{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T06:46:43Z","timestamp":1776322003143,"version":"3.50.1"},"reference-count":15,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,11,16]],"date-time":"2025-11-16T00:00:00Z","timestamp":1763251200000},"content-version":"vor","delay-in-days":46,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100000957","name":"Alzheimer's Association","doi-asserted-by":"publisher","award":["AARFD\u2010231151386"],"award-info":[{"award-number":["AARFD\u2010231151386"]}],"id":[{"id":"10.13039\/100000957","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alz &amp; Dem Diag Ass &amp; Dis Mo"],"published-print":{"date-parts":[[2025,10]]},"abstract":"Abstract<\/jats:title>\n \n INTRODUCTION<\/jats:title>\n We compared the accuracy of pattern\u2010recognition protocols to prospectively identify Alzheimer's disease and related dementias (ADRD) and differentiate these from normal aging or stroke.<\/jats:p>\n <\/jats:sec>\n \n METHODS<\/jats:title>\n Patterns of cognitive decline in cognitively unimpaired participants who completed \u2265 5 assessments for the Health and Retirement Study were examined to identify dementia\/stroke and compared to both recorded clinical and objective diagnoses of amnestic cognitive impairment (aCI) and dementia. We report prevalence and sensitivity\/specificity to detect new\u2010onset ADRD and stroke.<\/jats:p>\n <\/jats:sec>\n \n RESULTS<\/jats:title>\n ADRD\u2010related accelerated cognitive decline was identified in 372 (14.6%) participants, while stepwise decline consistent with stroke was identified in 917 (36.1%) participants. Accelerated decline was found preceding 75.8%\/76.7% cases of aCI and objective dementia, respectively. Sensitivity for accelerated decline to detect aCI\/objective dementia was excellent (96.2%\/91.9%). Stepwise decline preceded diagnosis with executive cognitive impairment (eCI)\/clinical stroke in 40.0%\/43.3% of participants, and sensitivity was moderate for eCI\/clinical stroke (45.3%\/58.8%).<\/jats:p>\n <\/jats:sec>\n \n DISCUSSION<\/jats:title>\n Longitudinal patterns of cognitive decline can help differentially diagnose ADRD from stroke in longitudinal studies of cognitive decline.<\/jats:p>\n <\/jats:sec>\n \n Highlights<\/jats:title>\n \n \n \n Pattern recognition identified 95.3% of all cases of dementia in this study.<\/jats:p>\n <\/jats:list-item>\n \n Sensitivity of accelerated cognitive decline to detect incident dementia was 94.3%.<\/jats:p>\n <\/jats:list-item>\n \n Differential diagnosis for dementia might begin to rely on longitudinal cognition.<\/jats:p>\n <\/jats:list-item>\n \n Pattern recognition worked in cases of clinically and algorithmically diagnosed dementia.<\/jats:p>\n <\/jats:list-item>\n <\/jats:list>\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/dad2.70211","type":"journal-article","created":{"date-parts":[[2025,11,17]],"date-time":"2025-11-17T03:27:12Z","timestamp":1763350032000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Accuracy of pattern\u2010based dementia diagnostic protocols: Using longitudinal data to infer etiology of Alzheimer's disease and related dementias compared to stroke or normal aging"],"prefix":"10.1002","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6124-0329","authenticated-orcid":false,"given":"Sean A. P.","family":"Clouston","sequence":"first","affiliation":[{"name":"Program in Public Health and Department of Family Population, and Preventive Medicine Health Sciences Center Renaissance School of Medicine at Stony Brook University Stony Brook New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2186-5540","authenticated-orcid":false,"given":"Douglas William","family":"Hanes","sequence":"additional","affiliation":[{"name":"Program in Public Health and Department of Family Population, and Preventive Medicine Health Sciences Center Renaissance School of Medicine at Stony Brook University Stony Brook New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5802-1600","authenticated-orcid":false,"given":"Mahdieh Danesh","family":"Yazdi","sequence":"additional","affiliation":[{"name":"Program in Public Health and Department of Family Population, and Preventive Medicine Health Sciences Center Renaissance School of Medicine at Stony Brook University Stony Brook New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,11,16]]},"reference":[{"key":"e_1_2_9_2_1","article-title":"Leading Causes of Death. Centers for Disease Control and Prevention","author":"Centers for Disease Control and Prevention","year":"2022","journal-title":"FastStats"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2011.03.005"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/(sici)1097\u20100258(20000615\/30)19:11\/12<1555::aid\u2010sim445>3.0.co;2\u20103"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.37133"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1159\/000510133"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.dadm.2015.06.001"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1159\/000503002"},{"key":"e_1_2_9_9_1","unstructured":"Health and Retirement Study (HRS).Data from: Health and Retirement Study Public use dataset. Produced and Distributed by the University of Michigan with funding from the National Institute on Aging; Ann Arbor MI 2025."},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/0001-6918(67)90011-X"},{"issue":"2","key":"e_1_2_9_11_1","first-page":"111","article-title":"The telephone interview for cognitive status","volume":"1","author":"Brandt J","year":"1988","journal-title":"Cogn Behav Neurol"},{"key":"e_1_2_9_12_1","doi-asserted-by":"crossref","unstructured":"OfstedalMB FisherGG HerzogAR.Documentation of cognitive functioning measures in the Health and Retirement Study. University of Michigan;2005.","DOI":"10.7826\/ISR-UM.06.585031.001.05.0010.2005"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2011.03.008"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.63.5.665"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-018-4377-y"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.14053"}],"container-title":["Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dad2.70211","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,29]],"date-time":"2025-12-29T13:12:56Z","timestamp":1767013976000},"score":1,"resource":{"primary":{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/10.1002\/dad2.70211"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,10]]},"references-count":15,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1002\/dad2.70211"],"URL":"https:\/\/doi.org\/10.1002\/dad2.70211","archive":["Portico"],"relation":{},"ISSN":["2352-8729","2352-8729"],"issn-type":[{"value":"2352-8729","type":"print"},{"value":"2352-8729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,10]]},"assertion":[{"value":"2025-03-10","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-10-05","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70211"}}