261448583","DOIUrl":"https://doi.org/10.1177/25424823261448583","url":null,"abstract":"<p><strong>Background: </strong>The relationship between serum thyroid function indicators and cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease (AD) pathology, as well as their diagnostic value in dementia differentiation, remains poorly understood in individuals without overt thyroid dysfunction.</p><p><strong>Objective: </strong>The study aims to evaluate the diagnostic value of thyroid hormones in AD.</p><p><strong>Methods: </strong>225 participants including controls and Alzheimer's disease dementia (ADD), and 322 participants including controls, ADD and other neurodegenerative dementia (NonADD), were selected from cohort 1 and 2, respectively. CSF biomarkers (Aβ₄₂, pTau181, tTau) and thyroid function indicators including free triiodothyronine (FT3), free thyroxine (FT4), total triiodothyronine (TT3), total thyroxine (TT4), and other related parameters, were measured. Statistical analyses assess predictive performance and correlations.</p><p><strong>Results: </strong>In both cohorts, ADD patients exhibited significantly lower levels of FT3, FT4, TT3, and TT4 compared to CN and NonADD groups (<i>p</i> < 0.001). ROC analyses demonstrated moderate diagnostic performance: serum thyroid hormones reached 0.763-0.856. Combined models integrating AD CSF biomarkers, thyroid hormones, and <i>APOE</i> genotype significantly improved classification (AUCs 0.906-0.952). Notably, across all participants, serum thyroid hormone levels correlated positively with Aβ₄₂ (<i>p</i> < 0.01) and negatively with tau pathology (<i>p</i> < 0.05), suggesting a link between thyroid hormone level and AD-related neurodegeneration.</p><p><strong>Conclusions: </strong>Our findings demonstrate that AD patients exhibit distinct reductions in thyroid hormones (FT3/FT4/TT3/TT4) that correlate strongly with hallmark AD CSF biomarkers and the integration of thyroid indicators with CSF biomarkers significantly improves dementia subtype differentiation, supporting their potential as complementary diagnostic tools in clinical practice.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"10 ","pages":"25424823261448583"},"PeriodicalIF":2.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149197713","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":"Spermidine protects mitochondria against amyloid-β oligomers.","authors":"Drake Mosca, Ekaterina Parfenova, Yuan Bie, Anthony Mutsaers, Paul A Spagnuolo","doi":"10.1177/25424823261449500","DOIUrl":"https://doi.org/10.1177/25424823261449500","url":null,"abstract":"<p><strong>Background: </strong>Alzheimer's disease (AD) is a neurodegenerative condition characterized by amyloid-β (Aβ) plaques in the brain. In early pathological conditions, Aβ oligomers localize in mitochondria to promote disease progression by causing mitochondrial dysfunction.</p><p><strong>Objective: </strong>Establish a robust AD pathological <i>in vitro</i> model and assess the therapeutic effect of spermidine (SPD) against extracellular Aβ oligomers.</p><p><strong>Methods: </strong>In this study, high-resolution respirometry, flow cytometry, and immunoblotting techniques were used to characterize the negative effects of Aβ oligomer localization in mitochondria and assess the potential neuroprotective effects of SPD.</p><p><strong>Results: </strong>Oligomeric Aβ accumulates in and causes mitochondrial dysfunction, as evidenced by increased mitochondrial superoxide production, decreased mitochondrial mass, and decreased maximal mitochondrial respiration and spare reserve capacity. SPD, an endogenously produced polyamine that can also be provided through exogenous supplementation, improved these markers and protected mitochondria of oligomer-treated cells.</p><p><strong>Conclusions: </strong>SPD ameliorated mitochondrial dysfunction caused by Aβ oligomers <i>in vitro.</i></p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"10 ","pages":"25424823261449500"},"PeriodicalIF":2.8,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198392","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":"Pre-pilot study: Reactivating brain waste clearance via vasopressin fragment-A novel approach to Alzheimer's disease therapy.","authors":"Junichi Imamura","doi":"10.1177/25424823261449497","DOIUrl":"https://doi.org/10.1177/25424823261449497","url":null,"abstract":"<p><strong>Background: </strong>Impaired clearance of amyloid-β (Aβ) and other metabolic waste products has been implicated in Alzheimer's disease (AD). Arginine vasopressin (AVP) fragments have been associated with memory-related effects and may influence glymphatic-related pathways.</p><p><strong>Objective: </strong>This pre-pilot exploratory study investigated the potential effects of an AVP (4-9) fragment analog on Aβ-related biomarkers and cognitive function.</p><p><strong>Methods: </strong>Seven participants (three healthy adults and four individuals with AD) received intranasal administration of an AVP (4-9) fragment analog for two weeks at a daily dose of 60 ng. Aβ-related burden was assessed using blood-based Composite Biomarker (CB) values reported to correlate with amyloid PET findings. Cognitive function in AD participants was evaluated using the Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog).