1
|
Chantanachai T, Sturnieks DL, Lord SR, Menant J, Delbaere K, Sachdev PS, Brodaty H, Humburg P, Taylor ME. Cognitive and physical declines and falls in older people with and without mild cognitive impairment: a 7-year longitudinal study. Int Psychogeriatr 2024; 36:306-316. [PMID: 37078463 DOI: 10.1017/s1041610223000315] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
OBJECTIVES We examined longitudinal changes in cognitive and physical function and associations between change in function and falls in people with and without mild cognitive impairment (MCI). DESIGN Prospective cohort study with assessments every 2 years (for up to 6 years). SETTING Community, Sydney, Australia. PARTICIPANTS Four hundred and eighty one people were classified into three groups: those with MCI at baseline and MCI or dementia at follow-up assessments (n = 92); those who fluctuated between cognitively normal and MCI throughout follow-up (cognitively fluctuating) (n = 157), and those who were cognitively normal at baseline and all reassessments (n = 232). MEASUREMENTS Cognitive and physical function measured over 2-6 years follow-up. Falls in the year following participants' final assessment. RESULTS In summary, 27.4%, 38.5%, and 34.1% of participants completed 2, 4, and 6 years follow-up of cognitive and physical performance, respectively. The MCI and cognitive fluctuating groups demonstrated cognitive decline, whereas the cognitively normal group did not. The MCI group had worse physical function than the cognitively normal group at baseline but decline over time in physical performance was similar across all groups. Decline in global cognitive function and sensorimotor performance were associated with multiple falls in the cognitively normal group and decline in mobility (timed-up-and-go test) was associated with multiple falls across the whole sample. CONCLUSIONS Cognitive declines were not associated with falls in people with MCI and fluctuating cognition. Declines in physical function were similar between groups and decline in mobility was associated with falls in the whole sample. As exercise has multiple health benefits including maintaining physical function, it should be recommended for all older people. Programs aimed at mitigating cognitive decline should be encouraged in people with MCI.
Collapse
Affiliation(s)
- Thanwarat Chantanachai
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Faculty of Physical Therapy, Mahidol University, Nakhon Pathom, Thailand
| | - Daina L Sturnieks
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Biomedical Sciences, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Stephen R Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Jasmine Menant
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| | - Peter Humburg
- Stats Central, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW, Australia
| | - Morag E Taylor
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Randwick, NSW, Australia
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
| |
Collapse
|
2
|
Fernández I, Tomás JM, Bethmann A. Latent trajectories of recent and delayed memory and their predictors: evidence from SHARE. Int Psychogeriatr 2024; 36:210-220. [PMID: 36756761 DOI: 10.1017/s1041610222001016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
OBJECTIVES Cognitive decline is common in the old age, but some evidence suggests it may already occur during adulthood. Previous studies have linked age, gender, educational attainment, depression, physical activity, and social engagement to better cognitive performance over time. However, most studies have used global measures of cognition, which could mask subtle changes in specific cognitive domains. The aim of this study is to examine trajectories of recent and delayed memory recall from a variable-centered perspective, in order to elucidate the impact of age, gender, educational attainment, depression, physical activity, and social engagement on recent and delayed memory both at initial time and across a 10-year period. DESIGN AND PARTICIPANTS The sample was formed by 56,616 adults and older adults that participated in waves 4 to 8 of the Survey of Health, Aging and Retirement in Europe (SHARE). ANALYSES We used latent growth modeling to establish latent recent and delayed memory trajectories, and then tested the effects of the aforementioned covariates on the latent intercept and slopes. RESULTS Results showed that both recent and delayed recall display a quadratic trajectory of decline. All covariates significantly explained initial levels of immediate and delayed recall, but only a few had statistically significant effects on the slope terms. CONCLUSIONS We discuss differences between present results and those previously reported in studies using a person-centered approach. This study provides evidence of memory decline during adulthood and old adulthood. Further, results provide support for the neural compensation reserve theory.
Collapse
Affiliation(s)
- Irene Fernández
- Department of Methodology of the Behavioral Sciences, University of Valencia, Spain
| | - José M Tomás
- Department of Methodology of the Behavioral Sciences, University of Valencia, Spain
| | - Arne Bethmann
- Technical University of Munich/Munich Center for the Economics of Aging, Max Planck Institute for Social Law and Social Policy, Germany
| |
Collapse
|
3
|
Bednorz A, Religa D. Utility of the Comprehensive Trail Making Test in the Assessment of Mild Cognitive Impairment in Older Patients. Geriatrics (Basel) 2023; 8:108. [PMID: 37987468 PMCID: PMC10660718 DOI: 10.3390/geriatrics8060108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 10/18/2023] [Accepted: 10/28/2023] [Indexed: 11/22/2023] Open
Abstract
INTRODUCTION The purpose of this study is to determine the usefulness of the CTMT (Comprehensive Trail Making Test) in diagnosing mild cognitive impairment in older patients. The test is used to assess executive functions, of which impairment is already observed in the early stages of the neurodegenerative process. MATERIALS AND METHODS The study includes 98 patients of a geriatric ward assigned to 2 groups of 49 patients each: patients diagnosed with a mild cognitive impairment and patients without a cognitive impairment, constituting the control group (group K). A set of screening tests was used in the initial study: the MMSE (Mini-Mental State Examination), MoCA (Montreal Cognitive Assessment), and CDT (Clock Drawing Test), GDS (Geriatric Depression Scale). The second study included the performance of the CTMT; the performance indicator was the time of performance. RESULTS Statistically significant differences are obtained between patients with mild cognitive impairments and those in cognitive normality in the performance of the CTMT test (p < 0.01). Patients with MCIs took longer to complete all trails of the test. To identify cognitive impairment, cutoff points were proposed for the CTMT total score and the other test trails. The CTMT overall score and CTMT 5 scored the highest AUCs (CTMT overall score = 0.77, CTMT Trail 5 = 0.80). CONCLUSIONS The Comprehensive Trail Making Test may be useful in diagnosing mild cognitive impairment as a complementary screening tool.
Collapse
Affiliation(s)
- Adam Bednorz
- John Paul II Geriatric Hospital, 40-353 Katowice, Poland;
- Institute of Psychology, Humanitas Academy, 41-200 Sosnowiec, Poland
| | - Dorota Religa
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, 171 77 Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, 141 86 Huddinge, Sweden
| |
Collapse
|
4
|
Schenning KJ, Mahanna-Gabrielli E, Deiner SG. Update on Perioperative Delirium. Anesthesiol Clin 2023; 41:567-581. [PMID: 37516495 DOI: 10.1016/j.anclin.2023.02.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2023]
Abstract
A strong association between frailty and in-hospital delirium in nonsurgical patients has been shown. Physical and cognitive frailties have been associated with decline and dysfunction in the frontal cognitive domains. Risk factors for frailty are similar to risk factors for postoperative delirium (POD). Frailty can be screened and diagnosed by various tools and instruments. Different anesthetic techniques have been studied to decrease the incidence of POD. However, no anesthetic technique has been conclusively proven to decrease the risk of POD. Patients with dementia develop delirium more often, and delirium is associated with accelerated cognitive decline.
Collapse
Affiliation(s)
- Katie J Schenning
- Department of Anesthesiology & Perioperative Medicine, Oregon Health & Science University, 3181 Southwest Sam Jackson Park Road L459, Portland, OR 97239, USA.
| | - Elizabeth Mahanna-Gabrielli
- Department of Anesthesiology, Perioperative Medicine and Pain Management, University of Miami Miller School of Medicine, 2000 S Bayshore Drive Apartment 51, Miami, FL 33133, USA
| | - Stacie G Deiner
- Department of Anesthesiology, Dartmouth Hitchcock Medical Center, Lebanon, NH, USA
| |
Collapse
|
5
|
Predictors of Successful Memory Aging in Older Mexican Adults. Behav Neurol 2022; 2022:9045290. [PMID: 35795033 PMCID: PMC9252847 DOI: 10.1155/2022/9045290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2021] [Revised: 05/19/2022] [Accepted: 06/07/2022] [Indexed: 11/25/2022] Open
Abstract
Background Research suggests a significant association between increasing age and memory impairments. Nevertheless, for some individuals, memory performance stays within or above the normative values of younger subjects. This is known as successful memory aging and is associated with specific neurophysiological features and psychological and lifestyle-related variables. To date, little is known about the association between successful memory aging and intrinsic capacity (IC) defined as “the composite of all the physical and mental (including psychosocial) capacities that an individual can draw on at any point in time” and resilience. Hence, the aim of this study was to determine if longitudinal associations between IC and successful memory aging and resilience exist and to find differences in cognitive performance between Mexican older adults with successful memory aging, older adults with average memory, and older adults with memory impairment. Methods Longitudinal data from 590 individuals from the third wave (2012) and the Mex-Cog subsample (2016) of the Mexican Health and Aging Study was analysed. Subjects were classified into 3 groups: (1) older adults with successful memory aging (SUMA), (2) older adults with average memory (AVMA), and (3) older adults with memory impairment (IMA). Cognitive domains of orientation, language, attention, constructional praxis, and executive function were evaluated. IC and resilience were measured using items from the MHAS battery. Analysis of variance and multinomial logistic regressions were used to find differences in IC and resilience across the memory aging groups. Results ANOVAs showed significant differences across the three cognitive performance groups in all cognitive domains. Multinomial logistic regression analyses revealed that respondents with higher scores in the psychological and cognitive domains of IC at baseline were more likely to have successful memory aging in the subsequent wave of the study. More resilient subjects in 2012 were not more likely to become a SUMA in 2016. However, this could be a result of the way resilience was measured. Conclusion Our main findings suggest that intrinsic capacity could be used as a predictor of successful memory aging specifically in the psychological and the cognitive domains. More longitudinal studies are needed to further examine these associations.
Collapse
|
6
|
Lin SY, Lin PC, Lin YC, Lee YJ, Wang CY, Peng SW, Wang PN. The Clinical Course of Early and Late Mild Cognitive Impairment. Front Neurol 2022; 13:685636. [PMID: 35651352 PMCID: PMC9149311 DOI: 10.3389/fneur.2022.685636] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Accepted: 04/19/2022] [Indexed: 11/13/2022] Open
Abstract
Introduction Amnestic mild cognitive impairment (MCI) can be classified as either early MCI (EMCI) or late MCI (LMCI) according to the severity of memory impairment. The aim of this study was to compare the prognosis and clinical course between EMCI and LMCI. Methods Between January 2009 and December 2017, a total of 418 patients with MCI and 146 subjects with normal cognition were recruited from a memory clinic. All the patients received at least two series of neuropsychological evaluations each year and were categorized as either EMCI or LMCI according to Alzheimer's Disease Neuroimaging Initiative 2 (ADNI2) criteria. Results In total, our study included 161 patients with EMCI, 258 with LMCI, and 146 subjects with normal cognition as controls (NCs). The mean follow-up duration was 3.55 ± 2.18 years (range: 1–9). In a first-year follow-up assessment, 54 cases (32.8%) of EMCI and 16 (5%) of LMCI showed a normal cognitive status. There was no significant difference between the first year EMCI reverter and NCs in terms of dementia-free survival and further cognitive decline. However, first-year LMCI reverters still had a higher risk of cognitive decline during the following evaluations. Until the last follow-up, annual dementia conversion rates were 1.74, 4.33, and 18.6% in the NC, EMCI, and LMCI groups, respectively. The EMCI and LMCI groups showed a higher rate of progression to dementia (log-rank test, p < 0.001) than normal subjects. Compared with NCs, patients in the LMCI group showed a significantly faster annual decline in global cognition [annual rate of change for the mini-mental status examination (MMSE) score: −1.035, p < 0.001]) and all cognitive domains, while those in the EMCI group showed a faster rate of decline in global cognitive function (annual rate of change for the MMSE score: −0.299, p = 0.001). Conclusion It is important to arrange follow-up visits for patients with MCI, even in the EMCI stage. One-year short-term follow-up may provide clues about the progression of cognitive function and help to identify relatively low-risk EMCI subjects.
