{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T17:51:07Z","timestamp":1791395467587,"version":"4.3.3"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T00:00:00Z","timestamp":1785974400000},"content-version":"vor","delay-in-days":36,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["alz-journals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Alz &amp;amp; Dem Diag Ass &amp;amp; Dis Mo"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>INTRODUCTION<\/jats:title>\n                    <jats:p>Multimorbidity \u2013 the coexistence of multiple chronic conditions \u2013 is common among older adults with cognitive impairment but is rarely addressed in an integrated manner.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>We analyzed 17,915 adults aged 55 to 84 years (8997 receiving uMETHOD clinical decision\u2010support care plans and 8918 from the National Health and Nutrition Examination Survey). The mean age was 69.0 years (SD 7.65; 95% CI: 68.86 to 69.1). Multimorbidity was quantified from diagnoses, labs, medications, vitals, and platform\u2010inferred conditions. Associations with cognitive impairment were modeled using age\u2010 and sex\u2010adjusted logistic regression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>\n                      Cognitive impairment was reported in 25.91% of participants (97.5% with \u22652 conditions); each additional condition was associated with higher odds (odds ratio: 1.069; 95% CI: 1.061 to 1.077;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.0001). Prominent clusters included vascular\u2010metabolic disorders and micronutrient deficiencies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>DISCUSSION<\/jats:title>\n                    <jats:p>Cognitive vulnerability rises stepwise with disease burden. Precision, multimorbidity\u2010aware decision support that integrates multidomain data can align cognitive and systemic care in real\u2010world practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/dad2.70395","type":"journal-article","created":{"date-parts":[[2026,8,6]],"date-time":"2026-08-06T09:22:55Z","timestamp":1786008175000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Management of multimorbidity in the midst of cognitive decline through clinical decision\u2010support software"],"prefix":"10.1002","volume":"18","author":[{"given":"Mark C.","family":"Zelek","sequence":"first","affiliation":[{"name":"uMETHOD Health  Raleigh North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"II","given":"John Q.","family":"Walker","sequence":"additional","affiliation":[{"name":"uMETHOD Health  Raleigh North Carolina USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marwan N.","family":"Sabbagh","sequence":"additional","affiliation":[{"name":"Barrow Neurological Institute  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,6]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.2174\/1874609811666181019101430"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(15)60461\u20105"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2018.08.004"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(17)31363\u20106"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(20)30367\u20106"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140\u20106736(24)01296\u20100"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2025.12923"},{"key":"e_1_2_11_9_1","unstructured":"National Center for Health Statistics (NCHS) Centers for Disease Control and Prevention (CDC). National Health and Nutrition Examination Survey (NHANES).NCHS; [cited 2025 Sep 4]. Available from:https:\/\/wwwn.cdc.gov\/nchs\/nhanes\/Default.aspx"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6727a1"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaneurol.2022.3543"},{"key":"e_1_2_11_12_1","unstructured":"ICD List \u2013 Trusted 2025 ICD\u201010\u2010CM & PCS code lookup.ICD List;2025[cited 2025 Sep 7]. Available from:https:\/\/icdlist.com\/"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tjpad.2025.100164"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.archger.2025.105760"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12916\u2010024\u201003642\u20102"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.32124"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s10157\u2010024\u201002494\u20107"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.brainres.2025.149814"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.3892\/mmr.2024.13219"},{"key":"e_1_2_11_20_1","volume-title":"Integrated care for older people (ICOPE): guidance for person\u2010centred assessment and pathways in primary care","author":"World Health Organization","year":"2024"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1017\/pcm.2023.8"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmed.2024.1386689"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1002\/alz.042243"}],"container-title":["Alzheimer's &amp; Dementia: Diagnosis, Assessment &amp; Disease Monitoring"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dad2.70395","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/dad2.70395","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/dad2.70395","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T16:57:31Z","timestamp":1791392251000},"score":1,"resource":{"primary":{"URL":"https:\/\/alz-journals.onlinelibrary.wiley.com\/doi\/10.1002\/dad2.70395"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7]]},"references-count":22,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,7]]}},"alternative-id":["10.1002\/dad2.70395"],"URL":"https:\/\/doi.org\/10.1002\/dad2.70395","archive":["Portico"],"relation":{},"ISSN":["2352-8729","2352-8729"],"issn-type":[{"value":"2352-8729","type":"print"},{"value":"2352-8729","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7]]},"assertion":[{"value":"2025-11-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-26","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-06","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70395"}}