We are proud to highlight a recent publication in Neurology Open Access (March 2026) by CADRC Director Dr. Jagan Pillai alongside investigators from the Administrative and Clinical Cores. Their work utilizing data from U.S. Alzheimer’s Disease Research Centers provides a new framework for understanding the early stages of dementia.

The study analyzed 1,028 participants from U.S. Alzheimer’s Disease Research Centers (ADRCs) across the United States who had autopsy-confirmed diagnoses of Alzheimer’s disease pathology (ADP), Lewy body pathology (LBP), or mixed AD-LBP. Using longitudinal data coordinated through the National Alzheimer Coordinating Center, researchers focused on participants who were in the early stages of cognitive impairment (Clinical Dementia Rating ≤1) at the time of their baseline assessments.

The research investigated how early cognitive performance and behavioral and psychological symptoms of dementia (BPSD) combine to form clinically meaningful subtypes. By moving beyond traditional pathology-based classifications, the team used cluster analysis to identify three distinct clinical subtypes.

These subtypes differed in:

• Symptom burden
• Rate of decline
• Genetic risk factors (e.g., APOE ε4 status)

The goal of this work was to better understand how cognitive and behavioral symptoms interact early in dementia. Identifying these subtypes can:

• Improve early diagnosis and prognosis
• Support personalized care planning
• Enhance clinical trial design by accounting for disease heterogeneity

This research underscores the CADRC’s commitment to advancing our understanding of dementia and improving the lives of those affected through innovative, collaborative science.