Collapse
Affiliation(s)
- Szu-Ying Lin
- Department of Neurology, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan
| | - Po-Chen Lin
- Doctoral Degree Program of Translational Medicine, National Yang Ming Chiao Tung University and Academia Sinica, Hsinchu, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Yi-Cheng Lin
- Department of Neurology, Taipei Municipal Gan-Dau Hospital, Taipei, Taiwan.,Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Neuroscience, School of Life Sciences, National Yang-Ming Chiao Tung University, Taipei, Taiwan
| | - Yi-Jung Lee
- Division of Neurology, Department of Medicine, Taipei City Hospital Renai Branch, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming Chia Tung University, Taipei, Taiwan
| | - Chen-Yu Wang
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Shih-Wei Peng
- Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Pei-Ning Wang
- Division of General Neurology, Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.,Brain Research Center, National Yang-Ming Chia Tung University, Taipei, Taiwan.,Aging and Health Research Center, National Yang-Ming Chia Tung University, Taipei, Taiwan.,Department of Neurology, School of Medicine, National Yang-Ming Chia Tung University, Taipei, Taiwan
| |
Collapse
|
7
|
Horgusluoglu E, Neff R, Song W, Wang M, Wang Q, Arnold M, Krumsiek J, Galindo‐Prieto B, Ming C, Nho K, Kastenmüller G, Han X, Baillie R, Zeng Q, Andrews S, Cheng H, Hao K, Goate A, Bennett DA, Saykin AJ, Kaddurah‐Daouk R, Zhang B. Integrative metabolomics-genomics approach reveals key metabolic pathways and regulators of Alzheimer's disease. Alzheimers Dement 2022; 18:1260-1278. [PMID: 34757660 PMCID: PMC9085975 DOI: 10.1002/alz.12468] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 04/14/2021] [Accepted: 04/17/2021] [Indexed: 12/29/2022]
Abstract
Metabolites, the biochemical products of the cellular process, can be used to measure alterations in biochemical pathways related to the pathogenesis of Alzheimer's disease (AD). However, the relationships between systemic abnormalities in metabolism and the pathogenesis of AD are poorly understood. In this study, we aim to identify AD-specific metabolomic changes and their potential upstream genetic and transcriptional regulators through an integrative systems biology framework for analyzing genetic, transcriptomic, metabolomic, and proteomic data in AD. Metabolite co-expression network analysis of the blood metabolomic data in the Alzheimer's Disease Neuroimaging Initiative (ADNI) shows short-chain acylcarnitines/amino acids and medium/long-chain acylcarnitines are most associated with AD clinical outcomes, including episodic memory scores and disease severity. Integration of the gene expression data in both the blood from the ADNI and the brain from the Accelerating Medicines Partnership Alzheimer's Disease (AMP-AD) program reveals ABCA1 and CPT1A are involved in the regulation of acylcarnitines and amino acids in AD. Gene co-expression network analysis of the AMP-AD brain RNA-seq data suggests the CPT1A- and ABCA1-centered subnetworks are associated with neuronal system and immune response, respectively. Increased ABCA1 gene expression and adiponectin protein, a regulator of ABCA1, correspond to decreased short-chain acylcarnitines and amines in AD in the ADNI. In summary, our integrated analysis of large-scale multiomics data in AD systematically identifies novel metabolites and their potential regulators in AD and the findings pave a way for not only developing sensitive and specific diagnostic biomarkers for AD but also identifying novel molecular mechanisms of AD pathogenesis.
Collapse
Affiliation(s)
- Emrin Horgusluoglu
- Department of Genetics and Genomic SciencesMount Sinai Center for Transformative Disease ModelingIcahn School of Medicine at Mount SinaiIcahn Institute of Genomics and Multiscale BiologyNew YorkNew YorkUSA
| | - Ryan Neff
- Department of Genetics and Genomic SciencesMount Sinai Center for Transformative Disease ModelingIcahn School of Medicine at Mount SinaiIcahn Institute of Genomics and Multiscale BiologyNew YorkNew YorkUSA
| | - Won‐Min Song
- Department of Genetics and Genomic SciencesMount Sinai Center for Transformative Disease ModelingIcahn School of Medicine at Mount SinaiIcahn Institute of Genomics and Multiscale BiologyNew YorkNew YorkUSA
| | - Minghui Wang
- Department of Genetics and Genomic SciencesMount Sinai Center for Transformative Disease ModelingIcahn School of Medicine at Mount SinaiIcahn Institute of Genomics and Multiscale BiologyNew YorkNew YorkUSA
| | - Qian Wang
- Department of Genetics and Genomic SciencesMount Sinai Center for Transformative Disease ModelingIcahn School of Medicine at Mount SinaiIcahn Institute of Genomics and Multiscale BiologyNew YorkNew YorkUSA
| | - Matthias Arnold
- Institute of Computational BiologyHelmholtz Zentrum MünchenGerman Research Center for Environmental HealthNeuherbergGermany
- Department of Psychiatry and Behavioral SciencesDuke UniversityDurhamNorth CarolinaUSA
| | - Jan Krumsiek
- Department of Physiology and BiophysicsWeill Cornell MedicineInstitute for Computational BiomedicineEnglander Institute for Precision MedicineNew YorkNew YorkUSA
| | - Beatriz Galindo‐Prieto
- Department of Physiology and BiophysicsWeill Cornell MedicineInstitute for Computational BiomedicineEnglander Institute for Precision MedicineNew YorkNew YorkUSA
- Helen and Robert Appel Alzheimer's Disease Research InstituteBrain and Mind Research InstituteWeill Cornell MedicineNew YorkNew YorkUSA
| | - Chen Ming
- Department of Genetics and Genomic SciencesMount Sinai Center for Transformative Disease ModelingIcahn School of Medicine at Mount SinaiIcahn Institute of Genomics and Multiscale BiologyNew YorkNew YorkUSA
| | - Kwangsik Nho
- Department of Radiology and Imaging Sciences; Indiana Alzheimer Disease CenterIndiana University School of MedicineIndianapolisIndianaUSA
| | - Gabi Kastenmüller
- Institute of Computational BiologyHelmholtz Zentrum MünchenGerman Research Center for Environmental HealthNeuherbergGermany
| | - Xianlin Han
- Barshop Institute for Longevity and Aging StudiesUniversity of Texas Health Science Center at San AntonioSan AntonioTexasUSA
| | | | - Qi Zeng
- Department of Genetics and Genomic SciencesMount Sinai Center for Transformative Disease ModelingIcahn School of Medicine at Mount SinaiIcahn Institute of Genomics and Multiscale BiologyNew YorkNew YorkUSA
| | - Shea Andrews
- Department of NeuroscienceRonald M. Loeb Center for Alzheimer's DiseaseIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - Haoxiang Cheng
- Department of Genetics and Genomic SciencesMount Sinai Center for Transformative Disease ModelingIcahn School of Medicine at Mount SinaiIcahn Institute of Genomics and Multiscale BiologyNew YorkNew YorkUSA
| | - Ke Hao
- Department of Genetics and Genomic SciencesMount Sinai Center for Transformative Disease ModelingIcahn School of Medicine at Mount SinaiIcahn Institute of Genomics and Multiscale BiologyNew YorkNew YorkUSA
| | - Alison Goate
- Department of NeuroscienceRonald M. Loeb Center for Alzheimer's DiseaseIcahn School of Medicine at Mount SinaiNew YorkNew YorkUSA
| | - David A. Bennett
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Andrew J. Saykin
- Department of Radiology and Imaging Sciences; Indiana Alzheimer Disease CenterIndiana University School of MedicineIndianapolisIndianaUSA
| | - Rima Kaddurah‐Daouk
- Department of Psychiatry and Behavioral SciencesDuke UniversityDurhamNorth CarolinaUSA
- Duke Institute of Brain SciencesDuke UniversityDurhamNorth CarolinaUSA
- Department of MedicineDuke UniversityDurhamNorth CarolinaUSA
| | - Bin Zhang
- Department of Genetics and Genomic SciencesMount Sinai Center for Transformative Disease ModelingIcahn School of Medicine at Mount SinaiIcahn Institute of Genomics and Multiscale BiologyNew YorkNew YorkUSA
| | | | | |
Collapse
|
8
|
Chantanachai T, Taylor ME, Lord SR, Menant J, Delbaere K, Sachdev PS, Kochan NA, Brodaty H, Sturnieks DL. Risk factors for falls in community-dwelling older people with mild cognitive impairment: a prospective one-year study. PeerJ 2022; 10:e13484. [PMID: 35663527 PMCID: PMC9161814 DOI: 10.7717/peerj.13484] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 05/03/2022] [Indexed: 01/17/2023] Open
Abstract
Objective Mild cognitive impairment (MCI) is considered an intermediate stage between normal cognitive function and dementia. Fall risk is increased in this group, but there is limited literature exploring specific fall risk factors that may be addressed in fall prevention strategies. The aim of this study was to examine risk factors for falls in older people with MCI, focusing on cognitive, psychological and physical factors. Methods Participants (n = 266, 45% women) were community-dwelling older people aged 70-90 years who met the criteria for MCI. Cognitive, psychological, sensorimotor and physical assessments, physical activity levels, medication use, general health and disability were ascertained at baseline. Falls were monitored prospectively for 12 months. Results During follow-up, 106 (40%) participants reported one or more falls. Poorer visual contrast sensitivity, increased postural sway, lower levels of weekly walking activity, higher levels of depressive symptoms and psychotropic medication use were significantly associated with faller status (≥1 falls) in univariable analyses. Of these factors, poor visual contrast sensitivity, increased postural sway and psychotropic medication use were found to be significant independent predictors of falls in multivariable analysis while controlling for age and sex. No measures of cognitive function were associated with falls. Conclusions Poor visual contrast sensitivity, impaired balance and psychotropic medication use predicted falls in community-dwelling people with MCI. These risk factors may be amenable to intervention, so these factors could be carefully considered in fall prevention programs for this population.
Collapse
Affiliation(s)
- Thanwarat Chantanachai
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia,School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Morag E. Taylor
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia,Prince of Wales Clinical School, University of New South Wales, Sydney, New South Wales, Australia
| | - Stephen R. Lord
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Jasmine Menant
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Kim Delbaere
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia,School of Population Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder S. Sachdev
- Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia,Faculty of Medicine and Health, University of New South Wales, Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Sydney, New South Wales, Australia
| | - Nicole A. Kochan
- Faculty of Medicine and Health, University of New South Wales, Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Sydney, New South Wales, Australia
| | - Henry Brodaty
- Faculty of Medicine and Health, University of New South Wales, Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, Sydney, New South Wales, Australia
| | - Daina L. Sturnieks
- Falls, Balance and Injury Research Centre, Neuroscience Research Australia, Sydney, New South Wales, Australia,School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
9
|
Gianattasio KZ, Bennett EE, Wei J, Mehrotra ML, Mosley T, Gottesman RF, Wong DF, Stuart EA, Griswold ME, Couper D, Glymour MM, Power MC. Generalizability of findings from a clinical sample to a community-based sample: A comparison of ADNI and ARIC. Alzheimers Dement 2021; 17:1265-1276. [PMID: 33527720 PMCID: PMC8359773 DOI: 10.1002/alz.12293] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2020] [Revised: 11/17/2020] [Accepted: 12/22/2020] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Clinic-based study samples, including the Alzheimer's Disease Neuroimaging Initiative (ADNI), offer rich data, but findings may not generalize to community-based settings. We compared associations in ADNI to those in the Atherosclerosis Risk in Communities (ARIC) study to assess generalizability across the two settings. METHODS We estimated cohort-specific associations among risk factors, cognitive test scores, and neuroimaging outcomes to identify and quantify the extent of significant and substantively meaningful differences in associations between cohorts. We explored whether using more homogenous samples improved comparability in effect estimates. RESULTS The proportion of associations that differed significantly between cohorts ranged from 27% to 34% across sample subsets. Many differences were substantively meaningful (e.g., odds ratios [OR] for apolipoprotein E ε4 on amyloid positivity in ARIC: OR = 2.8, in ADNI: OR = 8.6). DISCUSSION A higher proportion of associations differed significantly and substantively than would be expected by chance. Findings in clinical samples should be confirmed in more representative samples.
