{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T07:27:30Z","timestamp":1793950050053,"version":"4.8.0"},"reference-count":35,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T00:00:00Z","timestamp":1788307200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Parkinson\u2019s Disease"],"published-print":{"date-parts":[[2026,11]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Parkinson's disease (PD) patients may harbor coexisting Alzheimer's disease (AD) pathology that accelerates cognitive and motor decline. Defining biomarker-defined AD in PD is important for prognosis, patient counseling, and trial stratification.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To determine the prevalence of AD biomarker positivity in \u03b1-synuclein seed amplification assay (\u03b1Syn-SAA) positive PD and assess its impact on cognitive and motor progression.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed data from the Parkinson's Progression Markers Initiative, a multinational prospective cohort of de novo PD patients. Baseline CSF biomarkers included \u03b1Syn-SAA, amyloid-\u03b21-42 (A\u03b21-42), and phosphorylated tau181 (p-tau181). AD biomarker positivity was defined by a low A\u03b21-42\/high p-tau181 profile using the CSF A\u03b21-42\/p-tau181 ratio (&lt;39.2). \u03b1Syn-SAA-positive PD participants with and without AD biomarker positivity were compared. Outcomes included cognition, Montreal Cognitive Assessment (MoCA), neuropsychological testing, and MDS-UPDRS motor scores over follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 449 \u03b1Syn-SAA-positive PD patients, 42 (9.3%) met AD biomarker criteria (PD-AD). Baseline cognition and motor scores did not differ between PD-AD and PD without AD biomarkers (PD-nonAD). Over time, PD-AD patients showed greater cognitive decline, with lower MoCA scores and higher MCI prevalence at 5 years. At 8 years, PD-AD patients also demonstrated worse motor outcomes. MoCA &lt;24 predicted AD biomarker positivity (PPV 15%; OR 6.1). APOE \u03b54 status was not associated with cognition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Biomarker-defined AD identifies a distinct PD subgroup with accelerated cognitive and motor decline, independent of APOE \u03b54. A ratio-based CSF A\u03b21-42\/p-tau181 framework offers a practical approach to detect AD copathology in PD and refine prognostic stratification.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1877718x261477521","type":"journal-article","created":{"date-parts":[[2026,9,2]],"date-time":"2026-09-02T22:36:42Z","timestamp":1788388602000},"page":"1606-1614","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Cognitive and motor profiles in biologically defined Parkinson's and Alzheimer's disease"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-0704-1487","authenticated-orcid":false,"given":"Daniel","family":"Zarhin","sequence":"first","affiliation":[{"name":"Tel-Aviv University"},{"name":"Neurological Institute, Tel-Aviv Medical Center, Tel-Aviv, 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