{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,20]],"date-time":"2026-08-20T15:02:47Z","timestamp":1787238167928,"version":"build-2736575974"},"reference-count":50,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T00:00:00Z","timestamp":1750032000000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alzheimer's &amp;amp; Dementia"],"published-print":{"date-parts":[[2025,6]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>Knowing the relationship between initial clinical symptoms and rate of clinical decline by race is important in dementia care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>\n                      A retrospective longitudinal cohort study of 2887 participants with autopsy confirmed AD pathology (ADP), and mixed ADP with Lewy body pathology (AD\u2010LBP) in the National Alzheimer's Coordinating Center database. Two\u2010sample\n                      <jats:italic>t<\/jats:italic>\n                      \u2010tests and Fisher's exact tests were used to evaluate outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      African American participants (AAs) were less likely to have initial non\u2010amnestic symptoms than White participants (6.5%\u00a0vs 23%\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001). AAs showed a faster rate of clinical decline on the Clinical Dementia Rating\u2010Sum of Boxes than Whites in the amnestic group (0.30 points per year, 95% confidence interval [CI]: 0.04 to 0.55;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.023). When accounting for biological and social\u2010medical factors, the difference between the races were not significant (0.16, 95% CI: \u20130.10 to 0.42;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0=\u00a00.22).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Larger diverse cohorts are necessary to robustly evaluate interaction between race and clinical factors in determining dementia outcomes.<\/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>African American participants were less likely to have initial non\u2010amnestic symptoms than White participants with Alzheimer's disease and mixed Alzheimer's and Lewy body neuropathology.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>African American participants with initial amnestic symptoms in the National Alzheimer's Coordinating Center cohort also experienced a faster rate of cognitive and functional decline.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Interaction between race, clinical symptoms, and neuropathology in diverse populations is an important consideration in clinical trial design.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70360","type":"journal-article","created":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T09:38:58Z","timestamp":1750066738000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Non\u2010amnestic initial symptoms may be less prevalent in African American than White participants with Alzheimer's and mixed Lewy body and Alzheimer's pathology"],"prefix":"10.1002","volume":"21","author":[{"given":"Quintasha","family":"Beamon","sequence":"first","affiliation":[{"name":"Lou Ruvo Center for Brain Health Cleveland Clinic  Cleveland Ohio USA"},{"name":"Neurological Institute Cleveland Clinic  Cleveland Ohio USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Audrey","family":"Zhu","sequence":"additional","affiliation":[{"name":"Lou Ruvo Center for Brain Health Cleveland Clinic  Cleveland Ohio USA"},{"name":"Neurological Institute Cleveland Clinic  Cleveland Ohio 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