Collapse
Affiliation(s)
- Kan Z Gianattasio
- Department of Epidemiology, George Washington University, Washington, District of Columbia, USA
| | - Erin E Bennett
- Department of Epidemiology, George Washington University, Washington, District of Columbia, USA
| | - Jingkai Wei
- Department of Epidemiology, George Washington University, Washington, District of Columbia, USA
| | - Megha L Mehrotra
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Thomas Mosley
- Department of Neurology, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Rebecca F Gottesman
- Departments of Neurology and Epidemiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Dean F Wong
- Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Elizabeth A Stuart
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Michael E Griswold
- Department of Biostatistics, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - David Couper
- Department of Biostatistics, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA
| | - M Maria Glymour
- Department of Epidemiology & Biostatistics, University of California San Francisco, San Francisco, California, USA
| | - Melinda C Power
- Department of Epidemiology, George Washington University, Washington, District of Columbia, USA
| |
Collapse
|
10
|
Manser P, Thalmann M, Adcock M, Knols RH, de Bruin ED. Can Reactivity of Heart Rate Variability Be a Potential Biomarker and Monitoring Tool to Promote Healthy Aging? A Systematic Review With Meta-Analyses. Front Physiol 2021; 12:686129. [PMID: 34393813 PMCID: PMC8359814 DOI: 10.3389/fphys.2021.686129] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 06/29/2021] [Indexed: 01/01/2023] Open
Abstract
Background: Monitoring phasic responses of heart rate variability (HRV) in terms of HRV reactivity [i. e., the absolute change from resting state to on-task (i.e., absolute values of HRV measured during exercise)] might provide useful insights into the individual psychophysiological responses of healthy middle-aged to older adults (HOA) to cognitive and physical exercises. Objectives: To summarize the evidence of phasic HRV responses to cognitive and physical exercises, and to evaluate key moderating factors influencing these responses. Methods: A systematic review with meta-analyses was performed. Publications up to May 2020 of the databases Medline (EBSCO), Embase, Cochrane Library, CINAHL, Psycinfo, Web of Science, Scopus, and Pedro were considered. Controlled clinical trials and observational studies measuring phasic HRV responses to cognitive and/or physical exercises in HOA (≥50 years) were included. Results: The initial search identified 6,828 articles, of which 43 were included into the systematic review. Compared to resting state, vagally-mediated HRV indices were significantly reduced during all types of exercises [Hedge's g = -0.608, 95 % CI (-0.999 to -0.218), p = 0.002] indicating a significant parasympathetic withdrawal compared to rest. The key moderating variables of these responses identified included exercise intensity for physical exercises, and participant characteristics (i.e., level of cognitive functioning, physical fitness), task demands (i.e., task complexity and modality) and the individual responses to these cognitive challenges for cognitive exercises. In particular, higher task demands (task complexity and physical exercise intensity) were related to larger HRV reactivities. Better physical fitness and cognition were associated with lower HRV reactivities. Additionally, HRV reactivity appeared to be sensitive to training-induced cognitive and neural changes. Conclusion: HRV reactivity seems to be a promising biomarker for monitoring internal training load and evaluating neurobiological effects of training interventions. Further research is warranted to evaluate the potential of HRV reactivity as a monitoring parameter to guide cognitive-motor training interventions and/or as a biomarker for cognitive impairment. This may facilitate the early detection of cognitive impairment as well as allow individualized training adaptations that, in turn, support the healthy aging process by optimizing individual exercise dose and progression of cognitive-motor training.
Collapse
Affiliation(s)
- Patrick Manser
- Department of Health Sciences and Technology, Movement Control and Learning-Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Melanie Thalmann
- Department of Health Sciences and Technology, Movement Control and Learning-Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Manuela Adcock
- Department of Health Sciences and Technology, Movement Control and Learning-Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland
| | - Ruud H Knols
- Research and Education, Physiotherapy Occupational Therapy Research Center, University Hospital of Zurich, Zurich, Switzerland
| | - Eling D de Bruin
- Department of Health Sciences and Technology, Movement Control and Learning-Institute of Human Movement Sciences and Sport, ETH Zurich, Zurich, Switzerland.,Division of Physiotherapy, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
11
|
Zainal NH, Newman MG. Depression and executive functioning bidirectionally impair one another across 9 years: Evidence from within-person latent change and cross-lagged models. Eur Psychiatry 2021; 64:e43. [PMID: 34134796 PMCID: PMC8278253 DOI: 10.1192/j.eurpsy.2021.2217] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/18/2021] [Revised: 06/05/2021] [Accepted: 06/07/2021] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND Scar and vulnerability models assert that increased psychopathology may predict subsequent executive functioning (EF) deficits (and vice versa) over protracted timescales, yet most prior work on this topic has been cross-sectional. Thus, we tested the within- and between-person relations between EF, depression, and anxiety. METHODS Older adult participants (n = 856) were assessed across four waves, approximately 2 years apart. Performance-based EF and caregiver-rated symptom measures were administered. Bivariate latent change score and random-intercept cross-lagged panel models were conducted. RESULTS Within persons, random-intercept cross-lagged panel models revealed that prior greater depression forecasted lower subsequent EF, and vice versa (d = -0.292 vs. -0.292). Bivariate dual latent change score models showed that within-person rise in depression predicted EF decreases, and vice versa (d = -0.245 vs. -0.245). No within-person, cross-lagged, EF-anxiety relations emerged. Further, significant negative between-person EF-symptom relations were observed (d = -0.264 to -0.395). CONCLUSION Prospective, within-person findings offer some evidence for developmental scar and vulnerability models.
Collapse
Affiliation(s)
- Nur Hani Zainal
- National University of Singapore, Kent Ridge Campus, Singapore
| | | |
Collapse
|
12
|
Williams OA, An Y, Armstrong NM, Kitner-Triolo M, Ferrucci L, Resnick SM. Profiles of Cognitive Change in Preclinical and Prodromal Alzheimer's Disease Using Change-Point Analysis. J Alzheimers Dis 2021; 75:1169-1180. [PMID: 32390623 DOI: 10.3233/jad-191268] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) is now understood to have a long preclinical phase in which pathology starts to accumulate in the absence of clinical symptoms. Identifying the temporal stages of accelerated cognitive decline in this phase may help in developing more sensitive neuropsychological tools for early screening of preclinical cognitive decline. Change-point analyses are increasingly used to characterize the temporal stages of accelerated cognitive decline in the preclinical stages of AD. However, statistical comparisons of change-points between specific cognitive measures have not been reported. OBJECTIVE To characterize and compare the temporal stages of accelerated decline in performance on multiple cognitive tests in a sample of participants from the Baltimore Longitudinal Study on Aging (BLSA) who later developed AD. METHODS 165 older adults (baseline age range: 61.1-91.2) from the BLSA developed AD during follow-up. Linear and non-linear mixed models were fit for 11 cognitive measures to determine change-points in rates of decline before AD diagnosis. Bootstrapping was used to compare the timing of change-points across cognitive measures. RESULTS Change-points followed by accelerated decline ranged from 15.5 years (Standard Error (S.E.) = 1.72) for Card Rotations to 1.9 years (S.E. = 0.68) for the Trail-Making Test Part A before AD diagnosis. Accelerated decline in Card Rotations occurred significantly earlier than all other measures, including learning and memory measures. CONCLUSION Results suggest that visuospatial ability, as assessed by Card Rotations, may have the greatest utility as an early predictive tool in identifying preclinical AD.
Collapse
Affiliation(s)
- Owen A Williams
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA.,Department of Experimental Psychology, University of Oxford, Oxford, UK
| | - Yang An
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Nicole M Armstrong
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Melissa Kitner-Triolo
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Luigi Ferrucci
- Longitudinal Studies Section, Translational Gerontology Branch, National Institute on Aging, Baltimore, MD, USA
| | - Susan M Resnick
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| |
Collapse
|
13
|
Duggan EC, Graham RB, Piccinin AM, Jenkins ND, Clouston S, Muniz-Terrera G, Hofer SM. Systematic Review of Pulmonary Function and Cognition in Aging. J Gerontol B Psychol Sci Soc Sci 2021; 75:937-952. [PMID: 30380129 DOI: 10.1093/geronb/gby128] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Substantial research is dedicated to understanding the aging-related dynamics among individual differences in level, change, and variation across physical and cognitive abilities. Evaluating replicability and synthesizing findings has been limited by differences in measurements, samples, study design, and statistical analyses that confound between-person differences with within-person changes. Here, we systematically reviewed longitudinal results on the aging-related dynamics linking pulmonary function and cognitive performance. METHODS Preferred Reporting Items for Systematic Review and Meta-Analyses guidelines were used to systematically review longitudinal studies of pulmonary function and cognition. RESULTS Only four studies thoroughly investigating cognitive and pulmonary longitudinal associations (three or more measurement occasions) were identified. Expanded review criteria identified three studies reporting two measurement occasions, and seven studies reporting one measurement of pulmonary function or cognition and two or more measurements of the other. We identified numerous methodological quality and risk for bias issues across studies. CONCLUSIONS Despite documented correlational associations between pulmonary function and cognition, these results show there is very limited research thoroughly investigating their longitudinal associations. This highlights the need for longitudinal data, rigorous methodological design including key covariates, and clear communication of methods and analyses to facilitate replication across an array of samples. We recommend systematic study of outcome measures and covariates, inclusion of multiple measures (e.g., peak expiratory flow, forced expiratory volume in 1 s, and forced vital capacity), as well as application of the same analytic approach across multiple datasets.
Collapse
Affiliation(s)
- Emily Clare Duggan
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Raquel B Graham
- Department of Psychology, University of Victoria, British Columbia, Canada
| | - Andrea M Piccinin
- Department of Psychology, University of Victoria, British Columbia, Canada
| | | | - Sean Clouston
- Department of Family, Population and Preventive Medicine, Stony Brook University, New York
| | | | - Scott M Hofer
- Department of Psychology, University of Victoria, British Columbia, Canada.,Department of Neurology, Oregon Health and Science University, Portland
| |
Collapse
|
14
|
Moustafa AA, Tindle R, Alashwal H, Diallo TMO. A longitudinal study using latent curve models of groups with mild cognitive impairment and Alzheimer's disease. J Neurosci Methods 2020; 350:109040. [PMID: 33345945 DOI: 10.1016/j.jneumeth.2020.109040] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND This study explores how mild cognitive impairment (MCI) and Alzheimer's disease (AD) develop over time. NEW METHOD: this study involves a new application of latent curve models (LCM) to examine the development trajectory of a healthy, MCI, and AD groups on a series of clinical and neural measures. Multiple-group latent curve models were used to compare the parameters of the trajectories across groups. RESULTS LCM results showed that a linear functional form of growth was adequate for all the clinical and neural measures. Positive and significant differences in initial levels were seen across groups on all of the clinical and neural measures. In all groups, the following measures increased slightly, or considerably, over time: Clinical Dementia Rating, Alzheimer's disease Cognitive Assessment, and Montreal Assessment Test for Dementia. In contrast, a slight or a greatly decreasing trajectory was observed on the following measures: Fluorodeoxyglucose, Mini-Mental State Exam, Rey Auditory Verbal Learning Test as well as Hippocampus, Fusiform and Entorhinal Cortex volume measures. However, a constant mean trajectory was seen on Cognition Self Report Memory and languages scores. COMPARISION WITH EXISTING METHODS: there are no prior studies that applied LCM on large AD datasets. CONCLUSIONS cognitive decline occurs in the cognitively normal (CN), MCI, and AD groups but at different rates. Further, some important cognitive, neural, and clinical variables that (a) best differentiate between CN, MCI, and AD as well as (b) differentially change over time in MCI and AD, which may explain disease progression.
Collapse
Affiliation(s)
- Ahmed A Moustafa
- MARCS Institute for Brain and Behaviour & School of Psychology, Western Sydney University, Sydney, New South Wales, Australia; Department of Human Anatomy and Physiology, the Faculty of Health Sciences, University of Johannesburg, South Africa
| | - Richard Tindle
- School of Psychology, Charles Stuart University, Port Macquarie, NSW, Australia
| | - Hany Alashwal
- College of Information Technology, United Arab Emirates University, Al-Ain, 15551, United Arab Emirates.
| | - Thierno M O Diallo
- School of Social Science, Western Sydney University, Sydney, New South Wales, Australia; Statistiques & M.N., Canada
| | | |
Collapse
|
15
|
MacAulay RK, Halpin A, Cohen AS, Calamia M, Boeve A, Zhang L, Brouillette RM, Foil HC, Bruce-Keller A, Keller JN. Predictors of Heterogeneity in Cognitive Function: APOE-e4, Sex, Education, Depression, and Vascular Risk. Arch Clin Neuropsychol 2020; 35:660-670. [PMID: 32129455 DOI: 10.1093/arclin/acaa014] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/08/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Mild cognitive impairment and dementia are clinically heterogeneous disorders influenced by diverse risk factors. Improved characterization of the effect of multiple risk factors influence on specific cognitive functions may improve understanding of mechanisms in early cognitive change and lead to more effective interventions. METHODS Structural equation modeling (SEM) simultaneously examined the effects of modifiable (education, depression, and metabolic/vascular risk) and nonmodifiable risk factors (age, sex, and apolipoprotein E-ɛ4 allele [APOE-e4] status) on specific cognitive domains in 461 cognitively normal older adults. RESULTS The hypothesized model(s) provided an adequate fit for the data. Sex differences in cognition, depression, and vascular risk were found. On average, men were higher in vascular risk with generally lower cognitive performance than women; women were more likely to have depression. APOE-e4 associated with depression but not age, sex, or metabolic/vascular risk. Depression associated with lower executive attention, memory, and language performance, whereas metabolic/vascular risk associated with lower executive attention, memory, and working memory. Older age and lower education are associated with worse performance across the cognitive domains. The combined risk factors accounted for 16%-47% of the variance in the cognitive domains. CONCLUSIONS Results highlight the combined effect of risk factors on cognitive function. Future research is needed to determine whether the multifactorial risk effects on cognition vary by sex. Precision medicine approaches that integrate neuropsychological services may improve diagnostic accuracy and earlier identification of those at risk of cognitive decline.
