{"doi":"10.1002/dad2.70211","title":"Accuracy of pattern‐based dementia diagnostic protocols: Using longitudinal data to infer etiology of Alzheimer's disease and related dementias compared to stroke or normal aging","abstract":"INTRODUCTION: We compared the accuracy of pattern-recognition protocols to prospectively identify Alzheimer's disease and related dementias (ADRD) and differentiate these from normal aging or stroke. METHODS: Patterns of cognitive decline in cognitively unimpaired participants who completed ≥ 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-onset ADRD and stroke. RESULTS: ADRD-related 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%). DISCUSSION: Longitudinal patterns of cognitive decline can help differentially diagnose ADRD from stroke in longitudinal studies of cognitive decline. Highlights: Pattern recognition identified 95.3% of all cases of dementia in this study.Sensitivity of accelerated cognitive decline to detect incident dementia was 94.3%.Differential diagnosis for dementia might begin to rely on longitudinal cognition.Pattern recognition worked in cases of clinically and algorithmically diagnosed dementia.","journal":"Alzheimer s & Dementia Diagnosis Assessment & Disease Monitoring","year":2025,"id":537169,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":1,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.7697,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":366957,"name":"D. Hanes","orcid":"0000-0003-2186-5540","position":1,"is_corresponding":false},{"id":658283,"name":"Mahdieh Danesh Yazdi","orcid":"0000-0002-5802-1600","position":2,"is_corresponding":false},{"id":366958,"name":"Sean Clouston","orcid":"0000-0002-6124-0329","position":0,"is_corresponding":true}],"reference_count":11,"raw_metadata":null,"created_at":"2026-07-19T02:52:12.997494Z","pmid":"41250667","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}