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Papp KV, Jutten RJ, Soberanes D, Weizenbaum E, Hsieh S, Molinare C, Buckley R, Betensky RA, Marshall GA, Johnson KA, Rentz DM, Sperling R, Amariglio RE. Early Detection of Amyloid-Related Changes in Memory among Cognitively Unimpaired Older Adults with Daily Digital Testing. Ann Neurol 2024; 95:507-517. [PMID: 37991080 PMCID: PMC10922126 DOI: 10.1002/ana.26833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2023] [Revised: 09/28/2023] [Accepted: 10/23/2023] [Indexed: 11/23/2023]
Abstract
OBJECTIVE This study was undertaken to determine whether assessing learning over days reveals Alzheimer disease (AD) biomarker-related declines in memory consolidation that are otherwise undetectable with single time point assessments. METHODS Thirty-six (21.9%) cognitively unimpaired older adults (aged 60-91 years) were classified with elevated β-amyloid (Aβ+) and 128 (78%) were Aβ- using positron emission tomography with 11C Pittsburgh compound B. Participants completed the multiday Boston Remote Assessment for Neurocognitive Health (BRANCH) for 12 min/day on personal devices (ie, smartphones, laptops), which captures the trajectory of daily learning of the same content on 3 repeated tests (Digit Signs, Groceries-Prices, Face-Name). Learning is computed as a composite of accuracy across all 3 measures. Participants also completed standard in-clinic cognitive tests as part of the Preclinical Alzheimer's Cognitive Composite (PACC-5), with 123 participants undergoing PACC-5 follow-up after 1.07 (standard deviation = 0.25) years. RESULTS At the cross-section, there were no statistically significant differences in performance between Aβ+/- participants on any standard in-clinic cognitive tests (eg, PACC-5) or on day 1 of multiday BRANCH. Aβ+ participants exhibited diminished 7-day learning curves on multiday BRANCH after 4 days of testing relative to Aβ- participants (Cohen d = 0.49, 95% confidence interval = 0.10-0.87). Diminished learning curves were associated with greater annual PACC-5 decline (r = 0.54, p < 0.001). INTERPRETATION Very early Aβ-related memory declines can be revealed by assessing learning over days, suggesting that failures in memory consolidation predate other conventional amnestic deficits in AD. Repeated digital memory assessments, increasingly feasible and uniquely able to assess memory consolidation over short time periods, have the potential to be transformative for detecting the earliest cognitive changes in preclinical AD. ANN NEUROL 2024;95:507-517.
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Affiliation(s)
- Kathryn V. Papp
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Roos J. Jutten
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Daniel Soberanes
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Emma Weizenbaum
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, 02129
| | - Stephanie Hsieh
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Cassidy Molinare
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Rachel Buckley
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Rebecca A. Betensky
- Department of Biostatistics, New York University School of Global Public Health, New York, NY, 10003
| | - Gad A. Marshall
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Keith A Johnson
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
- Department of Radiology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Dorene M. Rentz
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Reisa Sperling
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
| | - Rebecca E. Amariglio
- Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts 02115
- Department of Neurology, Massachusetts General Hospital, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts 02114
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Jutten RJ, Amariglio RE, Maruff P, Properzi MJ, Rentz DM, Johnson KA, Sperling RA, Papp KV. Increased intraindividual variability in reaction time performance is associated with emerging cognitive decline in cognitively unimpaired adults. Neuropsychology 2024; 38:184-197. [PMID: 37971861 DOI: 10.1037/neu0000928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
OBJECTIVE To investigate whether intraindividual variability (IIV) in reaction time (RT) over monthly administered cognitive tasks is increased in cognitively unimpaired older adults who are at risk for cognitive decline, and whether this is independent of mean RT performance. METHOD N = 109 cognitively unimpaired individuals (age 77.4 ± 5.0, 61.5% female, Mini-Mental State Examination 29.1 ± 1.3) from the Harvard Aging Brain Study completed the self-administered Computerized Cognitive Composite (C3) monthly at home for up to 1 year (12.7 ± 3.2 C3 assessments). Baseline C3 assessment coincided with routine in-clinic visits, including amyloid and tau positron emission tomography imaging and standardized cognitive testing, with cognitive testing repeated annually (1.6 ± 1.2 years follow-up). The C3 includes two simple RT tasks and two complex RT tasks. IIV estimates were derived by computing intraindividual standard deviations on residual RT scores after regressing out age and session order effects. Cross-sectional associations of IIV with cognition (global cognition, memory, executive functions [EF], processing speed) and amyloid and tau burden were examined using linear regression analyses correcting for demographics and mean RT. The association between IIV and cognitive decline was assessed using linear mixed models correcting for demographic factors, mean RT, and amyloid burden. RESULTS After adjusting for mean RT, increased IIV on complex RT tasks was independently associated with worse EF performance (β = -0.10, 95% CI [-.16, -0.03], p = .004), greater inferior-temporal tau deposition (β = 0.18, 95% CI [0.02, 0.34], p = .024), and faster cognitive decline in those with elevated amyloid (β = -0.62, 95% CI [-1.18, -0.06], p = .033). CONCLUSIONS Increased variability in monthly RT may reflect subtle EF deficits and provide unique information about short-term cognitive decline in preclinical Alzheimer's disease. (PsycInfo Database Record (c) 2024 APA, all rights reserved).