Collapse
Affiliation(s)
| | - Amy Halpin
- Department of Psychology, University of Maine, Orono, ME 04469, USA
| | - Alex S Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Matthew Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Angelica Boeve
- Department of Psychology, University of Maine, Orono, ME 04469, USA
| | - Le Zhang
- Pennington Biomedical Research Center, Institute for Dementia Research and Prevention/LSU, Baton Rouge, LA 70808, USA.,Institute on Aging, Department of Geriatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Robert M Brouillette
- Pennington Biomedical Research Center, Institute for Dementia Research and Prevention/LSU, Baton Rouge, LA 70808, USA
| | - Heather C Foil
- Pennington Biomedical Research Center, Institute for Dementia Research and Prevention/LSU, Baton Rouge, LA 70808, USA
| | - Annadora Bruce-Keller
- Pennington Biomedical Research Center, Institute for Dementia Research and Prevention/LSU, Baton Rouge, LA 70808, USA
| | - Jeffrey N Keller
- Pennington Biomedical Research Center, Institute for Dementia Research and Prevention/LSU, Baton Rouge, LA 70808, USA
| |
Collapse
|
16
|
Junquera A, García-Zamora E, Olazarán J, Parra MA, Fernández-Guinea S. Role of Executive Functions in the Conversion from Mild Cognitive Impairment to Dementia. J Alzheimers Dis 2020; 77:641-653. [DOI: 10.3233/jad-200586] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Recent research pointed to executive dysfunction as a potential early predictor of the progression of mild cognitive impairment (MCI) to dementia in Alzheimer’s clinical syndrome (ACS). Such cognitive impairments account for functional impairments in instrumental activities of daily living (IADL). Objective: The present study analyzes the contributions of executive functions to predict MCI–dementia progression in ACS. Methods: We assessed 145 participants, 51 cognitively unimpaired and 94 MCI. The latter were divided using the traditional, memory-based MCI classification (single domain amnestic, multidomain amnestic, and non-amnestic). Eight tests assessing executive functions were administered at baseline and at 1-year follow-up, together with cognitive screening tools and IADL measures. MCI patients were reclassified based on the outcomes from a K-mean cluster analysis which identified three groups. A simple lineal regression model was used to examine whether the classification based on executive functioning could more accurately predict progression to dementia a year later. Results: Clusters based on executive function deficits explained a significant proportion of the variance linked to MCI–dementia conversion, even after controlling for the severity of MCI at baseline (F(1, 68) = 116.25, p = 0.000, R2 = 0.63). Classical memory-based MCI classification failed to predict such a conversion (F(1, 68) = 5.09, p = 0.955, R2 = 0.07). Switching, categories generation, and planning were the executive functions that best distinguished between MCI converters and stable. Conclusion: MCI with a dysexecutive phenotype significantly predicts conversion to dementia in ACS a year later. Switching abilities and verbal fluency (categories) must be evaluated in MCI patients to assess risk of future dementia.
Collapse
Affiliation(s)
- Almudena Junquera
- Departamento de Psicología Experimental, Procesos Cognitivos y Logopedia, Facultad de Psicología, Universidad Complutense de Madrid, España
| | - Estefanía García-Zamora
- Departamento de Psicología Experimental, Procesos Cognitivos y Logopedia, Facultad de Psicología, Universidad Complutense de Madrid, España
| | - Javier Olazarán
- Hospital General Universitario Gregorio Marañón, Madrid, España
| | - Mario A. Parra
- School of Psychological Sciences and Health, University of Strathclyde, Glasgow, UK
- Neuroprogressive and Dementia Network, NHS Scotland, UK
- Universidad Autónoma del Caribe, Barranquilla, Colombia
| | - Sara Fernández-Guinea
- Departamento de Psicología Experimental, Procesos Cognitivos y Logopedia, Facultad de Psicología, Universidad Complutense de Madrid, España
| |
Collapse
|
17
|
Mirzaei N, Shi H, Oviatt M, Doustar J, Rentsendorj A, Fuchs DT, Sheyn J, Black KL, Koronyo Y, Koronyo-Hamaoui M. Alzheimer's Retinopathy: Seeing Disease in the Eyes. Front Neurosci 2020; 14:921. [PMID: 33041751 PMCID: PMC7523471 DOI: 10.3389/fnins.2020.00921] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/10/2020] [Indexed: 01/18/2023] Open
Abstract
The neurosensory retina emerges as a prominent site of Alzheimer's disease (AD) pathology. As a CNS extension of the brain, the neuro retina is easily accessible for noninvasive, high-resolution imaging. Studies have shown that along with cognitive decline, patients with mild cognitive impairment (MCI) and AD often suffer from visual impairments, abnormal electroretinogram patterns, and circadian rhythm disturbances that can, at least in part, be attributed to retinal damage. Over a decade ago, our group identified the main pathological hallmark of AD, amyloid β-protein (Aβ) plaques, in the retina of patients including early-stage clinical cases. Subsequent histological, biochemical and in vivo retinal imaging studies in animal models and in humans corroborated these findings and further revealed other signs of AD neuropathology in the retina. Among these signs, hyperphosphorylated tau, neuronal degeneration, retinal thinning, vascular abnormalities and gliosis were documented. Further, linear correlations between the severity of retinal and brain Aβ concentrations and plaque pathology were described. More recently, extensive retinal pericyte loss along with vascular platelet-derived growth factor receptor-β deficiency were discovered in postmortem retinas of MCI and AD patients. This progressive loss was closely associated with increased retinal vascular amyloidosis and predicted cerebral amyloid angiopathy scores. These studies brought excitement to the field of retinal exploration in AD. Indeed, many questions still remain open, such as queries related to the temporal progression of AD-related pathology in the retina compared to the brain, the relations between retinal and cerebral changes and whether retinal signs can predict cognitive decline. The extent to which AD affects the retina, including the susceptibility of certain topographical regions and cell types, is currently under intense investigation. Advances in retinal amyloid imaging, hyperspectral imaging, optical coherence tomography, and OCT-angiography encourage the use of such modalities to achieve more accurate, patient- and user-friendly, noninvasive detection and monitoring of AD. In this review, we summarize the current status in the field while addressing the many unknowns regarding Alzheimer's retinopathy.
Collapse
Affiliation(s)
- Nazanin Mirzaei
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Haoshen Shi
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Mia Oviatt
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Jonah Doustar
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Altan Rentsendorj
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Dieu-Trang Fuchs
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Julia Sheyn
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Keith L. Black
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Yosef Koronyo
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| | - Maya Koronyo-Hamaoui
- Department of Neurosurgery, Maxine Dunitz Neurosurgical Research Institute, Cedars-Sinai Medical Center, Los Angeles, CA, United States
- Department of Biomedical Sciences, Cedars-Sinai Medical Center, Los Angeles, CA, United States
| |
Collapse
|
18
|
Predicting Alzheimer's disease progression using deep recurrent neural networks. Neuroimage 2020; 222:117203. [PMID: 32763427 PMCID: PMC7797176 DOI: 10.1016/j.neuroimage.2020.117203] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 01/12/2023] Open
Abstract
Early identification of individuals at risk of developing Alzheimer’s disease (AD) dementia is important for developing disease-modifying therapies. In this study, given multimodal AD markers and clinical diagnosis of an individual from one or more timepoints, we seek to predict the clinical diagnosis, cognition and ventricular volume of the individual for every month (indefinitely) into the future. We proposed and applied a minimal recurrent neural network (minimalRNN) model to data from The Alzheimer’s Disease Prediction Of Longitudinal Evolution (TADPOLE) challenge, comprising longitudinal data of 1677 participants (Marinescu et al., 2018) from the Alzheimer’s Disease Neuroimaging Initiative (ADNI). We compared the performance of the minimalRNN model and four baseline algorithms up to 6 years into the future. Most previous work on predicting AD progression ignore the issue of missing data, which is a prevalent issue in longitudinal data. Here, we explored three different strategies to handle missing data. Two of the strategies treated the missing data as a “preprocessing” issue, by imputing the missing data using the previous timepoint (“forward filling”) or linear interpolation (“linear filling). The third strategy utilized the minimalRNN model itself to fill in the missing data both during training and testing (“model filling”). Our analyses suggest that the minimalRNN with “model filling” compared favorably with baseline algorithms, including support vector machine/regression, linear state space (LSS) model, and long short-term memory (LSTM) model. Importantly, although the training procedure utilized longitudinal data, we found that the trained minimalRNN model exhibited similar performance, when using only 1 input timepoint or 4 input timepoints, suggesting that our approach might work well with just cross-sectional data. An earlier version of our approach was ranked 5th (out of 53 entries) in the TADPOLE challenge in 2019. The current approach is ranked 2nd out of 63 entries as of June 3rd, 2020.
Collapse
|
19
|
Cerbone B, Massman PJ, Kulesz PA, Woods SP, York MK. Predictors of rate of cognitive decline in patients with amnestic mild cognitive impairment. Clin Neuropsychol 2020; 36:138-164. [DOI: 10.1080/13854046.2020.1773933] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Brittany Cerbone
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Paul J. Massman
- Department of Psychology, University of Houston, Houston, TX, USA
| | | | - Steven P. Woods
- Department of Psychology, University of Houston, Houston, TX, USA
| | - Michele K. York
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| |
Collapse
|
20
|
Chehrehnegar N, Nejati V, Shati M, Rashedi V, Lotfi M, Adelirad F, Foroughan M. Early detection of cognitive disturbances in mild cognitive impairment: a systematic review of observational studies. Psychogeriatrics 2020; 20:212-228. [PMID: 31808989 DOI: 10.1111/psyg.12484] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 09/11/2019] [Accepted: 09/21/2019] [Indexed: 11/28/2022]
Abstract
Mild cognitive impairment (MCI) is an intermediate state between normal cognition and early dementia and is not considered as a typical outcome of brain aging. It has been estimated that 10% to 20% of individuals above 65 years of age will be diagnosed as having MCI. The increased rate of dementia and the importance of early detection of its forerunners have encouraged researchers to focus on detecting MCI and modifiable risk factors with the hope of developing better ways of managing dementia and its consequences. The main aim of this study was to systematically review the related literature concerning the cognitive changes in the spectrum of cognitive aging to cognitive impairment. Articles included in this review were identified through searching the databases of PubMed, Psych Info, Embase, ProQuest, and Scopus. Many domains like verbal memory, language, executive function, visual memory, attentional skills, and working memory showed acceptable predictive power. Testing subdomains such as executive function, speed of processing, working memory and semantic language are critical and others may indicate some suggestions for further clinical deteriorations in normal individuals. Although various cognitive instruments have been used for evaluation of impaired cognitive domains, it remains challenging to select the most appropriate ones having high-level accuracy and their related cognitive subdomains. It also revealed that none of the identified cognitive domains solely fulfilled the criteria for MCI screening; in clinical settings, multiple neuropsychological batteries may be used for one single cognitive domain, while longitudinal studies prefer the use of at least two cognitive measures for each domain to improve accuracy and research settings might focus on only a single neuropsychological test. However, along with episodic memory, testing for amnestic MCI, executive function could increase the chance of early detection of MCI. Executive control has been found to deteriorate the earliest in MCI patients.
Collapse
Affiliation(s)
- Negin Chehrehnegar
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.,Occupational Therapy Department, School of Rehabilitation Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Nejati
- Department of Psychology and Educational Sciences, Shahid Behehsti University Tehran, Tehran, Iran.,Institute for Cognitive and Brain Sciences, Shahid Beheshti University, Tehran, Iran
| | - Mohsen Shati
- Mental Health Research Centre, School of Behavioural Science and Mental health, Tehran Institute of Psychiatry, Iran University of Medical Sciences, Tehran, Iran
| | - Vahid Rashedi
- School of Behavioral Sciences and Mental Health (Tehran Institute of Psychiatry), Iran University of Medical Sciences, Tehran, Iran
| | - Mohammadsajad Lotfi
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Fatemeh Adelirad
- Department of Health Education and Promotion, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mahshid Foroughan
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| |
Collapse
|
21
|
Horgusluoglu-Moloch E, Xiao G, Wang M, Wang Q, Zhou X, Nho K, Saykin AJ, Schadt E, Zhang B. Systems modeling of white matter microstructural abnormalities in Alzheimer's disease. Neuroimage Clin 2020; 26:102203. [PMID: 32062565 PMCID: PMC7025138 DOI: 10.1016/j.nicl.2020.102203] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Revised: 01/06/2020] [Accepted: 02/03/2020] [Indexed: 12/14/2022]
Abstract
INTRODUCTION Microstructural abnormalities in white matter (WM) are often reported in Alzheimer's disease (AD). However, it is unclear which brain regions have the strongest WM changes in presymptomatic AD and what biological processes underlie WM abnormality during disease progression. METHODS We developed a systems biology framework to integrate matched diffusion tensor imaging (DTI), genetic and transcriptomic data to investigate regional vulnerability to AD and identify genetic risk factors and gene subnetworks underlying WM abnormality in AD. RESULTS We quantified regional WM abnormality and identified most vulnerable brain regions. A SNP rs2203712 in CELF1 was most significantly associated with several DTI-derived features in the hippocampus, the top ranked brain region. An immune response gene subnetwork in the blood was most correlated with DTI features across all the brain regions. DISCUSSION Incorporation of image analysis with gene network analysis enhances our understanding of disease progression and facilitates identification of novel therapeutic strategies for AD.
