MRI-derived global small vessel disease burden serves as a marker of hippocampal sclerosis and clinical stage across the probable Alzheimer’s disease continuum

MRI-derived global SVD burden, reflecting the combined effects of CAA and HA, is strongly associated with cognition, clinical staging, and HS across the probable AD continuum, supporting the global SVD score as a clinically useful biomarker of vascular contributions. Since MCI/AD diagnoses were based on clinical criteria without confirmation using cerebrospinal fluid or positive positron emission tomography biomarkers, potential misclassification may exist; findings should be interpreted with caution.