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Affiliation(s)
- Roos J Jutten
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Rebecca E Amariglio
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | | | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Dorene M Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Keith A Johnson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - Kathryn V Papp
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
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Dubbelman MA, Postema MC, Jutten RJ, Harrison JE, Ritchie CW, Aleman A, de Jong FJ, Schalet BD, Terwee CB, van der Flier WM, Scheltens P, Sikkes SAM. What's in a score: A longitudinal investigation of scores based on item response theory and classical test theory for the Amsterdam Instrumental Activities of Daily Living Questionnaire in cognitively normal and impaired older adults. Neuropsychology 2024; 38:96-105. [PMID: 37676135 DOI: 10.1037/neu0000914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/08/2023] Open
Abstract
OBJECTIVE We aimed to investigate whether item response theory (IRT)-based scoring allows for a more accurate, responsive, and less biased assessment of everyday functioning than traditional classical test theory (CTT)-based scoring, as measured with the Amsterdam Instrumental Activities of Daily Living Questionnaire. METHOD In this longitudinal multicenter study including cognitively normal and impaired individuals, we examined IRT-based and CTT-based score distributions and differences between diagnostic groups using linear regressions, and investigated scale attenuation. We compared change over time between scoring methods using linear mixed models with random intercepts and slopes for time. RESULTS Two thousand two hundred ninety-four participants were included (66.6 ± 7.7 years, 54% female): n = 2,032 (89%) with normal cognition, n = 93 (4%) with subjective cognitive decline, n = 79 (3%) with mild cognitive impairment, and n = 91 (4%) with dementia. At baseline, IRT-based and CTT-based scores were highly correlated (r = -0.92). IRT-based scores showed less scale attenuation than CTT-based scores. In a subsample of n = 1,145 (62%) who were followed for a mean of 1.3 (SD = 0.6) years, IRT-based scores declined significantly among cognitively normal individuals (unstandardized coefficient [B] = -0.15, 95% confidence interval, 95% CI [-0.28, -0.03], effect size = -0.02), whereas CTT-based scores did not (B = 0.20, 95% CI [-0.02, 0.41], effect size = 0.02). In the other diagnostic groups, effect sizes of change over time were similar. CONCLUSIONS IRT-based scores were less affected by scale attenuation than CTT-based scores. With regard to responsiveness, IRT-based scores showed more signal than CTT-based scores in early disease stages, highlighting the IRT-based scores' superior suitability for use in preclinical populations. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Mark A Dubbelman
- Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC
| | - Merel C Postema
- Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC
| | - Roos J Jutten
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School
| | - John E Harrison
- Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC
| | | | - André Aleman
- Department of Neurosciences, University Medical Center Groningen, University of Groningen
| | | | | | | | - Wiesje M van der Flier
- Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC
| | - Sietske A M Sikkes
- Department of Neurology, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC
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Munro CE, Boyle R, Chen X, Coughlan G, Gonzalez C, Jutten RJ, Martinez J, Orlovsky I, Robinson T, Weizenbaum E, Pluim CF, Quiroz YT, Gatchel JR, Vannini P, Amariglio R. Recent contributions to the field of subjective cognitive decline in aging: A literature review. Alzheimers Dement (Amst) 2023; 15:e12475. [PMID: 37869044 PMCID: PMC10585124 DOI: 10.1002/dad2.12475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Revised: 06/23/2023] [Accepted: 08/04/2023] [Indexed: 10/24/2023]
Abstract
Subjective cognitive decline (SCD) is defined as self-experienced, persistent concerns of decline in cognitive capacity in the context of normal performance on objective cognitive measures. Although SCD was initially thought to represent the "worried well," these concerns can be linked to subtle brain changes prior to changes in objective cognitive performance and, therefore, in some individuals, SCD may represent the early stages of an underlying neurodegenerative disease process (e.g., Alzheimer's disease). The field of SCD research has expanded rapidly over the years, and this review aims to provide an update on new advances in, and contributions to, the field of SCD in key areas and themes identified by researchers in this field as particularly important and impactful. First, we highlight recent studies examining sociodemographic and genetic risk factors for SCD, including explorations of SCD across racial and ethnic minoritized groups, and examinations of sex and gender considerations. Next, we review new findings on relationships between SCD and in vivo markers of pathophysiology, utilizing neuroimaging and biofluid data, as well as associations between SCD and objective cognitive tests and neuropsychiatric measures. Finally, we summarize recent work on interventions for SCD and areas of future growth in the field of SCD.