Collapse
Affiliation(s)
- Emrin Horgusluoglu-Moloch
- Department of Genetics and Genomic Sciences, Icahn Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Gaoyu Xiao
- Department of Genetics and Genomic Sciences, Icahn Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Minghui Wang
- Department of Genetics and Genomic Sciences, Icahn Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Qian Wang
- Department of Genetics and Genomic Sciences, Icahn Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Xianxiao Zhou
- Department of Genetics and Genomic Sciences, Icahn Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Kwangsik Nho
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Andrew J Saykin
- Center for Neuroimaging, Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA; Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Eric Schadt
- Department of Genetics and Genomic Sciences, Icahn Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Bin Zhang
- Department of Genetics and Genomic Sciences, Icahn Institute of Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, NY, USA.
| |
Collapse
|
22
|
Costumero V, Marin-Marin L, Calabria M, Belloch V, Escudero J, Baquero M, Hernandez M, Ruiz de Miras J, Costa A, Parcet MA, Ávila C. A cross-sectional and longitudinal study on the protective effect of bilingualism against dementia using brain atrophy and cognitive measures. ALZHEIMERS RESEARCH & THERAPY 2020; 12:11. [PMID: 31924269 PMCID: PMC6954576 DOI: 10.1186/s13195-020-0581-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 01/05/2020] [Indexed: 01/27/2023]
Abstract
Background Evidence from previous studies suggests that bilingualism contributes to cognitive reserve because bilinguals manifest the first symptoms of Alzheimer’s disease (AD) up to 5 years later than monolinguals. Other cross-sectional studies demonstrate that bilinguals show greater amounts of brain atrophy and hypometabolism than monolinguals, despite sharing the same diagnosis and suffering from the same symptoms. However, these studies may be biased by possible pre-existing between-group differences. Methods In this study, we used global parenchymal measures of atrophy and cognitive tests to investigate the protective effect of bilingualism against dementia cross-sectionally and prospectively, using a sample of bilinguals and monolinguals in the same clinical stage and matched on sociodemographic variables. Results Our results suggest that the two groups did not differ in their cognitive status at baseline, but bilinguals had less parenchymal volume than monolinguals, especially in areas related to brain atrophy in dementia. In addition, a longitudinal prospective analysis revealed that monolinguals lost more parenchyma and had more cognitive decline than bilinguals in a mean follow-up period of 7 months. Conclusion These results provide the first prospective evidence that bilingualism may act as a neuroprotective factor against dementia and could be considered a factor in cognitive reserve.
Collapse
Affiliation(s)
- Víctor Costumero
- Center for Brain and Cognition, University Pompeu Fabra, Barcelona, Spain.,Neuropsychology and Functional Neuroimaging Group, University Jaume I, Castellón, Spain.,ERI Lectura, University of Valencia, Valencia, Spain
| | - Lidon Marin-Marin
- Neuropsychology and Functional Neuroimaging Group, University Jaume I, Castellón, Spain
| | - Marco Calabria
- Center for Brain and Cognition, University Pompeu Fabra, Barcelona, Spain
| | | | - Joaquín Escudero
- Department of Neurology, General Hospital of Valencia, Valencia, Spain
| | - Miguel Baquero
- Neurology Unit, University and Polytechnic Hospital La Fe, Valencia, Spain
| | - Mireia Hernandez
- Department of Cognition, Development, and Educational Psychology Section of Cognitive Processes, University of Barcelona, Barcelona, Spain.,Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), L'Hospitalet de Llobregat, Spain
| | | | - Albert Costa
- Center for Brain and Cognition, University Pompeu Fabra, Barcelona, Spain
| | - Maria-Antònia Parcet
- Neuropsychology and Functional Neuroimaging Group, University Jaume I, Castellón, Spain
| | - César Ávila
- Neuropsychology and Functional Neuroimaging Group, University Jaume I, Castellón, Spain.
| |
Collapse
|
23
|
Mella N, Fagot D, Renaud O, Kliegel M, De Ribaupierre A. Individual Differences in Developmental Change: Quantifying the Amplitude and Heterogeneity in Cognitive Change across Old Age. J Intell 2018; 6:E10. [PMID: 31162437 PMCID: PMC6480728 DOI: 10.3390/jintelligence6010010] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2017] [Revised: 02/10/2018] [Accepted: 02/12/2018] [Indexed: 11/17/2022] Open
Abstract
It is well known that cognitive decline in older adults is of smaller amplitude in longitudinal than in cross-sectional studies. Yet, the measure of interest rests generally with aggregated group data. A focus on individual developmental trajectories is rare, mainly because it is difficult to assess intraindividual change reliably. Individual differences in developmental trajectories may differ quantitatively (e.g., larger or smaller decline) or qualitatively (e.g., decline vs improvement), as well as in the degree of heterogeneity of change across different cognitive domains or different tasks. The present paper aims at exploring, within the Geneva Variability Study, individual change across several cognitive domains in 92 older adults (aged 59-89 years at baseline) over a maximum of seven years and a half. Two novel, complementary methods were used to explore change in cognitive performance while remaining entirely at the intra-individual level. A bootstrap based confidence interval was estimated, for each participant and for each experimental condition, making it possible to define three patterns: stability, increase or decrease in performance. Within-person ANOVAs were also conducted for each individual on all the tasks. Those two methods allowed quantifying the direction, the amplitude and the heterogeneity of change for each individual. Results show that trajectories differed widely among individuals and that decline is far from being the rule.
Collapse
Affiliation(s)
- Nathalie Mella
- Cognitive Aging Lab, University of Geneva, 1211 Geneva, Switzerland.
| | - Delphine Fagot
- Center for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, 1211 Geneva, Switzerland.
| | - Olivier Renaud
- Methodology and Data Analysis, Section of psychology, University of Geneva, 1211 Geneva, Switzerland.
| | - Matthias Kliegel
- Cognitive Aging Lab, University of Geneva, 1211 Geneva, Switzerland.
- Center for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, 1211 Geneva, Switzerland.
| | - Anik De Ribaupierre
- Center for the Interdisciplinary Study of Gerontology and Vulnerability (CIGEV), University of Geneva, 1211 Geneva, Switzerland.
| |
Collapse
|
24
|
Roalf DR, Quarmley M, Mechanic-Hamilton D, Wolk DA, Arnold SE, Moberg PJ. Within-Individual Variability: An Index for Subtle Change in Neurocognition in Mild Cognitive Impairment. J Alzheimers Dis 2018; 54:325-35. [PMID: 27567827 DOI: 10.3233/jad-160259] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The transition from mild cognitive impairment (MCI) to Alzheimer's disease is characterized by a decline in cognitive performance in many domains. Cognitive performance profiles in MCI are heterogeneous, however, and additional insights into markers of incipient dementia are needed. Typically, studies focus on average or mean performance, but ignore consistency of performance across domains. WIV (within-individual variability) provides an index of this consistency and is a potential marker of cognitive decline. OBJECTIVE To use neurocognitive data from the Alzheimer's Disease Neuroimaging Initiative cohort to measure neurocognitive variability. METHODS The utility of WIV was measured, in addition to global neurocognitive performance (GNP), for identifying AD and MCI. In addition, the association between changes in neurocognitive variability and diagnostic transition over 12 months was measured. RESULTS As expected, variability was higher in AD and MCI as compared to healthy controls; GNP was lower in both groups as compared to healthy subjects. Global neurocognitive performance alone best distinguished those with dementia from healthy older adults. Yet, for individuals with MCI, including variability along with GNP improved diagnostic classification. Variability was higher at baseline in individuals transitioning from MCI to AD over a 12-month period. CONCLUSION We conclude that variability offers complementary information about neurocognitive performance in dementia, particularly in individuals with MCI, and may provide beneficial information about disease transition.
Collapse
Affiliation(s)
| | | | | | - David A Wolk
- Department of Neurology, Philadelphia, PA, USA.,Alzheimer's Disease Center of the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Steven E Arnold
- Department of Psychiatry, Philadelphia, PA, USA.,Department of Neurology, Philadelphia, PA, USA.,Alzheimer's Disease Center of the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA.,Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Paul J Moberg
- Department of Psychiatry, Philadelphia, PA, USA.,Department of Neurology, Philadelphia, PA, USA.,Alzheimer's Disease Center of the University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | |
Collapse
|
25
|
Seo EH, Kim H, Lee KH, Choo IH. Altered Executive Function in Pre-Mild Cognitive Impairment. J Alzheimers Dis 2018; 54:933-940. [PMID: 27567814 DOI: 10.3233/jad-160052] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND For the early detection of Alzheimer's disease (AD), there is increasing interest in pre-mild cognitive impairment (pre-MCI). OBJECTIVE We explored the neuropsychological characteristics in a group of pre-MCI and cognitively normal (CN) elderly individuals, with the aim of providing measures sensitive to cognitive change in pre-MCI. METHODS We included 188 CN elderly and 77 individuals with pre-MCI. All participants underwent comprehensive clinical and neuropsychological assessment. We compared 17 cognitive tests between the CN and pre-MCI groups by using one-way ANOVAs with false discovery rate correction for multiple comparisons. Pearson's correlations were also obtained between episodic memory and executive function tests in the pre-MCI group. RESULTS The pre-MCI group showed significantly lower scores for visual immediate recall, fluency tests, and Stroop color naming in the color-word incongruent condition than the CN group (p < 0.05). Most of these executive function measures were significantly correlated with episodic memory (p < 0.05). There were no significant group-differences in other tests assessing attention, verbal memory, visuospatial ability, and language. CONCLUSION Our findings indicate that poor executive function especially demanding inhibition and goal-directed behaviors within time limit could be the characteristics of the very early cognitive sign in the course of AD.
Collapse
Affiliation(s)
- Eun Hyun Seo
- National Research Center for Dementia, Gwangju, Korea.,Premedical Science, College of Medicine, Chosun University, Gwangju, Korea
| | - Hoowon Kim
- National Research Center for Dementia, Gwangju, Korea.,Department of Neurology, School of Medicine, Chosun University/Chosun University Hospital, Gwangju, Korea
| | - Kun Ho Lee
- National Research Center for Dementia, Gwangju, Korea.,College of Natural Sciences, Chosun University, Gwangju, South Korea
| | - Il Han Choo
- National Research Center for Dementia, Gwangju, Korea.,Department of Neuropsychiatry, School of Medicine, Chosun University/Chosun University Hospital, Gwangju, Korea
| |
Collapse
|
26
|
Vasunilashorn SM, Fong TG, Albuquerque A, Marcantonio ER, Schmitt EM, Tommet D, Gou Y, Travison TG, Jones RN, Inouye SK. Delirium Severity Post-Surgery and its Relationship with Long-Term Cognitive Decline in a Cohort of Patients without Dementia. J Alzheimers Dis 2018; 61:347-358. [PMID: 29171992 PMCID: PMC5714669 DOI: 10.3233/jad-170288] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Delirium has been associated with more rapid cognitive decline. However, it is unknown whether increased delirium severity is associated with a higher rate of long-term cognitive decline. OBJECTIVE To evaluate delirium severity and the presence and rate of cognitive decline over 36 months following surgery. METHODS We examined patients from the Successful Aging after Elective Surgery Study, who were age ≥70 years undergoing major elective surgery (N = 560). Delirium severity was determined by the peak Confusion Assessment Method-Severity (CAM-S) score for each patient's hospitalization and grouped based on the sample distribution: scores of 0-2, 3-7, and 8-19. A neuropsychological composite, General Cognitive Performance (GCP), and proxy-reported Informant Questionnaire for Cognitive Decline (IQCODE) were used to examine cognitive outcomes following surgery at 0, 1, and 2 months, and then every 6 months for up to 3 years. RESULTS No significant cognitive decline was observed for patients with peak CAM-S scores 0-2 (-0.17 GCP units/year, 95% confidence interval [CI] -0.35, 0.01). GCP scores decreased significantly in the group with peak CAM-S scores 3-7 (-0.30 GCP units/year, 95% CI -0.51, -0.09), and decreased almost three times faster in the highest delirium severity group (peak CAM-S scores 8-19; -0.82 GCP units/year, 95% CI -1.28, -0.37). A similar association was found for delirium severity and the proportion of patients who developed IQCODE impairment over time. CONCLUSION Patients with the highest delirium severity experienced the greatest rate of cognitive decline, which exceeds the rate previously observed for patients with dementia, on serial neuropsychological testing administered over 3 years, with a dose-response relationship between delirium severity and long-term cognitive decline.
