Alzheimer's & Dementia最新文献

{"title":"Female vulnerability to microvascular transport dysfunction emerges early across the Alzheimer's disease continuum","authors":"Manxi Xu, Yian Gao, Peiling Ou, Haoyu Yang, Jia Wang, Wulong Liu, Ni Shu, Yu Sun, Liping Fu, Lidia Glodzik, Tracy A Butler, Gloria C Chaing, Yi Li, Yi Wang, Liangdong Zhou, Guolin Ma","doi":"10.1002/alz.71811","DOIUrl":"https://doi.org/10.1002/alz.71811","url":null,"abstract":"INTRODUCTION We tested whether quantitative transport mapping (QTM)‐derived perfusion velocity would detect earlier and more sex‐specific microvascular alterations than cerebral blood flow (CBF) across the Alzheimer's disease (AD) continuum. METHODS In 182 participants (cognitively normal = 53, subjective cognitive decline [SCD] = 48, mild cognitive impairment [MCI] = 31, AD = 50), seven‐delay arterial spin labeling was used to derive CBF and QTM velocity. Age/sex‐adjusted models assessed diagnostic and sex effects, associations with plasma biomarkers and Mini‐Mental State Examination (MMSE), and mediation of the hippocampal volume–cognition relationship. RESULTS QTM velocity was reduced already in SCD, including the hippocampus, whereas CBF declined mainly in MCI/AD. Sex × Diagnosis interactions were significant for QTM in gray and white matter, but not for CBF. QTM, especially in females, was inversely associated with plasma NfL/GFAP, related to MMSE, and parietal QTM partially mediated the hippocampal volume–MMSE association. DISCUSSION QTM is a non‐invasive biomarker more sensitive than CBF to early, female‐biased microvascular transport dysfunction in AD.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"159 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A world view: Considerations of sociocultural diversity in the study of subjective cognitive decline in Alzheimer's disease and related dementias.","authors":"Mark A Dubbelman, Tanisha G Hill-Jarrett, Silvia Chapman, Gustavo Alves Andrade Dos Santos, Martina Azar, Ganesh M Babulal, Tyler R Bell, Mark A Bernard, Carolina Boza-Calvo, Anthony Q Briggs, Omonigho Michael Bubu, Heather E Cuevas, N Maritza Dowling, Darlingtina K Esiaka, Bernadette A Fausto, Fabricio Ferreira de Oliveira, Carol E Franz, Joyla A Furlano, Christopher Gonzalez-Corona, M Aaron Guest, Veer Bala Gupta, Vivek K Gupta, Daija Jackson, Jillian L Joyce, Michael R Kann, William S Kremen, Athene Lee, Jairo E Martinez, Arjun V Masurkar, Maia A McLin, Elisa de Paula França Resende, Zahra Rahemi, Brianca C Renfro, Márlon Juliano Romero Aliberti, Shaina Shagalow, Andrea Slachevsky, Juliana N De Souza Talarico, Jean François Trani, Carol Van Hulle, Leah Waltrip, Stephen Ojiambo Wandera, Charles C Windon, Mônica Sanches Yassuda, Davide V Moretti, Elizabeth Kuhn, Elke Butterbrod, Katherine A Gifford, Sietske A M Sikkes, Raphael M Castilhos, Rachel Nosheny, Shana D Stites","doi":"10.1002/alz.71779","DOIUrl":"10.1002/alz.71779","url":null,"abstract":"<p><p>Subjective cognitive decline (SCD) refers to cognitive concerns that may occur with or without objective impairment on standardized testing. Studies suggest that SCD may be an early clinical marker of Alzheimer's disease and related dementias, and that it can predict future objective cognitive decline and progression to dementia. However, the research that supports these conclusions is primarily based on samples with homogeneous socioeconomic and cultural backgrounds. The limited studies in samples with more diverse representations of racial, ethnic, gender, and sexual orientation characteristics show varying SCD prevalence, correlates, and outcomes. Here, we review this literature, focusing on how to apply the findings to advance our understanding of SCD. We further evaluate how our findings inform a roadmap for future research. Overall, we conclude that broader investigations across more diverse populations enhance our understanding of the factors that may differentially contribute to SCD and shape its utility as a clinical metric.</p>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"22 9","pages":"e71779"},"PeriodicalIF":12.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13535858/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148872600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A strategic pathway for the ethical development of AI tools in dementia care.","authors":"Nicole Deaner, Morgan Daven, Aanand D Naik, Marwan Sabbagh, Andrew Breithaupt, Katherine Possin, Susan Alford, Ashley Alexander, Aaron Daniels, Lisa Dezzutti, Viviana F Bumaschny","doi":"10.1002/alz.71805","DOIUrl":"10.1002/alz.71805","url":null,"abstract":"<p><p>Artificial intelligence (AI) is rapidly entering dementia clinical practice, offering opportunities across the care continuum. However, cognitive decline creates a unique ethical challenge. This perspective article proposes a strategy to ensure the responsible development and deployment of AI tools for dementia. An interdisciplinary workgroup of the Alzheimer's Association Innovation Roundtable synthesized ethical frameworks, regulatory standards, and empirical evidence to generate expert consensus. The result is a six-step strategic pathway tailored to dementia care: establish ethical foundations, conduct stakeholder engagement, lead a co-design approach, conduct an impact assessment, establish iterative design and feedback loops, and provide education and digital literacy. A practical implementation checklist accompanies the framework. Because responsible progress requires both safety and timely innovation, ethical evaluation must balance the risks of premature deployment against those of harmful delay. Operationalizing ethics throughout the AI lifecycle can ensure that innovation advances autonomy, equity, and safety for people living with dementia.