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Affiliation(s)
| | - Rory Boyle
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Xi Chen
- Helen Wills Neuroscience InstituteUniversity of California BerkeleyBerkeleyCaliforniaUSA
| | - Gillian Coughlan
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Christopher Gonzalez
- Department of PsychologyIllinois Institute of TechnologyChicagoIllinoisUSA
- Department of PsychiatryMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Roos J. Jutten
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Jairo Martinez
- Department of PsychiatryMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of Psychological and Brain SciencesBoston UniversityBostonMassachusettsUSA
| | - Irina Orlovsky
- Department of Psychological and Brain SciencesUniversity of Massachusetts AmherstAmherstMassachusettsUSA
| | | | - Emma Weizenbaum
- Department of PsychiatryMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Celina F. Pluim
- Brigham and Women's HospitalBostonMassachusettsUSA
- Department of PsychiatryMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of Psychological and Brain SciencesBoston UniversityBostonMassachusettsUSA
| | - Yakeel T. Quiroz
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Department of PsychiatryMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Jennifer R. Gatchel
- Department of PsychiatryMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Patrizia Vannini
- Brigham and Women's HospitalBostonMassachusettsUSA
- Department of NeurologyMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
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Jutten RJ, Papp KV, Hendrix S, Ellison N, Langbaum JB, Donohue MC, Hassenstab J, Maruff P, Rentz DM, Harrison J, Cummings J, Scheltens P, Sikkes SAM. Why a clinical trial is as good as its outcome measure: A framework for the selection and use of cognitive outcome measures for clinical trials of Alzheimer's disease. Alzheimers Dement 2023; 19:708-720. [PMID: 36086926 PMCID: PMC9931632 DOI: 10.1002/alz.12773] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/29/2022] [Accepted: 07/22/2022] [Indexed: 11/11/2022]
Abstract
A crucial aspect of any clinical trial is using the right outcome measure to assess treatment efficacy. Compared to the rapidly evolved understanding and measurement of pathophysiology in preclinical and early symptomatic stages of Alzheimer's disease (AD), relatively less progress has been made in the evolution of clinical outcome assessments (COAs) for those stages. The current paper aims to provide a benchmark for the design and evaluation of COAs for use in early AD trials. We discuss lessons learned on capturing cognitive changes in predementia stages of AD, including challenges when validating novel COAs for those early stages and necessary evidence for their implementation in clinical trials. Moving forward, we propose a multi-step framework to advance the use of more effective COAs to assess clinically meaningful changes in early AD, which will hopefully contribute to the much-needed consensus around more appropriate outcome measures to assess clinical efficacy of putative treatments. HIGHLIGHTS: We discuss lessons learned on capturing cognitive changes in predementia stages of AD. We propose a framework for the design and evaluation of performance based cognitive tests for use in early AD trials. We provide recommendations to facilitate the implementation of more effective cognitive outcome measures in AD trials.