Collapse
Affiliation(s)
- Sarinnapha M. Vasunilashorn
- Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center
- Harvard Medical School
| | - Tamara G. Fong
- Harvard Medical School
- Department of Neurology, Beth Israel Deaconess Medical Center
- Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife
| | - Asha Albuquerque
- Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife
| | - Edward R. Marcantonio
- Division of General Medicine and Primary Care, Department of Medicine, Beth Israel Deaconess Medical Center
- Harvard Medical School
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center
| | - Eva M. Schmitt
- Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife
| | - Douglas Tommet
- Departments of Psychiatry and Human Behavior and Neurology, Warren Alpert Medical School, Brown University
| | - Yun Gou
- Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife
| | - Thomas G. Travison
- Harvard Medical School
- Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife
- Research Program on Men’s Health, Aging, and Metabolism, Brigham and Women’s Hospital
| | - Richard N. Jones
- Departments of Psychiatry and Human Behavior and Neurology, Warren Alpert Medical School, Brown University
| | - Sharon K. Inouye
- Harvard Medical School
- Aging Brain Center, Institute for Aging Research, Hebrew SeniorLife
- Division of Gerontology, Department of Medicine, Beth Israel Deaconess Medical Center
| |
Collapse
|
27
|
MacAulay RK, Calamia MR, Cohen AS, Daigle K, Foil H, Brouillette R, Bruce-Keller AJ, Keller JN. Understanding heterogeneity in older adults: Latent growth curve modeling of cognitive functioning. J Clin Exp Neuropsychol 2017; 40:292-302. [DOI: 10.1080/13803395.2017.1342772] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Matthew R. Calamia
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Alex S. Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
| | - Katrina Daigle
- Department of Psychology, University of Maine, Orono, ME, USA
| | - Heather Foil
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Robert Brouillette
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | | | - Jeffrey N. Keller
- Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| |
Collapse
|
28
|
A comparison of theoretical and statistically derived indices for predicting cognitive decline. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2016; 6:171-181. [PMID: 28275699 PMCID: PMC5328960 DOI: 10.1016/j.dadm.2016.10.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Both theoretical and statistically derived approaches have been used in research settings for predicting cognitive decline. METHODS Fifty-eight cognitively normal (NC) and 71 mild cognitive impairment (MCI) subjects completed a comprehensive cognitive battery for up to 5 years of follow-up. Composite indices of cognitive function were derived using a classic theoretical approach and exploratory factor analysis (EFA). Cognitive variables comprising each factor were averaged to form the EFA composite indices. Logistic regression was used to investigate whether these cognitive composites can reliably predict cognitive outcomes. RESULTS Neither method predicted decline in NC. The theoretical memory, executive, attention, and language composites and the EFA-derived "attention/executive" and "verbal memory" composites were significant predictors of decline in MCI. The best models achieved an area under the curve of 0.94 in MCI. CONCLUSIONS The theoretical and the statistically derived cognitive composite approaches are useful in predicting decline in MCI but not in NC.
Collapse
|
29
|
Application of Latent Variable Methods to the Study of Cognitive Decline When Tests Change over Time. Epidemiology 2016; 26:878-87. [PMID: 26414855 DOI: 10.1097/ede.0000000000000379] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND The way a construct is measured can differ across cohort study visits, complicating longitudinal comparisons. We demonstrated the use of factor analysis to link differing cognitive test batteries over visits to common metrics representing general cognitive performance, memory, executive functioning, and language. METHODS We used data from three visits (over 26 years) of the Atherosclerosis Risk in Communities Neurocognitive Study (N = 14,252). We allowed individual tests to contribute information differentially by race, an important factor to consider in cognitive aging. Using generalized estimating equations, we compared associations of diabetes with cognitive change using general and domain-specific factor scores versus averages of equally weighted standardized test scores. RESULTS Factor scores provided stronger associations with diabetes at the expense of greater variability around estimates (e.g., for general cognitive performance, -0.064 standard deviation units/year, standard error = 0.015, vs. -0.041 standard deviation units/year, standard error = 0.014), which is consistent with the notion that factor scores more explicitly address error in measuring assessed traits than averages of standardized tests. CONCLUSIONS Factor analysis facilitates use of all available data when measures change over time, and further, it allows objective evaluation and correction for differential item functioning.
Collapse
|
30
|
The short-term and long-term relationship between delirium and cognitive trajectory in older surgical patients. Alzheimers Dement 2016; 12:766-75. [PMID: 27103261 DOI: 10.1016/j.jalz.2016.03.005] [Citation(s) in RCA: 271] [Impact Index Per Article: 33.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Revised: 02/24/2016] [Accepted: 03/01/2016] [Indexed: 11/22/2022]
Abstract
INTRODUCTION As the relationship between delirium and long-term cognitive decline has not been well-explored, we evaluated this association in a prospective study. METHODS SAGES is an ongoing study involving 560 adults age 70 years or more without dementia scheduled for major surgery. Delirium was assessed daily in the postoperative period using the Confusion Assessment Method. General Cognitive Performance (GCP) and the Informant Questionnaire for Cognitive Decline in the Elderly were assessed preoperatively then repeatedly out to 36 months. RESULTS On average, patients with postoperative delirium had significantly lower preoperative cognitive performance, greater immediate (1 month) impairment, equivalent recovery at 2 months, and significantly greater long-term cognitive decline relative to the nondelirium group. Proxy reports corroborated the clinical significance of the long-term cognitive decline in delirious patients. DISCUSSION Cognitive decline after surgery is biphasic and accelerated among persons with delirium. The pace of long-term decline is similar to that seen with mild cognitive impairment.
Collapse
|
31
|
Tripodis Y, Zirogiannis N. Dynamic Factor Analysis for Multivariate Time Series: An Application to Cognitive Trajectories. INTERNATIONAL JOURNAL OF CLINICAL BIOSTATISTICS AND BIOMETRICS 2015; 1:001. [PMID: 26753177 PMCID: PMC4704801 DOI: 10.23937/2469-5831/1510001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
We propose a dynamic factor model appropriate for large epidemiological studies and develop an estimation algorithm which can handle datasets with large number of subjects and short temporal information. The algorithm uses a two cycle iterative approach for parameter estimation in such a large dataset. Each iteration consists of two distinct cycles, both following an EM algorithm approach. This iterative process will continue until convergence is achieved. We utilized a dataset from the National Alzheimer Coordinating Center (NACC) to estimate underlying measures of cognition based on a battery of observed neuropsychological tests. We assess the goodness of fit and the precision of the dynamic factor model estimators and compare it with a non-dynamic version in which temporal information is not used. The dynamic factor model is superior to a non-dynamic version with respect to fit statistics shown in simulation experiments. Moreover, it has increased power to detect differences in the rate of decline for a given sample size.
Collapse
|
32
|
Predictors of Retest Effects in a Longitudinal Study of Cognitive Aging in a Diverse Community-Based Sample. J Int Neuropsychol Soc 2015; 21:506-18. [PMID: 26527240 PMCID: PMC4783169 DOI: 10.1017/s1355617715000508] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Better performance due to repeated testing can bias long-term trajectories of cognitive aging and correlates of change. We examined whether retest effects differ as a function of individual differences pertinent to cognitive aging: race/ethnicity, age, sex, language, years of education, literacy, and dementia risk factors including apolipoprotein E ε4 status, baseline cognitive performance, and cardiovascular risk. We used data from the Washington Heights-Inwood Columbia Aging Project, a community-based cohort of older adults (n=4073). We modeled cognitive change and retest effects in summary factors for general cognitive performance, memory, executive functioning, and language using multilevel models. Retest effects were parameterized in two ways, as improvement between the first and subsequent testings, and as the square root of the number of prior testings. We evaluated whether the retest effect differed by individual characteristics. The mean retest effect for general cognitive performance was 0.60 standard deviations (95% confidence interval [0.46, 0.74]), and was similar for memory, executive functioning, and language. Retest effects were greater for participants in the lowest quartile of cognitive performance (many of whom met criteria for dementia based on a study algorithm), consistent with regression to the mean. Retest did not differ by other characteristics. Retest effects are large in this community-based sample, but do not vary by demographic or dementia-related characteristics. Differential retest effects may not limit the generalizability of inferences across different groups in longitudinal research.
Collapse
|
33
|
Sisco S, Gross AL, Shih RA, Sachs BC, Glymour MM, Bangen KJ, Benitez A, Skinner J, Schneider BC, Manly JJ. The role of early-life educational quality and literacy in explaining racial disparities in cognition in late life. J Gerontol B Psychol Sci Soc Sci 2015; 70:557-67. [PMID: 24584038 PMCID: PMC4462668 DOI: 10.1093/geronb/gbt133] [Citation(s) in RCA: 173] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2013] [Accepted: 12/05/2013] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Racial disparities in late-life cognition persist even after accounting for educational attainment. We examined whether early-life educational quality and literacy in later life help explain these disparities. METHOD We used longitudinal data from the Washington Heights-Inwood Columbia Aging Project (WHICAP). Educational quality (percent white students; urban/rural school; combined grades in classroom) was operationalized using canonical correlation analysis. Late-life literacy (reading comprehension and ability, writing) was operationalized using confirmatory factor analysis. We examined whether these factors attenuated race-related differences in late-life cognition. RESULTS The sample consisted of 1,679 U.S.-born, non-Hispanic, community-living adults aged 65-102 (71% black, 29% white; 70% women). Accounting for educational quality and literacy reduced disparities by 29% for general cognitive functioning, 26% for memory, and 32% for executive functioning but did not predict differences in rate of cognitive change. DISCUSSION Early-life educational quality and literacy in late life explain a substantial portion of race-related disparities in late-life cognitive function.
Collapse
Affiliation(s)
- Shannon Sisco
- Department of Veterans Affairs, North Florida/South Georgia Veterans Health System, Gainesville.
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Bonnie C Sachs
- Department of Neurology, Virginia Commonwealth University School of Medicine, Richmond
| | - M Maria Glymour
- Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts. Department of Epidemiology & Biostatistics, University of California, San Francisco
| | | | - Andreana Benitez
- Department of Radiology and Radiological Sciences, Center for Biomedical Imaging, Medical University of South Carolina, Charleston
| | - Jeannine Skinner
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| | - Brooke C Schneider
- Department of Psychology, VA Greater Los Angeles Healthcare System, California
| | - Jennifer J Manly
- Cognitive Neuroscience Division, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York
| |
Collapse
|
34
|
Facal D, Guàrdia-Olmos J, Juncos-Rabadán O. Diagnostic transitions in mild cognitive impairment by use of simple Markov models. Int J Geriatr Psychiatry 2015; 30:669-76. [PMID: 25315251 DOI: 10.1002/gps.4197] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 07/17/2014] [Accepted: 07/31/2014] [Indexed: 11/06/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is a complex entity, which can involve persistence of the symptoms, conversion to dementia or improvement. The aim was to study the transitions between normal cognitive ageing and three MCI subtypes by using Markov transition models for different intervals between baseline and the follow-up assessment. METHODS A total of 294 participants over 50 years old attending primary care centres were assessed and diagnosed at baseline as multi-domain amnestic MCI (22 participants), single domain amnestic MCI (44), non-amnestic MCI (non-amnestic MCI) (26) or controls (202). We adopted an overlapping interval strategy by constructing six different mid-point time intervals according to the time between the baseline and the follow-up assessment. We used Markov transition models to study diagnostic changes in the groups in the different time intervals RESULTS The rate of change was lowest in the control group. In the single domain amnestic MCI and non-amnestic MCI groups, the same diagnosis was usually retained or changed to normal cognitive functioning. In the multi-domain amnestic MCI group, the rate of transition to normal functioning was lowest, and the conversion to dementia was the highest of all groups. The best fit to the Markov models was found for the period between 18-21 months, whereas the worst fit was for the period between 9-15 months CONCLUSIONS Markov models provide a comprehensive view of transitions between MCI and normal cognitive functioning. Time interval strategies seem to provide a good opportunity to monitor diagnostic transitions, although wider intervals including subsequent assessments are needed. The low rates of conversion to dementia are discussed.
