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Its significance in primary age\u2010related tauopathy (PART) is unknown. We investigated the influence of LB on cognition and brain atrophy in AD and PART.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      We performed a retrospective cohort study in a large sample of autopsied participants with AD neuropathological change (ADNC) with and without LB and PART with and without LB, with corresponding\n                      <jats:italic>ante mortem<\/jats:italic>\n                      magnetic resonance imaging (MRI) data from the National Alzheimer's Coordinating Center dataset.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>LB co\u2010pathology worsened cognitive impairment in both PART and ADNC. On longitudinal follow\u2010up, LB impacted cognitive decline in multiple domains. Additionally, LB influenced brain atrophy on MRI across groups and LB regional staging was different in PART and ADNC, accompanying tauopathy progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>These results suggest that LB co\u2010pathology is associated with divergent patterns of cognitive impairment, brain atrophy, and regional pathological distribution in PART and AD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Highlights<\/jats:title>\n                    <jats:p>\n                      <jats:list list-type=\"bullet\">\n                        <jats:list-item>\n                          <jats:p>Lewy body (LB) co\u2010pathology is frequent in Alzheimer's disease (AD) with important clinical implications.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>LB co\u2010pathology is also present in primary age\u2010related tauopathy (PART), but its significance is still understudied.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>In PART and AD, LB leads to higher cognitive impairment and brain regional atrophy.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>In PART and AD, LB tends to accompany neurofibrillary tangle progression, suggesting amyloid pathology might be a trigger for regional pathology progression.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  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