Overview

• Researchers analyzed longitudinal electronic health records from nearly 25,000 University of California Health Data Warehouse patients to uncover sequential diagnostic patterns leading to Alzheimer’s disease.
• The study identified four progression trajectories—mental health, encephalopathy, mild cognitive impairment and vascular disease—that map step-by-step routes toward dementia.
• Validation in the nationally diverse All of Us Research Program confirmed that these multi-step pathways predict Alzheimer’s risk more accurately than single diagnoses alone.
• About 26 percent of diagnostic sequences exhibited consistent directional ordering, with examples such as hypertension preceding depressive episodes that increase dementia risk.
• Each trajectory displayed distinct demographic and clinical profiles, suggesting new opportunities for refined risk stratification and personalized prevention strategies.