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Ridge\u2010penalized logistic regressions assessed associations between comorbidities and dementia. Tetrachoric correlations and hierarchical clustering informed mixed\u2010effects analyses of longitudinal trajectories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Fazekas score \u2265 2 (odds ratio [OR] 2.48, 95% confidence interval [CI] 1.64\u20134.54), stroke (OR 2.15, 95% CI 1.23\u20133.23), alcohol abuse (OR 2.13, 95% CI 1.22\u20104.92), hearing loss (OR 1.99, 95% CI 1.06\u20133.94), visual loss (OR 1.94, 95% CI 1.04\u20134.01), and low education (OR 1.21, 95% CI 1.09\u20131.54) were associated with dementia cross\u2010sectionally. Comorbidities formed four clusters: cerebrovascular, cardiometabolic, neurosensory, substance abuse. Higher cerebrovascular burden predicted a 158% faster rate of cognitive decline in individuals with dementia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Our findings show four dementia comorbidity clusters and identify cerebrovascular burden as a prognostic marker of faster cognitive decline.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alz.71341","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T02:54:35Z","timestamp":1775184875000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Cross\u2010sectional and longitudinal cognitive trajectories associated with dementia comorbidity clusters: Results from a 10\u2010year follow\u2010up real\u2010world outpatient memory clinic in Brazil"],"prefix":"10.1002","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-3212-3932","authenticated-orcid":false,"given":"Fernando Jacob","family":"Lazzaretti","sequence":"first","affiliation":[{"name":"School of Medicine Pontifical Catholic University of Rio Grande do Sul  Porto Alegre RS Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenza Pabst","family":"Botton","sequence":"additional","affiliation":[{"name":"School of Medicine Pontifical Catholic University of Rio Grande do Sul  Porto Alegre RS Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Gustavo","family":"Lokschin","sequence":"additional","affiliation":[{"name":"School of Medicine Pontifical Catholic University of Rio Grande do Sul  Porto Alegre RS Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andressa","family":"de Oliveira Fel\u00edcio","sequence":"additional","affiliation":[{"name":"School of Medicine Pontifical Catholic University of Rio Grande do Sul  Porto Alegre RS Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julia","family":"Patatt","sequence":"additional","affiliation":[{"name":"School of Medicine Pontifical Catholic University of Rio Grande do Sul  Porto Alegre RS Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaderson Costa","family":"da Costa","sequence":"additional","affiliation":[{"name":"School of Medicine Pontifical Catholic University of Rio Grande do Sul  Porto Alegre RS Brazil"},{"name":"Brain Institute of Rio Grande do Sul  Porto Alegre RS Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristiano S.","family":"Aguzzoli","sequence":"additional","affiliation":[{"name":"Brain Institute of Rio Grande do Sul  Porto Alegre RS Brazil"},{"name":"Neurology Department S\u00e3o Lucas Hospital of PUCRS  Porto Alegre RS Brazil"},{"name":"Global Brain Health Institute Memory and Aging Center University of California  San Francisco USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucas Porcello","family":"Schilling","sequence":"additional","affiliation":[{"name":"School of Medicine Pontifical Catholic University of Rio Grande do Sul  Porto Alegre RS Brazil"},{"name":"Brain Institute of Rio Grande do Sul  Porto Alegre RS Brazil"},{"name":"Neurology Department S\u00e3o Lucas Hospital of PUCRS  Porto Alegre RS Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,2]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(21)00249-8"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjgh-2021-007409"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2019.04.015"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.12157"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12974-018-1313-3"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2018.1123"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.3389\/fnagi.2021.631770"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2021.2943"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2214-109X(24)00275-4"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(24)01296-0"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.lana.2025.101209"},{"key":"e_1_2_8_13_1","doi-asserted-by":"publisher","DOI":"10.3233\/JAD-240650"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-024-56023-3"},{"key":"e_1_2_8_15_1","unstructured":"World Health Organization. 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