</p>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"22 9","pages":"e71805"},"PeriodicalIF":12.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529824/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interpreting \"intermittent\" psychological distress in dementia research: A classification that obscures more than it reveals.","authors":"Li-Bing Liang, Kun-Peng Li, Cai-Qin Wu","doi":"10.1002/alz.71801","DOIUrl":"10.1002/alz.71801","url":null,"abstract":"","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"22 9","pages":"e71801"},"PeriodicalIF":12.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13538125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Regional ventricular enlargement as an in vivo biomarker of cumulative biomechanical neurodegeneration in former American football players.","authors":"Brian Szekely, Jared Stearns, Anya S Mirmajlesi, Rebecca D Folkerth, Sylvain Bouix, Daniel H Daneshvar, Charles H Adler, Charles Bernick, Laura J Balcer, Jeffrey L Cummings, Eric M Reiman, Robert A Stern, Martha E Shenton, Richard J Rushmore, Hector Arciniega","doi":"10.1002/alz.71764","DOIUrl":"10.1002/alz.71764","url":null,"abstract":"<p><strong>Introduction: </strong>Repetitive head impacts (RHIs) have been linked to later life neurodegeneration, yet the in vivo structural correlates of cumulative biomechanical loading remain unclear. We examined whether regional ventricular morphology in former American football players reflects exposure burden and traumatic encephalopathy syndrome (TES) classification.</p><p><strong>Methods: </strong>Participants included 170 male former football players and 54 age-matched asymptomatic male controls from the Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy Research Project. Subject-specific manual segmentation quantified lateral ventricle, inferior horn, third ventricle, and fourth ventricle volumes. Group and exposure associations were tested using generalized least squares models.</p><p><strong>Results: </strong>Former players showed larger left inferior lateral ventricle volume than controls, with the largest effects among professional players. Greater cumulative linear and rotational acceleration exposure was associated with enlargement across lateral ventricular and inferior horn regions.</p><p><strong>Discussion: </strong>Regional ventricular enlargement may represent an in vivo marker of cumulative biomechanical loading after RHI exposure.</p>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"22 9","pages":"e71764"},"PeriodicalIF":12.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13529812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148863194","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes reported in interventional studies for mild cognitive impairment: a scoping umbrella review to inform core outcome set development","authors":"Victoria Grace Gabb,Sam Harding,Tomas Lemke,Sophie Alderman,Natalie Woodward,Julie Clayton,Angus McNair,Winsome Barrett‐Muir,Alan Richardson,Jemima Dooley,Sarah Rudd,Elizabeth Coulthard,Nicholas Turner","doi":"10.1002/alz.71800","DOIUrl":"https://doi.org/10.1002/alz.71800","url":null,"abstract":"Abstract There is currently no consensus on the most important treatment outcomes in patients with mild cognitive impairment (MCI). As part of developing a core outcome set for MCI, we conducted a pragmatic scoping umbrella review to summarize outcomes reported in previous studies. Six electronic databases were searched from inception to August 2023. Systematic and scoping reviews in English with ≥70% of studies describing at least one quantitative outcome of interventions involving adults with MCI were eligible. Verbatim outcomes were extracted from eligible papers within selected reviews. From 170 papers covering 153 studies from 42 reviews, 143 unique outcomes were identified. Global cognition was the only outcome reported by more than 50% of studies. Two‐thirds of outcomes were reported by no more than three studies. Heterogeneous outcome reporting limits evidence synthesis and treatment evaluation. A core outcome set for MCI is warranted to standardize outcome reporting and offer stronger evidence for decision‐making.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"35 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148894039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Response to Interpreting \"intermittent\" psychological distress in dementia research: A classification that obscures more than it reveals.","authors":"Jean Stafford, Serhiy Dekhtyar, Tom C Russ, Archana Singh-Manoux, Jane Maddock, Kate Walters, Vasiliki Orgeta, Neil Davies, James B Kirkbride, Marcus Richards, Robert Howard, Praveetha Patalay","doi":"10.1002/alz.71803","DOIUrl":"https://doi.org/10.1002/alz.71803","url":null,"abstract":"","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"22 9","pages":"e71803"},"PeriodicalIF":12.