</p><p><strong>Results: </strong>At baseline, CB values were 5- to 20-fold higher in individuals with AD than in healthy adults. Following treatment, mean CB values in the AD group decreased by 36%, with comparable relative reductions observed across groups. ADAS-Cog scores improved by a mean of 8.1 points over two weeks. No adverse events were observed.</p><p><strong>Conclusions: </strong>AVP (4-9) fragments may influence cognitive processes and glymphatic-related pathways. These findings should be interpreted cautiously given the small sample size and open-label design but may provide a basis for future controlled investigations.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"10 ","pages":"25424823261449497"},"PeriodicalIF":2.8,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662335/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198444","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":"Deep brain stimulation in Alzheimer's disease.","authors":"Zain Majeed, Jad Majeed, Francisco A Ponce, Hannah Mahanti, Boris Decourt, Anna D Burke, Marwan N Sabbagh","doi":"10.1177/25424823261441166","DOIUrl":"https://doi.org/10.1177/25424823261441166","url":null,"abstract":"<p><p>Deep brain stimulation (DBS) is a well-established treatment for neurological disorders, but its efficacy and safety in Alzheimer's disease (AD) remain uncertain. This narrative review synthesizes nine clinical trials in patients with mild to severe AD, focusing on stimulation of the fornix, nucleus basalis of Meynert (NBM), and ventral capsule/ventral striatum. Literature was identified through PubMed using the terms \"deep brain stimulation\" and \"Alzheimer's disease,\" and the results were restricted to clinical trials and case reports in English, with additional references identified through Google Scholar. Across studies, DBS was safe and well tolerated, with few adverse events. Stimulation produced short-term cognitive improvements, most commonly measured by Alzheimer's Disease Assessment Scale cognitive subscale, along with transient reversal of glucose hypometabolism and activation of memory-related networks. One study reported slowed hippocampal atrophy, suggesting neuroplastic effects. In severe AD, DBS targeting both the fornix and NBM yielded transient cognitive gains, with NBM-DBS showing greater benefit for neuropsychiatric symptoms and caregiver burden. Patients with higher baseline cognition and glucose metabolism responded more favorably to DBS. Age-related differences emerged: younger patients (<65 years old), with earlier onset and more aggressive progression, showed less favorable responses to DBS targeting the fornix, whereas older patients (≥65 years old) had comparatively better outcomes. Despite these benefits, DBS does not halt disease progression or reverse AD pathology. Larger, biomarker-stratified, sham-controlled trials with extended follow-up are needed to clarify durability, identify optimal patient subgroups, and determine the most effective stimulation targets.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"10 ","pages":"25424823261441166"},"PeriodicalIF":2.8,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13710408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149290432","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":"Improving biomarkers of inflammation including phosphorylated tau in a patient with chronic Lyme disease/post-treatment Lyme disease syndrome using dapsone combination therapy: A case study and literature review.","authors":"Richard Horowitz","doi":"10.1177/25424823261445434","DOIUrl":"https://doi.org/10.1177/25424823261445434","url":null,"abstract":"<p><strong>Background: </strong><i>Borrelia burgdorferi</i>, the agent of Lyme disease, has been found to co-localize in Alzheimer's disease autopsy brain tissues with biofilm, amyloid, and phosphorylated tau.</p><p><strong>Objective: </strong>To determine whether dapsone combination therapy (DCT), a biofilm/persister antibiotic regimen with good central nervous system penetration can improve p-tau and peripheral inflammatory markers in a patient with chronic Lyme disease (CLD)/post-treatment Lyme disease syndrome (PTLDs).</p><p><strong>Methods: </strong>A 67-year-old female with CLD/PTLDs, and <i>Ehrlichia</i>, <i>Babesia</i>, <i>Bartonella</i>, and <i>Coxiella burnetii</i> had a 15-year history of joint pain with inflammation and mild cognitive impairment despite prior treatment with doxycycline. She was checked for changes in peripheral inflammation, i.e., rheumatoid factors (RFs) and changes in serum p-tau181, p-tau 217, and amyloid-β (Aβ) 42:40 ratios before and after treatment with DCT.</p><p><strong>Results: </strong>Elevated RFs at 20 IU/mL decreased into normal range three months post treatment accompanied by a decrease in pain with improved flexibility. An initially elevated serum p-tau 217 level in the blood at 0.33 pg/mL (normal range <0.15 pg/mL) prior to using DCT normalized, decreasing to 0.12 pg/mL three months post therapy, while p-tau 181 levels remained within normal limits. Aβ ratios simultaneously improved post DCT increasing from 0.185 pg/mL to 0.216 (normal range >0.170) accompanied by subjective improvements in concentration and recall.