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Divergent patterns of cognitive decline in preclinical Alzheimer's disease: Implications for secondary prevention trials
Runpeng Li, Oliver Langford, Philip S. Insel, Reisa Anne Sperling, Rema Raman, Paul S. S Aisen, Michael Donohue. Alzheimer s & Dementia, 2026-04-01
Topic: Amyloid, tau and blood-test diagnosis
Three trajectory classes were identified: stable, slow decliners, and fast decliners. Higher phosphorylated tau at 217 (p-tau217), smaller hippocampal volume, and elevated tau positron emission tomography were associated with declining classes. About 70% of Aβ+ individuals were stable. Latent class modeling reveals substantial heterogeneity in preclinical trajectories with important implications for prevention trial design.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Li, R., Langford, O., Insel, P. S., Sperling, R. A., Raman, R., Aisen, P. S. S., et al. (2026). Divergent patterns of cognitive decline in preclinical Alzheimer's disease: Implications for secondary prevention trials. Alzheimer s & Dementia. https://doi.org/10.1002/alz.71366
Vancouver
Li R, Langford O, Insel PS, Sperling RA, Raman R, Aisen PSS, et al. Divergent patterns of cognitive decline in preclinical Alzheimer's disease: Implications for secondary prevention trials. Alzheimer s & Dementia. 2026. doi:10.1002/alz.71366. PMID: 42015324.
BibTeX
@article{li2026-42015324,
author = {Li, Runpeng and Langford, Oliver and Insel, Philip S. and Sperling, Reisa Anne and Raman, Rema and Aisen, Paul S. S and Donohue, Michael},
title = {{Divergent patterns of cognitive decline in preclinical Alzheimer's disease: Implications for secondary prevention trials}},
journal = {Alzheimer s \& Dementia},
year = {2026},
doi = {10.1002/alz.71366},
pmid = {42015324},
url = {https://doi.org/10.1002/alz.71366}
}
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 names 7 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
Key findings
- Three trajectory classes were identified: stable, slow decliners, and fast decliners.
- Higher phosphorylated tau at 217 (p-tau217), smaller hippocampal volume, and elevated tau positron emission tomography were associated with declining classes.
- About 70% of Aβ+ individuals were stable.
- Latent class modeling reveals substantial heterogeneity in preclinical trajectories with important implications for prevention trial design.
Why it matters
This longitudinal study identified three cognitive trajectory classes in preclinical Alzheimer's disease: stable, slow decliners, and fast decliners, with about 70% of amyloid-positive individuals remaining stable. Higher p-tau217, smaller hippocampal volume, and elevated tau PET were associated with the declining classes, which the authors say has important implications for prevention trial design.
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Study details
- Study designlongitudinal study
- Evidence strengthModerate
How this study scored 50/100
Published in a peer-reviewed journal, and it is a longitudinal study following the same people over time. Scored zero for sample size, effect reported, studied in people and randomized / 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 | 7 / 12 | A longitudinal study following the same people over time |
| 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 | 5 / 5 | 2026 — within 1 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) |
| Randomized / blinded | 0 / 2 | No randomization or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 1 / 7 | Cited 1 times (OpenAlex, 2026-10-10) |
| Citations per year | 0 / 5 | 0.5 citations a year over 2 year(s) since 2026 |
| Impact for its field and year | 3 / 6 | Cited 4.7× 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 | 0 / 4 | Cited 1 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 3 / 4 | Last-listed author Michael Donohue: h-index 87 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | Harvard University: institution h-index 3,235 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 5 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 42015324) |
| Free to read | 2 / 2 | Free to read |
| Total | 50 / 100 | — |
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Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
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