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Affiliation(s)
- Roos J. Jutten
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Kathryn V. Papp
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | | | | | - Michael C. Donohue
- Alzheimer’s Therapeutic Research Institute, Keck School of Medicine, University of Southern California, San Diego, California, USA
| | - Jason Hassenstab
- Knight Alzheimer Disease Research Center, Department of Neurology, Washington University in St. Louis, St. Louis, Missouri, USA
| | - Paul Maruff
- Cogstate Ltd., Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Dorene M. Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
- Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - John Harrison
- Metis Cognition Ltd., Kilmington, UK
- Department of Psychiatry, Psychology & Neuroscience, King’s College London, UK
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, location VUmc, VU University, Amsterdam, The Netherlands
| | - Jeffrey Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada Las Vegas (UNLV), Las Vegas, Nevada, USA
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, location VUmc, VU University, Amsterdam, The Netherlands
| | - Sietske A. M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, location VUmc, VU University, Amsterdam, The Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Faculty of Movement and Behavioral Sciences, VU University, Amsterdam, The Netherlands
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Jutten RJ, Rentz DM, Amariglio RE, Properzi MJ, Maruff P, Johnson KA, Sperling RA, Papp KV. Fluctuations in reaction time performance as a marker of incipient amyloid‐related cognitive decline in clinically unimpaired older adults. Alzheimers Dement 2022. [DOI: 10.1002/alz.066578] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Roos J. Jutten
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Dorene M. Rentz
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | - Rebecca E. Amariglio
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
| | | | - Paul Maruff
- Cogstate Ltd. Melbourne VIC Australia
- The Florey Institute of Neuroscience and Mental Health Melbourne VIC Australia
| | - Keith A. Johnson
- Massachusetts General Hospital, Brigham and Women’s Hospital,Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Brigham and Women’s Hospital,Harvard Medical School Boston MA USA
| | - Kathryn V. Papp
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women’s Hospital, Harvard Medical School Boston MA USA
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Dubbelman MA, Verrijp M, Terwee CB, Jutten RJ, Postema MC, Barkhof F, Berckel BNM, Gillissen F, Teeuwen V, Teunissen C, van de Flier WM, Scheltens P, Sikkes SAM. Determining the Minimal Important Change of Everyday Functioning in Dementia: Pursuing Clinical Meaningfulness. Neurology 2022; 99:e954-e964. [PMID: 35641309 PMCID: PMC9502738 DOI: 10.1212/wnl.0000000000200781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Accepted: 04/11/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Decline in everyday functioning is a key clinical change in Alzheimer disease and related disorders (ADRD). An important challenge remains the determination of what constitutes a clinically meaningful change in everyday functioning. We aimed to investigate this by establishing the minimal important change (MIC): the smallest amount of change that has a meaningful effect on patients' lives. We retrospectively investigated meaningful change in a memory clinic cohort. METHODS In the first, qualitative part of the study, community-recruited informal caregivers of patients with ADRD and memory clinic clinicians completed a survey in which they judged various situations representing changes in everyday functioning. Their judgments of meaningful change were used to determine thresholds for MIC, both for decline and improvement, on the Amsterdam Instrumental Activities of Daily Living (IADL) Questionnaire. In the second, quantitative part, we applied these values in an independent longitudinal cohort study of unselected memory clinic patients. RESULTS MIC thresholds were established at the average threshold of caregivers (N = 1,629; 62.4 ± 9.5 years; 77% female) and clinicians (N = 13): -2.2 points for clinically meaningful decline and +5.0 points for clinically meaningful improvement. Memory clinic patients (N = 230; 64.3 ± 7.7 years; 39% female; 60% dementia diagnosis) were followed for 1 year, 102 (45%) of whom showed a decline larger than the MIC, after a mean of 6.7 ± 3.5 months. Patients with a dementia diagnosis and more atrophy of the medial temporal lobe had larger odds (odds ratio [OR] = 3.4, 95% CI [1.5-7.8] and OR = 5.0, 95% CI [1.2-20.0], respectively) for passing the MIC threshold for decline than those with subjective cognitive complaints and no atrophy. DISCUSSION We were able to operationalize clinically meaningful decline in IADL by determining the MIC. The usefulness of the MIC was supported by our findings from the clinical sample that nearly half of a sample of unselected memory clinic patients showed a meaningful decline in less than a year. Disease stage and medial temporal atrophy were predictors of functional decline greater than the MIC. Our findings provide guidance in interpreting changes in IADL and may help evaluate treatment effects and monitor disease progression.
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Affiliation(s)
- Mark A Dubbelman
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (M.A.D., M.V., M.C.P., F.G., V.T., W.M.F., P.S., S.A.M.S.); Department of Epidemiology and Data Science, Amsterdam UMC, The Netherlands (C.B.T., W.M.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (R.J.J.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (F.B., B.N.M.B.); Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom (F.B.); Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands (C.T.); and Faculty of Behavioural and Movement Sciences (S.A.M.S.), Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, the Netherlands.