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148878872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neurobiological mechanisms of 40-Hz stimulation in Alzheimer's disease: evidence, heterogeneity, and constraints.","authors":"Lin Qi, Weiye Wang, Reema Abdullah, Yilei Zhao, Zhibin Wang, Yi Tang, Benyan Luo, Guoping Peng","doi":"10.1002/alz.71806","DOIUrl":"10.1002/alz.71806","url":null,"abstract":"<p><p>Early disruption of gamma oscillations is increasingly recognized as a contributor to neurodegeneration and cognitive decline in Alzheimer's disease (AD), positioning 40-Hz stimulation as a promising neuromodulatory strategy. However, its neurophysiological and cognitive effects remain highly variable across studies, underscoring the need for a more integrated mechanistic framework. This review synthesizes current evidence on the neurobiological mechanisms engaged by 40-Hz stimulation in AD, including circuit-, cellular-, and system-level processes underlying network dynamics, glial responses, and multi-target biological effects. We further highlight the conceptual distinction between \"physiological resonance\" and \"artificial superimposition\" as a potential determinant of deep-brain engagement and therapeutic outcomes. By integrating both supportive and conflicting findings, we highlight disease stage, biological sex, and behavioral state as important contributors to the heterogeneity of 40-Hz stimulation outcomes. Building on these observations, we propose that future research should move toward mechanistic stratification and precision neuromodulation to facilitate clinical translation.</p>","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"22 9","pages":"e71806"},"PeriodicalIF":12.8,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13542583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148886037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Brain‐derived plasma p‐tau217 shows enhanced dynamic range for Alzheimer's disease neuropathological change","authors":"Marisa N. Denkinger, Wagner S. Brum, Antoine Leuzy, Alpana Singh, Taina M. Marques, Valentina Ghisays, Hillary Protas, Yi Su, Ali Atri, Thomas G. Beach, Geidy E. Serrano, Kinal Bhatt, Corey M. Carlson, Katharine Hoffmann, Eric M. Reiman, Nicholas J. Ashton","doi":"10.1002/alz.71773","DOIUrl":"https://doi.org/10.1002/alz.71773","url":null,"abstract":"INTRODUCTION Plasma phosphorylated tau (p‐tau), particularly p‐tau217, is a highly specific biomarker of Alzheimer's disease (AD) pathology. However, plasma p‐tau217 can be elevated in rare non‐AD conditions. Brain‐derived (BD) p‐tau217 may reduce these off‐target effects, but its performance against neuropathology has not been evaluated. METHODS We compared p‐tau217, BD p‐tau217, their amyloid beta 42 (Aβ42) ratios, BD p‐tau217/p‐tau217, and BD p‐tau217/BD tau in <jats:italic>end‐of‐life</jats:italic> plasma from 288 neuropathologically characterized participants using a fully automated immunoassay. Biomarkers were assessed against National Institute on Aging–Alzheimer's Association (NIA‐AA) classification, Thal phase, Braak stage, cognitive decline, and tau‐PET (positron emission tomography). RESULTS All markers tracked neuropathological severity, with BD p‐tau217 having larger fold‐changes than p‐tau217 but BD p‐tau217/Aβ42 enhancing this further. BD p‐tau217/BD tau achieved the highest area under the curve (AUC) for distinguishing Intermediate/High from Not/Low AD neuropathological change (ADNC) (0.89 vs 0.82 for p‐tau217). Although BD p‐tau217/p‐tau217 showed smaller fold‐changes, it had the strongest association with continuous tangle burden in AD ( <jats:italic> R <jats:sup>2</jats:sup> = </jats:italic> 0.68) and best predicted Clinical Dementia Rating Sum of Boxes (CDR‐SB decline) ( <jats:italic> R <jats:sup>2</jats:sup> = </jats:italic> 0.26). DISCUSSION BD p‐tau217 and BD‐based ratios enhance dynamic range and prognostic performance while maintaining diagnostic accuracy, supporting further clinical evaluation.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"35 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Building a dementia‐capable workforce: Implementation and evaluation of a state‐mandated dementia training program for memory care staff","authors":"Sara Crance, Gillian Hamilton, Calli Carlson, Kellie Garrett, Tory Roberg","doi":"10.1002/alz.71813","DOIUrl":"https://doi.org/10.1002/alz.71813","url":null,"abstract":"As dementia prevalence rises, developing a dementia‐capable workforce is a national priority. Training requirements vary widely across states, and many memory care staff receive limited dementia education. Although evidence supports dementia training, little is known about translating policy into practice. This paper describes the implementation and evaluation of a statewide mandated dementia training initiative in Arizona. After passage of AZ HB2764 (2024), developed and supported by the Alzheimer's Association Arizona Chapter, an interdisciplinary team at Hospice of the Valley developed a state‐approved program including 6 hours of online modules and a 2‐hour in‐person training. From August to December 2025, 3409 staff across diverse roles completed the program. Knowledge scores improved (79.74%–95.97%), with high satisfaction (4.89/5); 98.53% reported role applicability, and 94.6% reported improved care ability at 3 months. Findings support mandated, statewide dementia training as a feasible policy strategy to strengthen workforce capacity and improve dementia‐capable care.","PeriodicalId":7471,"journal":{"name":"Alzheimer's & Dementia","volume":"18 1","pages":""},"PeriodicalIF":14.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148860862","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}