Collapse
Affiliation(s)
- David Facal
- Departament of Developmental Psychology, University de Santiago de Compostela, A Coruña, Spain
| | - Joan Guàrdia-Olmos
- Departament de Metodologia de les Ciències del Comportament, University of Barcelona, Barcelona, Spain
| | - Onésimo Juncos-Rabadán
- Departament of Developmental Psychology, University de Santiago de Compostela, A Coruña, Spain
| |
Collapse
|
35
|
Weiner MW, Veitch DP, Aisen PS, Beckett LA, Cairns NJ, Cedarbaum J, Green RC, Harvey D, Jack CR, Jagust W, Luthman J, Morris JC, Petersen RC, Saykin AJ, Shaw L, Shen L, Schwarz A, Toga AW, Trojanowski JQ. 2014 Update of the Alzheimer's Disease Neuroimaging Initiative: A review of papers published since its inception. Alzheimers Dement 2015; 11:e1-120. [PMID: 26073027 PMCID: PMC5469297 DOI: 10.1016/j.jalz.2014.11.001] [Citation(s) in RCA: 203] [Impact Index Per Article: 22.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/18/2013] [Indexed: 01/18/2023]
Abstract
The Alzheimer's Disease Neuroimaging Initiative (ADNI) is an ongoing, longitudinal, multicenter study designed to develop clinical, imaging, genetic, and biochemical biomarkers for the early detection and tracking of Alzheimer's disease (AD). The initial study, ADNI-1, enrolled 400 subjects with early mild cognitive impairment (MCI), 200 with early AD, and 200 cognitively normal elderly controls. ADNI-1 was extended by a 2-year Grand Opportunities grant in 2009 and by a competitive renewal, ADNI-2, which enrolled an additional 550 participants and will run until 2015. This article reviews all papers published since the inception of the initiative and summarizes the results to the end of 2013. The major accomplishments of ADNI have been as follows: (1) the development of standardized methods for clinical tests, magnetic resonance imaging (MRI), positron emission tomography (PET), and cerebrospinal fluid (CSF) biomarkers in a multicenter setting; (2) elucidation of the patterns and rates of change of imaging and CSF biomarker measurements in control subjects, MCI patients, and AD patients. CSF biomarkers are largely consistent with disease trajectories predicted by β-amyloid cascade (Hardy, J Alzheimer's Dis 2006;9(Suppl 3):151-3) and tau-mediated neurodegeneration hypotheses for AD, whereas brain atrophy and hypometabolism levels show predicted patterns but exhibit differing rates of change depending on region and disease severity; (3) the assessment of alternative methods of diagnostic categorization. Currently, the best classifiers select and combine optimum features from multiple modalities, including MRI, [(18)F]-fluorodeoxyglucose-PET, amyloid PET, CSF biomarkers, and clinical tests; (4) the development of blood biomarkers for AD as potentially noninvasive and low-cost alternatives to CSF biomarkers for AD diagnosis and the assessment of α-syn as an additional biomarker; (5) the development of methods for the early detection of AD. CSF biomarkers, β-amyloid 42 and tau, as well as amyloid PET may reflect the earliest steps in AD pathology in mildly symptomatic or even nonsymptomatic subjects and are leading candidates for the detection of AD in its preclinical stages; (6) the improvement of clinical trial efficiency through the identification of subjects most likely to undergo imminent future clinical decline and the use of more sensitive outcome measures to reduce sample sizes. Multimodal methods incorporating APOE status and longitudinal MRI proved most highly predictive of future decline. Refinements of clinical tests used as outcome measures such as clinical dementia rating-sum of boxes further reduced sample sizes; (7) the pioneering of genome-wide association studies that leverage quantitative imaging and biomarker phenotypes, including longitudinal data, to confirm recently identified loci, CR1, CLU, and PICALM and to identify novel AD risk loci; (8) worldwide impact through the establishment of ADNI-like programs in Japan, Australia, Argentina, Taiwan, China, Korea, Europe, and Italy; (9) understanding the biology and pathobiology of normal aging, MCI, and AD through integration of ADNI biomarker and clinical data to stimulate research that will resolve controversies about competing hypotheses on the etiopathogenesis of AD, thereby advancing efforts to find disease-modifying drugs for AD; and (10) the establishment of infrastructure to allow sharing of all raw and processed data without embargo to interested scientific investigators throughout the world.
Collapse
Affiliation(s)
- Michael W Weiner
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA; Department of Radiology, University of California, San Francisco, CA, USA; Department of Medicine, University of California, San Francisco, CA, USA; Department of Psychiatry, University of California, San Francisco, CA, USA; Department of Neurology, University of California, San Francisco, CA, USA.
| | - Dallas P Veitch
- Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA
| | - Paul S Aisen
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Laurel A Beckett
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USA
| | - Nigel J Cairns
- Knight Alzheimer's Disease Research Center, Washington University School of Medicine, Saint Louis, MO, USA; Department of Neurology, Washington University School of Medicine, Saint Louis, MO, USA
| | - Jesse Cedarbaum
- Neurology Early Clinical Development, Biogen Idec, Cambridge, MA, USA
| | - Robert C Green
- Division of Genetics, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA
| | - Danielle Harvey
- Division of Biostatistics, Department of Public Health Sciences, University of California, Davis, CA, USA
| | | | - William Jagust
- Helen Wills Neuroscience Institute, University of California Berkeley, Berkeley, CA, USA
| | - Johan Luthman
- Neuroscience Clinical Development, Neuroscience & General Medicine Product Creation Unit, Eisai Inc., Philadelphia, PA, USA
| | - John C Morris
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | | | - Andrew J Saykin
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA; Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Leslie Shaw
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Li Shen
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Adam Schwarz
- Tailored Therapeutics, Eli Lilly and Company, Indianapolis, IN, USA
| | - Arthur W Toga
- Laboratory of Neuroimaging, Institute of Neuroimaging and Informatics, Keck School of Medicine of University of Southern California, Los Angeles, CA, USA
| | - John Q Trojanowski
- Institute on Aging, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Alzheimer's Disease Core Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Udall Parkinson's Research Center, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Pathology and Laboratory Medicine, Center for Neurodegenerative Research, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
36
|
Mueller KD, Koscik RL, LaRue A, Clark LR, Hermann B, Johnson SC, Sager MA. Verbal Fluency and Early Memory Decline: Results from the Wisconsin Registry for Alzheimer's Prevention. Arch Clin Neuropsychol 2015; 30:448-57. [PMID: 26025231 DOI: 10.1093/arclin/acv030] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/29/2015] [Indexed: 11/14/2022] Open
Abstract
This study examined the relationship between phonemic and semantic (category) verbal fluency and cognitive status in the Wisconsin Registry for Alzheimer's Prevention (WRAP), a longitudinal cohort enriched for family history of Alzheimer's disease. Participants were 283 WRAP subjects (age 53.1[6.5] years at baseline); who had completed three waves of assessment, over ∼6 years and met psychometric criteria either for "cognitively healthy" (CH) or for psychometric amnestic mild cognitive impairment (aMCI) using an approach that did not consider fluency scores. CH and aMCI groups differed significantly on phonemic total scores, category total scores, phonemic switching, and category mean cluster size. These results suggest that measures of both phonemic and semantic fluency yield lower scores in persons with evidence of psychometric aMCI compared with those who are CH. Differences have not previously been reported in a group this young, and provide evidence for the importance of including multiple verbal fluency tests targeting preclinical Alzheimer's disease.
Collapse
Affiliation(s)
- Kimberly Diggle Mueller
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Rebecca L Koscik
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Asenath LaRue
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Lindsay R Clark
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Bruce Hermann
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sterling C Johnson
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison, WI, USA Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Mark A Sager
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| |
Collapse
|
37
|
Sanders C, Low C, Schmitter-Edgecombe M. Assessment of planning abilities in individuals with mild cognitive impairment using an open-ended problem-solving task. J Clin Exp Neuropsychol 2014; 36:1084-97. [PMID: 25513952 DOI: 10.1080/13803395.2014.983462] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
INTRODUCTION There is currently limited research evaluating planning abilities, a core subcomponent of executive functioning, in individuals with mild cognitive impairment (MCI). In the present study, we utilized the "Amap Task," an open-ended problem-solving task, to separately evaluate the formulation and execution components of planning ability in individuals with MCI. METHOD Thirty-seven cognitively healthy older adults and 37 individuals with MCI used a map layout of a university apartment to develop and write out a strategy (formulation stage) to successfully complete a list of tasks (e.g., retrieve and fill a water pitcher before placing it in the refrigerator). Subsequently, participants carried out the tasks in the apartment with the aid of their formulated plan (execution stage). RESULTS MCI participants performed more poorly than older adult (OA) controls during both the formulation and execution stages on measures of task accuracy and task efficiency. However, both groups were able to adjust and improve task accuracy and efficiency from formulation to task execution. Finally, MCI participants took significantly longer to complete the task and adhered less to their formulated plans during task completion. CONCLUSIONS Using an open-ended problem-solving task, the findings revealed that individuals with MCI experienced difficulties with both the formulation and execution components of planning. Like controls, participants with MCI were able to successfully modify their plan online, improving their performance from task formulation to task execution.
Collapse
Affiliation(s)
- Chad Sanders
- a Department of Psychology , Washington State University , Pullman , WA , USA
| | | | | |
Collapse
|
38
|
Reinlieb M, Ercoli L, Siddarth P, St. Cyr N, Lavretsky H. The patterns of cognitive and functional impairment in amnestic and non-amnestic mild cognitive impairment in geriatric depression. Am J Geriatr Psychiatry 2014; 22:1487-95. [PMID: 24315561 PMCID: PMC4751142 DOI: 10.1016/j.jagp.2013.10.010] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2013] [Revised: 08/28/2013] [Accepted: 10/31/2013] [Indexed: 10/26/2022]
Abstract
OBJECTIVES Depressed older adults are at risk for the development of mild cognitive impairment (MCI), but few studies have characterized MCI subtypes in geriatric depression. The objective of this study was to identify the clinical patterns of MCI in late-life depression. DESIGN Baseline demographic, clinical, and neuropsychological test data collected as part of a randomized antidepressant trial for geriatric depression. SETTING UCLA-based outpatient clinic. PARTICIPANTS One hundred thirty-eight older adults with major depression. MEASUREMENTS A neuropsychological test battery and comprehensive evaluations of depression, apathy, quality of life, medical burden, and vascular risk factors. RESULTS Seventy-one participants (51%) had MCI and 67 (49%) were cognitively normal. Of subjects with MCI, 14 (20%) had amnestic MCI and 57 (80%) had non-amnestic MCI. Overall, patients with MCI had greater depression severity, poorer quality of life, and worse performance on the Mini-Mental State Exam than patients without MCI. Patients with non-amnestic MCI had significantly greater depression severity than patients without MCI. Across all subjects, depression severity correlated with impaired performance in language and visuospatial functioning. CONCLUSION Our findings suggest that MCI is associated with greater severity of depression, poorer quality of life, and worse global cognitive function. Overall, subtypes of MCI in geriatric depression differ in the patterns of functional impairment, which may require different therapeutic approaches.
Collapse
Affiliation(s)
| | | | | | | | - Helen Lavretsky
- UCLA Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA.
| |
Collapse
|
39
|
Donovan NJ, Amariglio RE, Zoller AS, Rudel RK, Gomez-Isla T, Blacker D, Hyman BT, Locascio JJ, Johnson KA, Sperling RA, Marshall GA, Rentz DM. Subjective cognitive concerns and neuropsychiatric predictors of progression to the early clinical stages of Alzheimer disease. Am J Geriatr Psychiatry 2014; 22:1642-51. [PMID: 24698445 PMCID: PMC4145054 DOI: 10.1016/j.jagp.2014.02.007] [Citation(s) in RCA: 151] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2014] [Revised: 02/22/2014] [Accepted: 02/24/2014] [Indexed: 12/23/2022]
Abstract
OBJECTIVE To examine neuropsychiatric and neuropsychological predictors of progression from normal to early clinical stages of Alzheimer disease (AD). METHODS From a total sample of 559 older adults from the Massachusetts Alzheimer's Disease Research Center longitudinal cohort, 454 were included in the primary analysis: 283 with clinically normal cognition (CN), 115 with mild cognitive impairment (MCI), and 56 with subjective cognitive concerns (SCC) but no objective impairment, a proposed transitional group between CN and MCI. Two latent cognitive factors (memory-semantic, attention-executive) and two neuropsychiatric factors (affective, psychotic) were derived from the Alzheimer's Disease Centers' Uniform Data Set neuropsychological battery and Neuropsychiatric Inventory brief questionnaire. Factors were analyzed as predictors of time to progression to a worse diagnosis using a Cox proportional hazards regression model with backward elimination. Covariates included baseline diagnosis, gender, age, education, prior depression, antidepressant medication, symptom duration, and interaction terms. RESULTS Higher/better memory-semantic factor score predicted lower hazard of progression (hazard ratio [HR] = 0.4 for 1 standard deviation [SD] increase, p <0.0001), and higher/worse affective factor score predicted higher hazard (HR = 1.3 for one SD increase, p = 0.01). No other predictors were significant in adjusted analyses. Using diagnosis as a sole predictor of transition to MCI, the SCC diagnosis carried a fourfold risk of progression compared with CN (HR = 4.1, p <0.0001). CONCLUSION These results identify affective and memory-semantic factors as significant predictors of more rapid progression from normal to early stages of cognitive decline and highlight the subgroup of cognitively normal elderly with SCC as those with elevated risk of progression to MCI.