| | - Merike Verrijp
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (M.A.D., M.V., M.C.P., F.G., V.T., W.M.F., P.S., S.A.M.S.); Department of Epidemiology and Data Science, Amsterdam UMC, The Netherlands (C.B.T., W.M.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (R.J.J.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (F.B., B.N.M.B.); Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom (F.B.); Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands (C.T.); and Faculty of Behavioural and Movement Sciences (S.A.M.S.), Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Caroline B Terwee
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (M.A.D., M.V., M.C.P., F.G., V.T., W.M.F., P.S., S.A.M.S.); Department of Epidemiology and Data Science, Amsterdam UMC, The Netherlands (C.B.T., W.M.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (R.J.J.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (F.B., B.N.M.B.); Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom (F.B.); Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands (C.T.); and Faculty of Behavioural and Movement Sciences (S.A.M.S.), Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Roos J Jutten
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (M.A.D., M.V., M.C.P., F.G., V.T., W.M.F., P.S., S.A.M.S.); Department of Epidemiology and Data Science, Amsterdam UMC, The Netherlands (C.B.T., W.M.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (R.J.J.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (F.B., B.N.M.B.); Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom (F.B.); Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands (C.T.); and Faculty of Behavioural and Movement Sciences (S.A.M.S.), Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Merel C Postema
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (M.A.D., M.V., M.C.P., F.G., V.T., W.M.F., P.S., S.A.M.S.); Department of Epidemiology and Data Science, Amsterdam UMC, The Netherlands (C.B.T., W.M.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (R.J.J.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (F.B., B.N.M.B.); Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom (F.B.); Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands (C.T.); and Faculty of Behavioural and Movement Sciences (S.A.M.S.), Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Frederik Barkhof
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (M.A.D., M.V., M.C.P., F.G., V.T., W.M.F., P.S., S.A.M.S.); Department of Epidemiology and Data Science, Amsterdam UMC, The Netherlands (C.B.T., W.M.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (R.J.J.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (F.B., B.N.M.B.); Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom (F.B.); Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands (C.T.); and Faculty of Behavioural and Movement Sciences (S.A.M.S.), Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Bart N M Berckel
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (M.A.D., M.V., M.C.P., F.G., V.T., W.M.F., P.S., S.A.M.S.); Department of Epidemiology and Data Science, Amsterdam UMC, The Netherlands (C.B.T., W.M.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (R.J.J.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (F.B., B.N.M.B.); Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom (F.B.); Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands (C.T.); and Faculty of Behavioural and Movement Sciences (S.A.M.S.), Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Freek Gillissen
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (M.A.D., M.V., M.C.P., F.G., V.T., W.M.F., P.S., S.A.M.S.); Department of Epidemiology and Data Science, Amsterdam UMC, The Netherlands (C.B.T., W.M.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (R.J.J.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (F.B., B.N.M.B.); Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom (F.B.); Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands (C.T.); and Faculty of Behavioural and Movement Sciences (S.A.M.S.), Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Vivianne Teeuwen
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (M.A.D., M.V., M.C.P., F.G., V.T., W.M.F., P.S., S.A.M.S.); Department of Epidemiology and Data Science, Amsterdam UMC, The Netherlands (C.B.T., W.M.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (R.J.J.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (F.B., B.N.M.B.); Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom (F.B.); Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands (C.T.); and Faculty of Behavioural and Movement Sciences (S.A.M.S.), Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Charlotte Teunissen
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (M.A.D., M.V., M.C.P., F.G., V.T., W.M.F., P.S., S.A.M.S.); Department of Epidemiology and Data Science, Amsterdam UMC, The Netherlands (C.B.T., W.M.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (R.J.J.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (F.B., B.N.M.B.); Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom (F.B.); Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands (C.T.); and Faculty of Behavioural and Movement Sciences (S.A.M.S.), Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Wiesje M van de Flier
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (M.A.D., M.V., M.C.P., F.G., V.T., W.M.F., P.S., S.A.M.S.); Department of Epidemiology and Data Science, Amsterdam UMC, The Netherlands (C.B.T., W.M.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (R.J.J.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (F.B., B.N.M.B.); Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom (F.B.); Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands (C.T.); and Faculty of Behavioural and Movement Sciences (S.A.M.S.), Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Philip Scheltens
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (M.A.D., M.V., M.C.P., F.G., V.T., W.M.F., P.S., S.A.M.S.); Department of Epidemiology and Data Science, Amsterdam UMC, The Netherlands (C.B.T., W.M.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (R.J.J.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (F.B., B.N.M.B.); Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom (F.B.); Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands (C.T.); and Faculty of Behavioural and Movement Sciences (S.A.M.S.), Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, the Netherlands
| | - Sietske A M Sikkes
