{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T00:25:56Z","timestamp":1793060756993,"version":"4.5.0"},"reference-count":42,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,27]],"date-time":"2026-09-27T00:00:00Z","timestamp":1790467200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["K24AG053435"],"award-info":[{"award-number":["K24AG053435"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","award":["R01AG075802"],"award-info":[{"award-number":["R01AG075802"]}],"id":[{"id":"10.13039\/100000002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2020\/14339\u20103"],"award-info":[{"award-number":["2020\/14339\u20103"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001807","name":"Funda\u00e7\u00e3o de Amparo \u00e0 Pesquisa do Estado de S\u00e3o Paulo","doi-asserted-by":"publisher","award":["2024\/03917\u20107"],"award-info":[{"award-number":["2024\/03917\u20107"]}],"id":[{"id":"10.13039\/501100001807","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000957","name":"Alzheimer's Association","doi-asserted-by":"publisher","award":["AARG\u201020\u2010678884"],"award-info":[{"award-number":["AARG\u201020\u2010678884"]}],"id":[{"id":"10.13039\/100000957","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000957","name":"Alzheimer's Association","doi-asserted-by":"publisher","award":["24CBIDR\u20101185483"],"award-info":[{"award-number":["24CBIDR\u20101185483"]}],"id":[{"id":"10.13039\/100000957","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000957","name":"Alzheimer's Association","doi-asserted-by":"publisher","award":["AARGD\u201022\u2010972378"],"award-info":[{"award-number":["AARGD\u201022\u2010972378"]}],"id":[{"id":"10.13039\/100000957","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100015442","name":"Global Brain Health Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100015442","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disorders"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lewy body disease (LBD) is defined by neuronal \u03b1\u2010synuclein pathology, but how Braak\u2010staged LBD relates to mixed neuropathology and clinical manifestations within a single population\u2010based cohort remains incompletely characterized. This is especially relevant in cohorts enriched for younger individuals, which may better inform real\u2010world biomarker interpretation and predictive value than cohorts dominated by the oldest\u2010old.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective of this study was to determine how Braak\u2010staged LBD relates to age, mixed neuropathology, and clinical manifestations within a single population\u2010based cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We studied 2480 autopsied participants from the Biobank for Aging Studies in S\u00e3o Paulo, Brazil (mean age 73.25\u2009\u00b1\u200914.15\u2009years, 49.7% female, mean education 5.17\u2009\u00b1\u20094.23\u2009years; 2004\u20132025). Structured postmortem informant interviews assessed cognition (CDR\u2010SB), parkinsonian symptoms (Tanner questionnaire), neuropsychiatric symptoms (Neuropsychiatric Inventory), and family\u2010reported premortem Parkinson's disease (PD) diagnosis. Brains were staged using Braak Parkinson's disease (Braak\u2010PD) staging and evaluated for copathologies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Overall, 10.4% had LBD, increasing from 0.7% among those younger than 50\u2009years to 20.0% among those aged \u226590\u2009years. Advanced Braak\u2010PD was associated with greater Alzheimer's disease\u2013related neuropathology, TDP\u201043 pathology, and cerebral amyloid angiopathy. Approximately 26.1% of individuals with Braak\u2010PD V\u2013VI had a family\u2010reported premortem PD diagnosis. In adjusted models, Braak\u2010PD V\u2013VI remained associated with worse cognition (\n                      <jats:italic>\u03b2<\/jats:italic>\n                      3.03, 95% confidence interval [CI]: 1.93\u20134.14), hallucinations (odds ratio [OR] 3.87, 95% CI: 2.27\u20136.61), and delusions (OR 2.79, 95% CI: 1.61\u20134.82), whereas total parkinsonism score was not independently associated. Nocturnal disturbances were already associated with Braak\u2010PD I\u2013II (OR 2.25, 95% CI: 1.13\u20134.47).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      In this population\u2010based cohort, LBD becomes more frequent with age, occurs in a mixed\u2010pathology context, and is more strongly expressed through cognition and psychosis\u2010related symptoms than through caregiver\u2010reported parkinsonian burden. \u00a9 2026 The Author(s).\n                      <jats:italic>Movement Disorders<\/jats:italic>\n                      published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mds.70515","type":"journal-article","created":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T06:53:12Z","timestamp":1790578392000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Lewy Body Disease Across Aging: Clinical and Neuropathological Correlates in a Population Brain Bank"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8752-5624","authenticated-orcid":false,"given":"Vitor Ribeiro","family":"Paes","sequence":"first","affiliation":[{"name":"Physiopathology in Aging Laboratory (LIM\u201022), Department of Pathology University of Sao Paulo Medical School  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9326-2365","authenticated-orcid":false,"given":"Felipe Luiz","family":"Pereira","sequence":"additional","affiliation":[{"name":"Department of Quantitative Health Sciences Mayo Clinic  Jacksonville Florida USA"},{"name":"Department of Neuroscience Mayo Clinic  Jacksonville Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caroline Matos","family":"Silva","sequence":"additional","affiliation":[{"name":"Physiopathology in Aging Laboratory (LIM\u201022), Department of Internal Medicine University of S\u00e3o Paulo Medical School  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Filipe Oto Cunha","family":"de Moraes","sequence":"additional","affiliation":[{"name":"Physiopathology in Aging Laboratory (LIM\u201022), Department of Pathology University of Sao Paulo Medical School  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"In\u00eas Liguori","family":"Padr\u00e3o","sequence":"additional","affiliation":[{"name":"Physiopathology in Aging Laboratory (LIM\u201022), Department of Pathology University of Sao Paulo Medical School  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5531-0485","authenticated-orcid":false,"given":"Alberto Fernando Oliveira","family":"Justo","sequence":"additional","affiliation":[{"name":"Physiopathology in Aging Laboratory (LIM\u201022), Department of Internal Medicine University of S\u00e3o Paulo Medical School  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roberta Diehl","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"Magnetic Resonance in Neuroradiology Lab (LIM\u201044) Institute of Radiology, University of Sao Paulo Medical School  Sao Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michel Satya","family":"Naslavsky","sequence":"additional","affiliation":[{"name":"Human Genome and Stem Cell Center, Biosciences Institute University of S\u00e3o Paulo  S\u00e3o Paulo 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Center, Biosciences Institute University of S\u00e3o Paulo  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Ferriolli","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine University of S\u00e3o Paulo Medical School  S\u00e3o Paulo Brazil"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5942-4778","authenticated-orcid":false,"given":"Claudia Kimie","family":"Suemoto","sequence":"additional","affiliation":[{"name":"Division of Geriatrics, Department of Internal Medicine University of S\u00e3o Paulo Medical School  S\u00e3o Paulo Brazil"},{"name":"Biggs Institute, University of Texas Health San Antonio  San Antonio Texas USA"},{"name":"Department of Quantitative and Qualitative Health Sciences Kate Marmion School of Public Health  San Antonio Texas 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