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The yes-no reversal phenomenon: Prevalence and correlates in mild cognitive impairment and dementia due to neurodegenerative, chronic cerebrovascular, and mixed etiologies
Edoardo Nicolò Aiello, Giulia De Luca, Arianna Moreschi, Beatrice Curti, Francesco Cazzini, Andrea Cerri, Selene Saba, Valerio Patisso et al.. Journal of Alzheimer s Disease, 2026-02-09
Topic: Risk, prevention and care in population studies
BackgroundThe yes-no reversal (YNR) phenomenon consists in a patient saying "yes" when meaning "no", or vice-versa.ObjectiveTo investigate the prevalence of the YNR phenomenon in mild cognitive impairment (MCI) and dementia across different neurodegenerative, chronic cerebrovascular, or mixed etiologies, and to explore its demographic and clinical correlates.MethodsInformants of N = 267 patients with MCI or dementia due to possible/probable Alzheimer's disease (AD; N = 164), frontotemporal lobar degeneration (N = 25), Lewy body disease (N = 18), mixed-i.e., AD and chronic cerebrovascular-etiologies (N = 37), Aβ-negative degenerative etiologies (N = 6), and chronic cerebrovascular disease (N = 17) were inquired on the occurrence of YNRs in everyday-life conversations. YNR+ and YNR- patients were compared on demographics (i.e., age, sex, education), disease duration (in months), disease severity (i.e., MCI versus dementia), etiology and total and subscale-/item-level Mini-Mental State Examination (MMSE) scores. A multiple logistic model was also run on the presence/absence of YNRs by addressing, as predictors, variables that yielded significance at an univariable level.ResultsThe YNR phenomenon was recorded in 23 patients (8.61%), all of them being demented (i.e., no MCI patient showed YNRs). YNR+ patients were younger and scored lower on Immediate recall and Language subscores of the MMSE. The prevalence of YNRs was higher in non-AD- (∼18%) versus AD-related (∼5%) etiologies. The effects of disease severity and etiology were confirmed by the multiple logistic model, while the others were not.ConclusionsThe YNR phenomenon is a clinical sign possibly associated with dementia due to non-AD etiologies.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Aiello, E. N., De Luca, G., Moreschi, A., Curti, B., Cazzini, F., Cerri, A., et al. (2026). The yes-no reversal phenomenon: Prevalence and correlates in mild cognitive impairment and dementia due to neurodegenerative, chronic cerebrovascular, and mixed etiologies. Journal of Alzheimer s Disease. https://doi.org/10.1177/13872877261418686
Vancouver
Aiello EN, De Luca G, Moreschi A, Curti B, Cazzini F, Cerri A, et al. The yes-no reversal phenomenon: Prevalence and correlates in mild cognitive impairment and dementia due to neurodegenerative, chronic cerebrovascular, and mixed etiologies. Journal of Alzheimer s Disease. 2026. doi:10.1177/13872877261418686. PMID: 41660964.
BibTeX
@article{aiello2026-41660964,
author = {Aiello, Edoardo Nicolò and De Luca, Giulia and Moreschi, Arianna and Curti, Beatrice and Cazzini, Francesco and Cerri, Andrea and Saba, Selene and Patisso, Valerio and others},
title = {{The yes-no reversal phenomenon: Prevalence and correlates in mild cognitive impairment and dementia due to neurodegenerative, chronic cerebrovascular, and mixed etiologies}},
journal = {Journal of Alzheimer s Disease},
year = {2026},
doi = {10.1177/13872877261418686},
pmid = {41660964},
url = {https://doi.org/10.1177/13872877261418686}
}
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Key findings
- YNR+ and YNR- patients were compared on demographics (i.e., age, sex, education), disease duration (in months), disease severity (i.e., MCI versus dementia), etiology and total and subscale-/item-level Mini-Mental State Examination (MMSE) scores.
- The prevalence of YNRs was higher in non-AD- (∼18%) versus AD-related (∼5%) etiologies.
- The effects of disease severity and etiology were confirmed by the multiple logistic model, while the others were not.ConclusionsThe YNR phenomenon is a clinical sign possibly associated with dementia due to non-AD etiologies.
Why it matters
This study found that the yes-no reversal phenomenon occurred in about 8.6% of patients, all of whom had dementia rather than mild cognitive impairment, and was more common in non-Alzheimer's etiologies. It describes a clinical sign and does not test any treatment.
Study details
- Participants267
- Effect size8.61%
- Evidence strengthLow
How this study scored 44/100
Published in a peer-reviewed journal. Scored zero for study design and randomized / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Journal of Alzheimer s Disease) |
| Journal's citation record | 2 / 4 | Journal of Alzheimer s Disease: journal h-index 218 (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 | 1 / 5 | Rated “low” 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 | 2 / 4 | 267 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) |
| 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 | 1 / 6 | Cited by 1 other studies in this library |
| 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 Federico Verde: h-index 26 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | University of Padua: institution h-index 1,158 (OpenAlex) |
| Multicenter collaboration | 2 / 3 | OpenAlex lists 4 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 41660964) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 44 / 100 | — |
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