</p><p><strong>Conclusions: </strong>This is the first case study proving that a short term, biofilm/persister drug regimen, i.e., DCT, can potentially improve peripheral autoantibodies (RFs) and pathological triggers of neuroinflammation (p-tau, Aβ) in a patient with CLD/PTLDs.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"10 ","pages":"25424823261445434"},"PeriodicalIF":2.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198373","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":"Low premorbid IQ effects biomarker-cognition relationships: A pilot study.","authors":"Lubnaa Badriyyah Abdullah, Zhengyang Zhou, Mohammad Housini, James Hall, Sid O'Bryant","doi":"10.1177/25424823261445643","DOIUrl":"10.1177/25424823261445643","url":null,"abstract":"<p><strong>Background: </strong>Previously, we found that plasma levels of phosphorylated tau 181 (p-tau 181), total tau (T-tau), and neurofilament light (NfL) differ significantly based on premorbid intellectual ability (pIQ).</p><p><strong>Objective: </strong>This study examines how these biomarkers are associated with cognitive outcomes across pIQ and racial/ethnic groups.</p><p><strong>Methods: </strong>Participants from the Health & Aging Brain Study-Health Disparities (HABS-HD) were categorized as having low (z ≤ -2.00) or average (z = 0.00 ± 1.00) pIQ using word reading scores. Regression analyses were conducted.</p><p><strong>Results: </strong>Among participants with low pIQ, elevated plasma p-tau 181 was more strongly associated with worse episodic memory. In stratified analyses, NfL, p-tau 181, and t-tau were differentially and inconsistently associated with cognitive outcomes, with varying strength based on pIQ grouping.</p><p><strong>Conclusions: </strong>A one-size-fits-all approach to biomarker-cognition associations interpretation may overlook important individual differences driven by pIQ. These exploratory analyses provide preliminary evidence to support future studies aimed at validating cognitive stratification in biomarker interpretation and interventions for individuals with low pIQ.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"10 ","pages":"25424823261445643"},"PeriodicalIF":2.8,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662347/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186181","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":"Cognitive impairment in patients with chronic unilateral vestibulopathy: A resting-state functional MRI study.","authors":"Minping Li, Junjie Guo, Junyu Wu, Zhezhi Deng, Weiwei Qi, Xintian Li, Zhihui Zheng, Gengxin Lu, Yuemin Qiu, Haiwei Huang, Xue Xu","doi":"10.1177/25424823261445998","DOIUrl":"https://doi.org/10.1177/25424823261445998","url":null,"abstract":"<p><strong>Background: </strong>The association between cognitive impairment and chronic unilateral vestibulopathy (CUVP) remains unclear. Vestibular dysfunction is linked to increased risk of Alzheimer's disease (AD), suggesting that cognitive deficits in CUVP may provide insight into early AD-related processes.</p><p><strong>Objective: </strong>To assess cognition in CUVP patients, and investigate its correlation with brain functional and structural changes.</p><p><strong>Methods: </strong>37 patients with left CUVP (LCUVP), 30 patients with right CUVP (RCUVP), and 38 healthy control (HC) were recruited. Patients underwent vestibular evaluations, neuropsychological scales, functional MRI (fMRI), and structural MRI (sMRI). The fractional amplitude of low frequency fluctuations (fALFF), regional homogeneity (ReHo), functional connectivity (FC) and voxel-based morphometry (VBM) were analyzed.</p><p><strong>Results: </strong>Compared with HC, CUVP patients showed extensive cognitive impairment. The fALFF of right precuneus, the ReHo of right lingual gyrus and precuneus were decreased in CUVP patients, and the FC between right precuneus and bilateral angular gyrus, between right lingual gyrus and middle occipital gyrus were changed (voxel <i>p</i> < 0.001 and cluster <i>p</i> < 0.01, corrected by GRF). Exploratory correlation analyses suggested trends between brain function and cognitive/vestibular measures. Sensitivity analyses controlling for mood symptoms confirmed the robustness of most imaging findings. VBM revealed no significant gray matter differences between CUVP patients and HC.</p><p><strong>Conclusions: </strong>In CUVP patients, abnormal functional activities mainly involved occipital and parietal lobes related to cognitive performance, while brain structure did not change, suggesting that functional brain alterations may be more sensitive than structural changes. These findings suggest potential neural correlates of vestibular-related cognitive decline that may be relevant to early stages of AD.