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Despite growing research on seizure detection and treatment in AD, the cognitive profiles of individuals with both AD and seizures remain poorly characterized using comprehensive neuropsychological methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Clinical and cognitive data from individuals age 65+ with AD were analyzed from the National Alzheimer's Coordinating Center (NACC) dataset. Cognitive domains assessed included memory, language, attention, processing speed, and executive function. Raw scores were converted into z\u2010scores using a control sample (n\u2009=\u200914,665). Group comparisons were conducted using independent <jats:italic>t<\/jats:italic> tests, \u03c7<jats:sup>2<\/jats:sup> tests, and Kruskal\u2010Wallis tests, and logistic regression was used to examine factors associated with seizures.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 9,662 individuals with AD, 1.2% (n\u2009=\u2009117) had active seizures (AD\u2010S). The AD\u2010S group was younger, had higher stroke and transient ischemic attack rates, earlier cognitive decline, longer symptom duration, cognitive fluctuations, abrupt cognitive changes, and worse cognitive and functional outcomes. Cognitive deficits in AD\u2010S, particularly in executive function and processing speed, persisted after adjusting for dementia severity. Compared to vascular dementia, AD\u2010S individuals exhibited greater impairments in fluency, naming, and processing speed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Comorbid AD and seizures are associated with distinct cognitive and clinical profiles, greater vascular disease burden, and more severe dementia. Findings emphasize the need for early seizure detection, comprehensive cognitive evaluations, and research on cerebrovascular contributions to inform targeted interventions. 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