Collapse
Affiliation(s)
- Nancy J Donovan
- Center for Alzheimer Research and Treatment and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
| | - Rebecca E Amariglio
- Center for Alzheimer Research and Treatment and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Amy S Zoller
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Rebecca K Rudel
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Teresa Gomez-Isla
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Deborah Blacker
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Joseph J Locascio
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Keith A Johnson
- Center for Alzheimer Research and Treatment and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Reisa A Sperling
- Center for Alzheimer Research and Treatment and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Gad A Marshall
- Center for Alzheimer Research and Treatment and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Dorene M Rentz
- Center for Alzheimer Research and Treatment and Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA; Massachusetts Alzheimer's Disease Research Center, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| |
Collapse
|
40
|
Hosseini SMH, Kramer JH, Kesler SR. Neural correlates of cognitive intervention in persons at risk of developing Alzheimer's disease. Front Aging Neurosci 2014; 6:231. [PMID: 25206335 PMCID: PMC4143724 DOI: 10.3389/fnagi.2014.00231] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2014] [Accepted: 08/11/2014] [Indexed: 01/18/2023] Open
Abstract
Cognitive training is an emergent approach that has begun to receive increased attention in recent years as a non-pharmacological, cost-effective intervention for Alzheimer’s disease (AD). There has been increasing behavioral evidence regarding training-related improvement in cognitive performance in early stages of AD. Although these studies provide important insight about the efficacy of cognitive training, neuroimaging studies are crucial to pinpoint changes in brain structure and function associated with training and to examine their overlap with pathology in AD. In this study, we reviewed the existing neuroimaging studies on cognitive training in persons at risk of developing AD to provide an overview of the overlap between neural networks rehabilitated by the current training methods and those affected in AD. The data suggest a consistent training-related increase in brain activity in medial temporal, prefrontal, and posterior default mode networks, as well as increase in gray matter structure in frontoparietal and entorhinal regions. This pattern differs from the observed pattern in healthy older adults that shows a combination of increased and decreased activity in response to training. Detailed investigation of the data suggests that training in persons at risk of developing AD mainly improves compensatory mechanisms and partly restores the affected functions. While current neuroimaging studies are quite helpful in identifying the mechanisms underlying cognitive training, the data calls for future multi-modal neuroimaging studies with focus on multi-domain cognitive training, network level connectivity, and individual differences in response to training.
Collapse
Affiliation(s)
- S M Hadi Hosseini
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine Stanford, CA, USA
| | - Joel H Kramer
- Department of Neurology, Memory and Aging Center, University of California San Francisco, CA, USA
| | - Shelli R Kesler
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine Stanford, CA, USA ; Stanford Cancer Institute Palo Alto, CA, USA
| |
Collapse
|
41
|
Abstract
Effects of an initial testing experience on the level of cognitive performance at a 2nd occasion are well documented. However, less is known about the effects of additional testing experiences beyond the 1st on the amount of cognitive change over a specified interval. This issue was investigated in a moderately large sample of adults between 18 and 95 years of age who performed a battery of cognitive tests either 2 or 3 times at variable intervals between each assessment. Multiple regression analyses were used to examine effects of the number of assessments on change while controlling the length of the interval between the 1st and last assessments. Change in each of 5 cognitive domains was less negative when there was an intervening assessment. To illustrate, for adults between 65 and 95 years of age, the estimated change from a 1st to a 2nd assessment across an average interval of 3.9 years was -.25 standard deviation units (p < .01), but it was only -.06 standard deviation units, and not significantly different from 0, when an intervening assessment occurred during the interval. These results indicate that cognitive change may not be detected when individuals are assessed frequently with relatively short intervals between the assessments.
Collapse
|
42
|
Schneider BC, Gross AL, Bangen KJ, Skinner JC, Benitez A, Glymour MM, Sachs BC, Shih RA, Sisco S, Manly JJ, Luchsinger JA. Association of vascular risk factors with cognition in a multiethnic sample. J Gerontol B Psychol Sci Soc Sci 2014; 70:532-44. [PMID: 24821298 DOI: 10.1093/geronb/gbu040] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Accepted: 03/24/2014] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVES To examine the relationship between cardiovascular risk factors (CVRFs) and cognitive performance in a multiethnic sample of older adults. METHOD We used longitudinal data from the Washington Heights-Inwood Columbia Aging Project. A composite score including smoking, stroke, heart disease, diabetes, hypertension, and central obesity represented CVRFs. Multiple group parallel process multivariate random effects regression models were used to model cognitive functioning and examine the contribution of CVRFs to baseline performance and change in general cognitive processing, memory, and executive functioning. RESULTS Presence of each CVRF was associated with a 0.1 SD lower score in general cognitive processing, memory, and executive functioning in black and Hispanic participants relative to whites. Baseline CVRFs were associated with poorer baseline cognitive performances among black women and Hispanic men. CVRF increase was related to baseline cognitive performance only among Hispanics. CVRFs were not related to cognitive decline. After adjustment for medications, CVRFs were not associated with cognition in Hispanic participants. DISCUSSION CVRFs are associated with poorer cognitive functioning, but not cognitive decline, among minority older adults. These relationships vary by gender and medication use. Consideration of unique racial, ethnic, and cultural factors is needed when examining relationships between CVRFs and cognition.
Collapse
Affiliation(s)
- Brooke C Schneider
- Psychology Service, VA Greater Los Angeles Healthcare System, California
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland. Center on Aging and Health, Johns Hopkins University, Baltimore, Maryland
| | | | - Jeannine C Skinner
- Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle
| | - Andreana Benitez
- Department of Radiology and Radiological Sciences, Center for Biomedical Imaging, Medical University of South Carolina, Charleston
| | - M Maria Glymour
- Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, Massachusetts. Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Bonnie C Sachs
- Department of Neurology, Virginia Commonwealth University School of Medicine, Richmond
| | | | - Shannon Sisco
- North Florida/South Georgia Veterans Health System, Department of Veterans Affairs, Gainesville
| | - Jennifer J Manly
- Cognitive Neuroscience Division, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York
| | - José A Luchsinger
- Department of Epidemiology, Joseph P. Mailman School of Public Health, and Department of Medicine, Columbia University Medical Center, New York.
| |
Collapse
|
43
|
Facal D, Guàrdia-Olmos J, Juncos-Rabadán O. [Methodological approaches to the study of longitudinal data in mild cognitive impairment]. Rev Esp Geriatr Gerontol 2014; 49:148-149. [PMID: 24704160 DOI: 10.1016/j.regg.2014.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2013] [Revised: 02/16/2014] [Accepted: 02/27/2014] [Indexed: 06/03/2023]
Affiliation(s)
- David Facal
- Departamento de Psicoloxía Evolutiva e da Educación, Universidade de Santiago de Compostela, Santiago de Compostela, La Coruña, España.
| | - Joan Guàrdia-Olmos
- Departament de Metodologia, Facultat de Psicologia, Universitat de Barcelona, Barcelona, España
| | - Onésimo Juncos-Rabadán
- Departamento de Psicoloxía Evolutiva e da Educación, Universidade de Santiago de Compostela, Santiago de Compostela, La Coruña, España
| |
Collapse
|
44
|
Thaler NS, O'Rourke JJ, Scott JG, Duff K, Mold J, Adams RL. Longitudinal stability of RBANS profiles in a geriatric community-dwelling sample. Clin Neuropsychol 2014; 28:269-80. [PMID: 24528211 DOI: 10.1080/13854046.2014.884243] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
This investigation is an extension of a previous study that identified four neurocognitive RBANS groups via cluster analysis in a geriatric community-dwelling sample of 699 individuals who were at least 65 years of age. Groups were examined longitudinally over a 2-year interval to establish if they exhibited marked score changes over three assessment periods. Dropout rates, onset of medical pathology, and self-reported functioning were tracked at each evaluation. Results confirmed that cluster scores were generally stable over time although the Low Immediate Memory group's Immediate Memory index score regressed upward toward the mean by the third assessment. Of interest, individuals in the Below Average group had substantial dropout between the first and third assessments. Results are interpreted through a clinical framework to explore how RBANS cluster profiles may have predictive value in general neurocognitive functioning over the observed time period and be potentially influenced by general health factors.
Collapse
Affiliation(s)
- Nicholas S Thaler
- a Department of Psychiatry and Biobehavioral Sciences , UCLA Semel Institute , Los Angeles , CA , USA
| | | | | | | | | | | |
Collapse
|
45
|
Executive functions in clinical and preclinical Alzheimer's disease. Rev Neurol (Paris) 2013; 169:695-708. [DOI: 10.1016/j.neurol.2013.07.020] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2013] [Revised: 07/23/2013] [Accepted: 07/23/2013] [Indexed: 01/18/2023]
|
46
|
Abstract
BACKGROUND To date evidence of the relationship between cognition and Aβ amyloid during the early stages of Alzheimer's Disease (AD) has been inconsistent. This study aimed to describe the nature and magnitude of the relationship between Aβ amyloid and cognitive performance of individuals without dementia. METHODS Composite cognitive measures were developed from the Australian Imaging Biomarkers and Lifestyle study neuropsychological test battery using data from 768 healthy older adults and 133 adults with mild cognitive impairment (MCI). A subgroup of this sample (174 healthy, 53 MCI) underwent neuroimaging for Aβ amyloid. RESULTS Within the MCI group individuals with high Aβ amyloid showed selective impairment for memory compared with those with low Aβ amyloid; however, this difference was not evident in the healthy group. CONCLUSIONS The current findings provide further evidence of the relationship between Aβ amyloid and cognition, with memory impairment being the primary symptom of the underlying disease during the prodromal phases of AD.
Collapse
|
47
|
Gross AL, Manly JJ, Pa J, Johnson JK, Park LQ, Mitchell MB, Melrose RJ, Inouye SK, McLaren DG. Cortical signatures of cognition and their relationship to Alzheimer's disease. Brain Imaging Behav 2012; 6:584-98. [PMID: 22718430 PMCID: PMC3553578 DOI: 10.1007/s11682-012-9180-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Recent changes in diagnostic criteria for Alzheimer's disease (AD) state that biomarkers can enhance certainty in a diagnosis of AD. In the present study, we combined cognitive function and brain morphology, a potential imaging biomarker, to predict conversion from mild cognitive impairment to AD. We identified four biomarkers, or cortical signatures of cognition (CSC), from regressions of cortical thickness on neuropsychological factors representing memory, executive function/processing speed, language, and visuospatial function among participants in the Alzheimer's Disease Neuroimaging Initiative (ADNI). Neuropsychological factor scores were created from a previously validated multidimensional factor structure of the neuropsychological battery in ADNI. Mean thickness of each CSC at the baseline study visit was used to evaluate risk of conversion to clinical AD among participants with mild cognitive impairment (MCI) and rate of decline on the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB) score. Of 307 MCI participants, 119 converted to AD. For all domain-specific CSC, a one standard deviation thinner cortical thickness was associated with an approximately 50% higher hazard of conversion and an increase of approximately 0.30 points annually on the CDR-SB. In combined models with a domain-specific CSC and neuropsychological factor score, both CSC and factor scores predicted conversion to AD and increasing clinical severity. The present study indicated that factor scores and CSCs for memory and language both significantly predicted risk of conversion to AD and accelerated deterioration in dementia severity. We conclude that predictive models are best when they utilize both neuropsychological measures and imaging biomarkers.
Collapse
Affiliation(s)
- Alden L Gross
- Institute for Aging Research, Harvard Medical School, Hebrew SeniorLife, 1200 Centre Street, Rm. 634, Boston, MA, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Mungas D, Crane PK, Gibbons LE, Manly JJ, Glymour MM, Jones RN. Advanced psychometric analysis and the Alzheimer's Disease Neuroimaging Initiative: reports from the 2011 Friday Harbor conference. Brain Imaging Behav 2012; 6:485-8. [PMID: 23232798 PMCID: PMC3532555 DOI: 10.1007/s11682-012-9211-2] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
This article summarizes a special series of articles from The Advanced Psychometric Methods in Cognitive Aging Research conference, held in June, 2011 at Friday Harbor, Washington. This conference used data from the Alzheimer's Disease Neuroimaging Initiative (ADNI) to address cognitive change associated with Alzheimer's disease (AD) and how it related to neuroimaging, genetic, and cerebrospinal fluid biomarkers. The 13 articles in this series present innovative approaches to measuring cognition and studying determinants of cognitive decline in AD.
Collapse
Affiliation(s)
- Dan Mungas
- Department of Neurology, University of California, Davis, Davis, CA, USA.
| | | | | | | | | | | |
Collapse
|