Early Behavioral and Cognitive Changes in Patients With Pathologically Confirmed Alzheimer Disease, Lewy Body Dementia, and Mixed Dementia
Ming Wang, Hongke Wu, Aaron Bonner‐Jackson, Yiming Chen, Wen Tang, Hao Feng, Lijun Zhang, Chixiang Chen et al.. Neurology Open Access, 2026-01-30
Topic: Amyloid, tau and blood-test diagnosis
The study included 1,028 participants (mean age at baseline 76.4 years; 47.6% female): 521 with ADP, 96 with LBP, and 411 with mixed AD-LBP. A three-cluster clinical subtype (CS) solution best fit the data. The most symptomatic group (CS-3) had the youngest age at first visit (mean 72.1 years), the highest BPSD burden, and the fastest cognitive and functional decline across ADP and AD-LBP groups. CS-1 and CS-2 exhibited milder early cognitive impairment and lower BPSD burden. Within ADP and AD-LBP, CS-2 showed slower progression than CS-1, fewer APOE ε4 carriers (41% vs. 58%), and better memory scores, despite reporting a higher frequency of agitation. These findings reveal distinct clinical subtypes that cut across traditional pathological boundaries, emphasizing the need to incorporate both cognitive and behavioral features into early dementia characterization. This multidimensional approach can improve guide personalized prognosis and care planning and enhance clinical trial design by considering disease heterogeneity. The study supports integrated clinical profiling as important factor in robust evaluation of dementia outcomes.
Key findings
- The study included 1,028 participants (mean age at baseline 76.4 years; 47.6% female): 521 with ADP, 96 with LBP, and 411 with mixed AD-LBP.
- A three-cluster clinical subtype (CS) solution best fit the data.
- The most symptomatic group (CS-3) had the youngest age at first visit (mean 72.1 years), the highest BPSD burden, and the fastest cognitive and functional decline across ADP and AD-LBP groups.
- CS-1 and CS-2 exhibited milder early cognitive impairment and lower BPSD burden.
- Within ADP and AD-LBP, CS-2 showed slower progression than CS-1, fewer APOE ε4 carriers (41% vs. 58%), and better memory scores, despite reporting a higher frequency of agitation.
Why it matters
This study found distinct clinical subtypes of dementia that cut across traditional pathological boundaries, based on cognitive and behavioral features. It suggests that incorporating both cognitive and behavioral features into early dementia characterization can improve personalized prognosis and care planning and enhance clinical trial design.
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Study details
- Study designcohort study
- Participants1,028
- Effect size47.6%
- Evidence strengthModerate
How this study scored 55/100
Published in a peer-reviewed journal, and it is a cohort study following people over time. Scored zero for randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Neurology Open Access) |
| Journal's citation record | 0 / 4 | Neurology Open Access: journal h-index 5 (OpenAlex, 2026-10-29) |
| Study design | 7 / 12 | A cohort study following 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 | 3 / 4 | 1,028 participants |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation 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 | 2 / 4 | Last-listed author Jagan A. Pillai: h-index 22 (OpenAlex, whole career) |
| Institution's track record | 3 / 3 | University of Washington: institution h-index 3,540 (OpenAlex) |
| Multi-centre collaboration | 2 / 3 | OpenAlex lists 6 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41809433) |
| Free to read | 2 / 2 | Free to read |
| Total | 55 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
- DOI: 10.1212/wn9.0000000000000055
- PubMed: 41809433
- Original source →
- Free full text: Neurology Open Access →
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
Wang, M., Wu, H., Bonner‐Jackson, A., Chen, Y., Tang, W., Feng, H., et al. (2026). Early Behavioral and Cognitive Changes in Patients With Pathologically Confirmed Alzheimer Disease, Lewy Body Dementia, and Mixed Dementia. Neurology Open Access. https://doi.org/10.1212/wn9.0000000000000055
Vancouver
Wang M, Wu H, Bonner‐Jackson A, Chen Y, Tang W, Feng H, et al. Early Behavioral and Cognitive Changes in Patients With Pathologically Confirmed Alzheimer Disease, Lewy Body Dementia, and Mixed Dementia. Neurology Open Access. 2026. doi:10.1212/wn9.0000000000000055. PMID: 41809433.
BibTeX
@article{wang2026-41809433,
author = {Wang, Ming and Wu, Hongke and Bonner‐Jackson, Aaron and Chen, Yiming and Tang, Wen and Feng, Hao and Zhang, Lijun and Chen, Chixiang and others},
title = {{Early Behavioral and Cognitive Changes in Patients With Pathologically Confirmed Alzheimer Disease, Lewy Body Dementia, and Mixed Dementia}},
journal = {Neurology Open Access},
year = {2026},
doi = {10.1212/wn9.0000000000000055},
pmid = {41809433},
url = {https://doi.org/10.1212/wn9.0000000000000055}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here. Showing 12 of 15.