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"10 ","pages":"25424823261445998"},"PeriodicalIF":2.8,"publicationDate":"2026-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662308/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198223","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":"Converting short cognitive screen scores: Comparing the Quick mild cognitive impairment screen, Montreal cognitive assessment, and Mini-mental state examination.","authors":"Rónán O'Caoimh, Eleanor Marks, Mark R O'Donovan","doi":"10.1177/25424823261441514","DOIUrl":"10.1177/25424823261441514","url":null,"abstract":"<p><strong>Background: </strong>The Quick Mild Cognitive Impairment (Q<i>mci</i>) screen is a short cognitive screening instrument developed to detect mild cognitive impairment (MCI). No conversion tables exist between the Q<i>mci</i> screen and commonly-used instruments such as the Mini-Mental State Examination (MMSE) or Montreal Cognitive Assessment (MoCA), limiting comparability across settings and studies.</p><p><strong>Objective: </strong>To create bidirectional conversion tables between the Q<i>mci</i> screen, MMSE, and MoCA in a memory clinic cohort.</p><p><strong>Methods: </strong>A secondary analysis of data from 551 older adults attending a single-center Irish university-hospital memory clinic (2012-2014) was performed. Participants were classified as normal (n = 101), subjective cognitive disorder (n = 73), MCI (n = 103), and dementia (n = 274). Q<i>mci</i> screen, MMSE, and MoCA scores were available for all participants. Equipercentile equating with log-linear smoothing generated score equivalencies and 95% confidence intervals (CI) between instruments.</p><p><strong>Results: </strong>The Q<i>mci</i> screen demonstrated a broader scoring range and greater sensitivity in the mid-range of cognitive performance than either the MMSE or MoCA. Conversion tables revealed a non-linear relationship between instruments, with ceiling effects observed for the MMSE and MoCA. At established cut-offs, an MMSE score of 24/30 equated to a Q<i>mci</i> screen score of 42/100, while a MoCA score of 26/30 corresponded to a Q<i>mci</i> screen score of 71/100 (95% CI: 68-74). Bidirectional tables allow translation of scores across tools.</p><p><strong>Conclusions: </strong>This study provides validated conversion tables between the Q<i>mci</i> screen and two widely-used cognitive instruments, to support the use of the Q<i>mci</i> screen in research (facilitating cross-instrument comparability and harmonization across studies), and clinical settings (determining eligibility for disease-modifying therapies).</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"10 ","pages":"25424823261441514"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662326/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149186796","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":"Macronutrient energy ratios and cognitive health in older adults: A binational study of nonlinear associations and mortality links.","authors":"Jinbiao Li, Xinkai Zhang, Yu Hu, Yamei Tang, Songhua Xiao, Yongteng Xu","doi":"10.1177/25424823261445034","DOIUrl":"https://doi.org/10.1177/25424823261445034","url":null,"abstract":"<p><strong>Background: </strong>The impact of dietary macronutrient composition on cognitive aging and Alzheimer's disease risk remains inadequately characterized.</p><p><strong>Objective: </strong>To investigate the associations of carbohydrate, protein, and fat energy ratios with cognitive function and all-cause mortality among older adults in this binational study.</p><p><strong>Methods: </strong>We analyzed data from the National Health and Nutrition Examination Survey (NHANES, 2011-2014; N = 2510) and the China Health and Nutrition Survey (CHNS, 1997-2006; N = 1600). Cognitive function was assessed using standardized composite z-scores. Associations were evaluated using weighted logistic regression (NHANES) and linear mixed-effects models (CHNS), with restricted cubic splines to examine nonlinearity. Cox models assessed mortality risk in NHANES.</p><p><strong>Results: </strong>A higher carbohydrate ratio (CRC) exhibited a nonlinear inverse U-shaped association with the risk of cognitive impairment, with a significant threshold effect observed at approximately 48.5% of total energy intake. Moderate protein intake (PRC = 0.125-0.153, representing approximately 15% of energy from protein) was associated with the lowest risk of cognitive impairment in both cohorts. The fat ratio (FRC) demonstrated a complex nonlinear association, with cognitive risk increasing significantly when FRC fell below 33.2%. Lower CRC was associated with reduced all-cause mortality in the U.S. cohort (HRs for the lower quartiles: 0.68-0.72).</p><p><strong>Conclusions: </strong>Modifiable macronutrient ratios are significantly associated with cognitive health and survival in older adults, with consistent findings across U.S. and Chinese populations. These results support dietary strategies that emphasize moderate carbohydrate intake (below approximately 48.5% of total energy) and balanced protein consumption (approximately 15% of energy) to promote cognitive health.</p>","PeriodicalId":73594,"journal":{"name":"Journal of Alzheimer's disease reports","volume":"10 ","pages":"25424823261445034"},"PeriodicalIF":2.8,"publicationDate":"2026-04-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13662369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149198453","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}