- From the Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (M.A.D., M.V., M.C.P., F.G., V.T., W.M.F., P.S., S.A.M.S.); Department of Epidemiology and Data Science, Amsterdam UMC, The Netherlands (C.B.T., W.M.F.); Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston (R.J.J.); Department of Radiology and Nuclear Medicine, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, The Netherlands (F.B., B.N.M.B.); Institutes of Neurology and Healthcare Engineering, University College London, United Kingdom (F.B.); Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, The Netherlands (C.T.); and Faculty of Behavioural and Movement Sciences (S.A.M.S.), Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam, the Netherlands
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Vonk JMJ, Gross AL, Zammit AR, Bertola L, Avila JF, Jutten RJ, Gaynor LS, Suemoto CK, Kobayashi LC, O’Connell ME, Elugbadebo O, Amofa PA, Staffaroni AM, Arce Rentería M, Turney IC, Jones RN, Manly JJ, Lee J, Zahodne LB. Cross-national harmonization of cognitive measures across HRS HCAP (USA) and LASI-DAD (India). PLoS One 2022; 17:e0264166. [PMID: 35213581 PMCID: PMC8880818 DOI: 10.1371/journal.pone.0264166] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Accepted: 02/04/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND As global populations age, cross-national comparisons of cognitive health and dementia risk are increasingly valuable. It remains unclear, however, whether country-level differences in cognitive function are attributable to population differences or bias due to incommensurate measurement. To demonstrate an effective method for cross-national comparison studies, we aimed to statistically harmonize measures of episodic memory and language function across two population-based cohorts of older adults in the United States (HRS HCAP) and India (LASI-DAD). METHODS Data for 3,496 HRS HCAP (≥65 years) and 3,152 LASI-DAD (≥60 years) participants were statistically harmonized for episodic memory and language performance using confirmatory factor analysis (CFA) methods. Episodic memory and language factor variables were investigated for differential item functioning (DIF) and precision. RESULTS CFA models estimating episodic memory and language domains based on a priori adjudication of comparable items fit the data well. DIF analyses revealed that four out of ten episodic memory items and five out of twelve language items measured the underlying construct comparably across samples. DIF-modified episodic memory and language factor scores showed comparable patterns of precision across the range of the latent trait for each sample. CONCLUSIONS Harmonization of cognitive measures will facilitate future investigation of cross-national differences in cognitive performance and differential effects of risk factors, policies, and treatments, reducing study-level measurement and administrative influences. As international aging studies become more widely available, advanced statistical methods such as those described in this study will become increasingly central to making universal generalizations and drawing valid conclusions about cognitive aging of the global population.
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Affiliation(s)
- Jet M. J. Vonk
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Alden L. Gross
- Department of Epidemiology, Center on Aging and Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, United States of America
| | - Andrea R. Zammit
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, United States of America
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois, United States of America
| | - Laiss Bertola
- Medical School, University of Sao Paulo, Sao Paulo, São Paulo, Brazil
| | - Justina F. Avila
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
| | - Roos J. Jutten
- Alzheimer Center & Department of Neurology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam Neuroscience, Amsterdam, the Netherlands
| | - Leslie S. Gaynor
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, Florida, United States of America
| | - Claudia K. Suemoto
- Division of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, São Paulo, Brazil
| | - Lindsay C. Kobayashi
- Department of Epidemiology, Center for Social Epidemiology and Population Health, University of Michigan School of Public Health, Ann Arbor, Michigan, United States of America
| | - Megan E. O’Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | | | - Priscilla A. Amofa
- Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida, United States of America
| | - Adam M. Staffaroni
- Department of Neurology, Memory and Aging Center, Weill Institute for Neurosciences, University of California at San Francisco (UCSF), San Francisco, California, United States of America
| | - Miguel Arce Rentería
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
| | - Indira C. Turney
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
| | - Richard N. Jones
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, Rhode Island, United States of America
| | - Jennifer J. Manly
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, United States of America
| | - Jinkook Lee
- Center for Economic and Social Research & Department of Economics, Dornsife College of Letters, Arts, and Sciences, University of Southern California, Los Angeles, USA and RAND Corporation, Santa Monica, California, United States of America
| | - Laura B. Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, United States of America
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9
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Jutten RJ, Thompson L, Sikkes SA, Maruff P, Molinuevo JL, Zetterberg H, Alber J, Faust D, Gauthier S, Gold M, Harrison J, Lee AK, Snyder PJ. A Neuropsychological Perspective on Defining Cognitive Impairment in the Clinical Study of Alzheimer’s Disease: Towards a More Continuous Approach. J Alzheimers Dis 2022; 86:511-524. [DOI: 10.3233/jad-215098] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The global fight against Alzheimer’s disease (AD) poses unique challenges for the field of neuropsychology. Along with the increased focus on early detection of AD pathophysiology, characterizing the earliest clinical stage of the disease has become a priority. We believe this is an important time for neuropsychology to consider how our approach to the characterization of cognitive impairment can be improved to detect subtle cognitive changes during early-stage AD. The present article aims to provide a critical examination of how we define and measure cognitive status in the context of aging and AD. First, we discuss pitfalls of current methods for defining cognitive impairment within the context of research shifting to earlier (pre)symptomatic disease stages. Next, we introduce a shift towards a more continuous approach for identifying early markers of cognitive decline and characterizing progression and discuss how this may be facilitated by novel assessment approaches. Finally, we summarize potential implications and challenges of characterizing cognitive status using a continuous approach.
