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We labeled individuals along the AD continuum with suspected concomitant LATE using the lower quartile hippocampal volume (HV) cut\u2010off and examined associated atrophy and cognitive profiles.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We studied cognitively impaired (CI) Alzheimer's Disease Neuroimaging Initiative (ADNI) participants with T1\u2010magnetic resonance imaging (MRI) and amyloid\u2010 and tau\u2010positron emission tomography (PET). Participants were classified into suspected (s) AD+sLATE\u2212, AD\u2212sLATE+, or AD+sLATE+ based on amyloid status and HV quartiles. Medial temporal lobe (MTL) and whole\u2010brain atrophy patterns and cognitive profiles were compared cross\u2010sectionally and longitudinally. Classification was validated in an autopsy cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>AD+sLATE+ showed greater anterior hippocampal (AH) and amygdala atrophy than AD+sLATE\u2212. AD\u2212sLATE+ and AD+sLATE+ showed greater anterior MTL atrophy and worse memory and language performance. AD+sLATE+ also exhibited faster cognitive decline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>A simple HV quartile cut\u2010off may help identify mixed AD\/LATE pathology and support clinical trial enrichment.<\/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>Quartiles of HVs stratify CI individuals.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>Approach distinguishes suspected AD+sLATE\u2013, AD\u2013sLATE+, and AD+sLATE+ subgroups.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>The method is simple, scalable, and requires no complex modeling or biomarker panels.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>It enables practical identification of mixed pathology in clinical settings.<\/jats:p>\n                        <\/jats:list-item>\n                        <jats:list-item>\n                          <jats:p>It supports trial enrichment by excluding or targeting mixed pathology cases.<\/jats:p>\n                        <\/jats:list-item>\n                      <\/jats:list>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.70970","type":"journal-article","created":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T10:35:53Z","timestamp":1765622153000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Enrichment of patients with concomitant limbic\u2010predominant age\u2010related TDP\u201043 encephalopathy (LATE) on the Alzheimer's disease continuum using hippocampal volume"],"prefix":"10.1002","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3108-6751","authenticated-orcid":false,"given":"Nidhi S.","family":"Mundada","sequence":"first","affiliation":[{"name":"Department of Bioengineering University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xueying","family":"Lyu","sequence":"additional","affiliation":[{"name":"Department of Bioengineering University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher A.","family":"Brown","sequence":"additional","affiliation":[{"name":"Department of Neurology Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania 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Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Gee","sequence":"additional","affiliation":[{"name":"Department of Radiology Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paul A.","family":"Yushkevich","sequence":"additional","affiliation":[{"name":"Department of Radiology Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandhitsu R.","family":"Das","sequence":"additional","affiliation":[{"name":"Department of Neurology Perelman School of Medicine at the University of Pennsylvania  Philadelphia Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David A.","family":"Wolk","sequence":"additional","affiliation":[{"name":"Department of Neurology Perelman School of Medicine at the 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