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AD blood biomarker phosphorylated tau217 was elevated in 55% of the cohort, significantly associated with decreased MoCA scores (<jats:italic>\u03b2<\/jats:italic>\u00a0=\u00a0\u22121.46, 95% confidence interval [CI] \u22122.53 to \u22120.39, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01), and accurately differentiated cognitive impairment (area under the curve 0.94, 95% CI 0.88\u20130.99).<\/jats:p><\/jats:sec><jats:sec><jats:title>DISCUSSION<\/jats:title><jats:p>This level of undiagnosed cognitive impairment and AD pathology exceeds what would be expected in the general population and highlights a potential need for screening and future work to better identify treatment options.<\/jats:p><\/jats:sec><jats:sec><jats:title>Highlights<\/jats:title><jats:p><jats:list list-type=\"bullet\">\n<jats:list-item><jats:p>Brain health outcomes are rarely evaluated in vascular patients.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>One hundred sixty\u2010two adults with asymptomatic cardiovascular disease but without diagnoses of cognitive impairment or dementia were evaluated.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>Phosphorylated tau217 accurately differentiated cognitive impairment in patients with cardiovascular disease.<\/jats:p><\/jats:list-item>\n<jats:list-item><jats:p>High levels of cognitive impairment and Alzheimer's disease pathology are greatly underdiagnosed in the cardiovascular population.<\/jats:p><\/jats:list-item>\n<\/jats:list><\/jats:p><\/jats:sec>","DOI":"10.1002\/alz.70565","type":"journal-article","created":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T09:57:04Z","timestamp":1754560624000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["Cognitive impairment and p\u2010tau217 are high in a vascular patient cohort"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0009-0004-1747-949X","authenticated-orcid":false,"given":"Scott 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