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Affiliation(s)
- Roos J. Jutten
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Louisa Thompson
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Memory and Aging Program, Butler Hospital, Providence, RI, USA
| | - Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
| | - Paul Maruff
- The Florey Institute of Neuroscience and Mental Health, Melbourne, VIC, Australia
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain
- Alzheimer’s Disease and Other Cognitive Disorders Unit, Hospital Clinic, Barcelona, Spain
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience & Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Jessica Alber
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, The University of Rhode Island, Kingston, RI, USA
- George and Anne Ryan Institute for Neuroscience, University of Rhode Island, Kingston, RI, USA
| | - David Faust
- Department of Psychology, University of Rhode Island, Kingston, RI, USA
| | | | | | - John Harrison
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam UMC, Vrije Universiteit, Amsterdam, the Netherlands
- Metis Cognition Ltd, Kilmington Common, UK
- Institute of Psychiatry, Psychology & Neuroscience, King’s College London, UK
| | - Athene K.W. Lee
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, RI, USA
- Memory and Aging Program, Butler Hospital, Providence, RI, USA
| | - Peter J. Snyder
- Department of Biomedical and Pharmaceutical Sciences, College of Pharmacy, The University of Rhode Island, Kingston, RI, USA
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10
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Jutten RJ, Rentz DM, Fu JF, Mayblyum DV, Amariglio RE, Buckley RF, Properzi MJ, Maruff P, Stark CE, Yassa MA, Johnson KA, Sperling RA, Papp KV. Monthly At-Home Computerized Cognitive Testing to Detect Diminished Practice Effects in Preclinical Alzheimer's Disease. Front Aging Neurosci 2022; 13:800126. [PMID: 35095476 PMCID: PMC8792465 DOI: 10.3389/fnagi.2021.800126] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Accepted: 12/14/2021] [Indexed: 01/12/2023] Open
Abstract
Introduction: We investigated whether monthly assessments of a computerized cognitive composite (C3) could aid in the detection of differences in practice effects (PE) in clinically unimpaired (CU) older adults, and whether diminished PE were associated with Alzheimer's disease (AD) biomarkers and annual cognitive decline. Materials and Methods: N = 114 CU participants (age 77.6 ± 5.0, 61% female, MMSE 29 ± 1.2) from the Harvard Aging Brain Study completed the self-administered C3 monthly, at-home, on an iPad for one year. At baseline, participants underwent in-clinic Preclinical Alzheimer's Cognitive Composite-5 (PACC5) testing, and a subsample (n = 72, age = 77.8 ± 4.9, 59% female, MMSE 29 ± 1.3) had 1-year follow-up in-clinic PACC5 testing available. Participants had undergone PIB-PET imaging (0.99 ± 1.6 years before at-home baseline) and Flortaucipir PET imaging (n = 105, 0.62 ± 1.1 years before at-home baseline). Linear mixed models were used to investigate change over months on the C3 adjusting for age, sex, and years of education, and to extract individual covariate-adjusted slopes over the first 3 months. We investigated the association of 3-month C3 slopes with global amyloid burden and tau deposition in eight predefined regions of interest, and conducted Receiver Operating Characteristic analyses to examine how accurately 3-month C3 slopes could identify individuals that showed >0.10 SD annual decline on the PACC-5. Results: Overall, individuals improved on all C3 measures over 12 months (β = 0.23, 95% CI [0.21-0.25], p < 0.001), but improvement over the first 3 months was greatest (β = 0.68, 95% CI [0.59-0.77], p < 0.001), suggesting stronger PE over initial repeated exposures. However, lower PE over 3 months were associated with more global amyloid burden (r = -0.20, 95% CI [-0.38 - -0.01], p = 0.049) and tau deposition in the entorhinal cortex (r = -0.38, 95% CI [-0.54 - -0.19], p < 0.001) and inferior-temporal lobe (r = -0.23, 95% CI [-0.41 - -0.02], p = 0.03). 3-month C3 slopes exhibited good discriminative ability to identify PACC-5 decliners (AUC 0.91, 95% CI [0.84-0.98]), which was better than baseline C3 (p < 0.001) and baseline PACC-5 scores (p = 0.02). Conclusion: While PE are commonly observed among CU adults, diminished PE over monthly cognitive testing are associated with greater AD biomarker burden and cognitive decline. Our findings imply that unsupervised computerized testing using monthly retest paradigms can provide rapid detection of diminished PE indicative of future cognitive decline in preclinical AD.
