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Co‐pathology in Alzheimer's disease and Lewy body disease and its association with neuropsychiatric symptoms
Lucy L. Gibson, Lea T. Grinberg, Vítor Ribeiro Paes, Christoph S. Mueller, Renata Elaine Paraízo Leite, Paula Villela Nunes, Alberto Fernando Oliveira Justo, Carlos Alberto Pasqualucci et al.. Alzheimer s & Dementia, 2025-09-01
Topic: Amyloid, tau and blood-test diagnosis
Co-existing neuropathology was frequent, even among individuals without clinical dementia. In cases with ADNC, comorbid neocortical LBD pathology was associated with hallucinations, regardless of cognitive status. However, ADNC co-pathology in LBD was linked to a greater NPS burden in the full cohort but not in individuals without dementia. Lewy bodies are associated with hallucinations independent of cognitive impairment, whereas ADNC co-pathology may contribute to NPS only when widespread and associated with cognitive dysfunction. HIGHLIGHTS: Neuropathological heterogeneity is high even in clinical stages without dementia. Neocortical but not limbic or brainstem LBD co-pathology is associated with hallucinations. LBs are associated with hallucinations independent of cognitive status. ADNC co-pathology is not associated with NPSs in LBD without dementia. LATE co-pathology is associated with increased risk of dementia but not NPS. Vascular co-pathology is associated with increased risk of delusions in ADNC.
Key findings
- Co-existing neuropathology was frequent, even among individuals without clinical dementia.
- In cases with ADNC, comorbid neocortical LBD pathology was associated with hallucinations, regardless of cognitive status.
- However, ADNC co-pathology in LBD was linked to a greater NPS burden in the full cohort but not in individuals without dementia.
- Lewy bodies are associated with hallucinations independent of cognitive impairment, whereas ADNC co-pathology may contribute to NPS only when widespread and associated with cognitive dysfunction.
- HIGHLIGHTS: Neuropathological heterogeneity is high even in clinical stages without dementia.
Why it matters
This study of brain tissue found that co-existing pathologies are common, that neocortical Lewy body co-pathology is associated with hallucinations regardless of cognitive status, and that Alzheimer's disease co-pathology in Lewy body disease was linked to more neuropsychiatric symptoms only in the full cohort. It clarifies how mixed pathologies relate to symptoms but does not test treatment, cure or prevention.
Study details
- Evidence strengthModerate
How this study scored 44/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Alzheimer s & Dementia) |
| Journal's citation record | 2 / 4 | Alzheimer s & Dementia: journal h-index 228 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 9 times (OpenAlex, 2026-10-10) |
| Citations per year | 2 / 5 | 3.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 5.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | 1 / 4 | Cited 9 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Cláudia Kimie Suemoto: h-index 48 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, San Francisco: institution h-index 1,915 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 5 countries |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40951924) |
| Free to read | 2 / 2 | Free to read |
| Total | 44 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Gibson, L. L., Grinberg, L. T., Paes, V. R., Mueller, C. S., Leite, R. E. P., Nunes, P. V., et al. (2025). Co‐pathology in Alzheimer's disease and Lewy body disease and its association with neuropsychiatric symptoms. Alzheimer s & Dementia. https://doi.org/10.1002/alz.70693
Vancouver
Gibson LL, Grinberg LT, Paes VR, Mueller CS, Leite REP, Nunes PV, et al. Co‐pathology in Alzheimer's disease and Lewy body disease and its association with neuropsychiatric symptoms. Alzheimer s & Dementia. 2025. doi:10.1002/alz.70693. PMID: 40951924.
BibTeX
@article{gibson2025-40951924,
author = {Gibson, Lucy L. and Grinberg, Lea T. and Paes, Vítor Ribeiro and Mueller, Christoph S. and Leite, Renata Elaine Paraízo and Nunes, Paula Villela and Justo, Alberto Fernando Oliveira and Pasqualucci, Carlos Alberto and others},
title = {{Co‐pathology in Alzheimer's disease and Lewy body disease and its association with neuropsychiatric symptoms}},
journal = {Alzheimer s \& Dementia},
year = {2025},
doi = {10.1002/alz.70693},
pmid = {40951924},
url = {https://doi.org/10.1002/alz.70693}
}
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