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Affiliation(s)
- Roos J. Jutten
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Dorene M. Rentz
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Jessie F. Fu
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Danielle V. Mayblyum
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Rebecca E. Amariglio
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Rachel F. Buckley
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, VIC, Australia
| | - Michael J. Properzi
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Paul Maruff
- CogState Ltd., Melbourne, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Melbourne, VIC, Australia
| | - Craig E. Stark
- Department of Neurobiology and Behavior, Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, United States
| | - Michael A. Yassa
- Department of Neurobiology and Behavior, Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, United States
| | - Keith A. Johnson
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
| | - Reisa A. Sperling
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
| | - Kathryn V. Papp
- Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States
- Department of Neurology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, United States
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11
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Verrijp M, Dubbelman MA, Visser LNC, Jutten RJ, Nijhuis EW, Zwan MD, van Hout HPJ, Scheltens P, van der Flier WM, Sikkes SAM. Everyday Functioning in a Community-Based Volunteer Population: Differences Between Participant- and Study Partner-Report. Front Aging Neurosci 2022; 13:761932. [PMID: 35069172 PMCID: PMC8767803 DOI: 10.3389/fnagi.2021.761932] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Accepted: 11/16/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Impaired awareness in dementia caused by Alzheimer's disease and related disorders made study partner-report the preferred method of measuring interference in "instrumental activities of daily living" (IADL). However, with a shifting focus toward earlier disease stages and prevention, the question arises whether self-report might be equally or even more appropriate. The aim of this study was to investigate how participant- and study partner-report IADL perform in a community-based volunteer population without dementia and which factors relate to differences between participant- and study partner-report. Methods: Participants (N = 3,288; 18-97 years, 70.4% females) and their study partners (N = 1,213; 18-88 years, 45.8% females) were recruited from the Dutch Brain Research Registry. IADL were measured using the Amsterdam IADL Questionnaire. The concordance between participant- and study partner-reported IADL difficulties was examined using intraclass correlation coefficient (ICC). Multinomial logistic regressions were used to investigate which demographic, cognitive, and psychosocial factors related to participant and study partner differences, by looking at the over- and underreport of IADL difficulties by the participant, relative to their study partner. Results: Most A-IADL-Q scores represented no difficulties for both participants (87.9%) and study partners (89.4%). The concordance between participants and study partners was moderate (ICC = 0.55, 95% confidence interval [CI] = [0.51, 0.59]); 24.5% (N = 297) of participants overreported their IADL difficulties compared with study partners, and 17.8% (N = 216) underreported difficulties. The presence of depressive symptoms (odds ratio [OR] = 1.31, 95% CI = [1.12, 1.54]), as well as memory complaints (OR = 2.45, 95% CI = [1.80, 3.34]), increased the odds of participants overreporting their IADL difficulties. Higher IADL ratings decreased the odds of participant underreport (OR = 0.71, 95% CI = [0.67, 0.74]). Conclusion: In this sample of community-based volunteers, most participants and study partners reported no major IADL difficulties. Differences between participant and study partner were, however, quite prevalent, with subjective factors indicative of increased report of IADL difficulties by the participant in particular. These findings suggest that self- and study partner-report measures may not be interchangeable, and that the level of awareness needs to be considered, even in cognitively healthy individuals.
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Affiliation(s)
- Merike Verrijp
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Mark A. Dubbelman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Leonie N. C. Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Elke W. Nijhuis
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Marissa D. Zwan
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Hein P. J. van Hout
- Department of General Practice and Medicine for Older Persons, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Wiesje M. van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam UMC, Amsterdam, Netherlands
| | - Sietske A. M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
- Faculty of Behavioural and Movement Sciences, Clinical Developmental Psychology, Clinical Neuropsychology, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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12
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Dubbelman MA, Jutten RJ, Harrison JE, Ritchie CW, Aleman A, de Jong FJ, Scheltens P, Sikkes SA. Capturing functional change in early Alzheimer’s disease: Comparing instruments and scoring techniques to detect subtle decline. Alzheimers Dement 2021. [DOI: 10.1002/alz.053749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mark A. Dubbelman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - John E Harrison
- King's College ‐ Institute of Psychiatry, Psychology & Neuroscience London United Kingdom
- Metis Cognition Ltd. Kilmington United Kingdom
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam Netherlands
| | - Craig W. Ritchie
- Centre for Clinical Brain Sciences, The University of Edinburgh Edinburgh United Kingdom
| | - André Aleman
- University of Groningen, University Medical Center Groningen Groningen Netherlands
| | - Frank Jan de Jong
- Department of Neurology & Alzheimer Center Erasmus MC, Erasmus Medical Center Rotterdam Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center, Amsterdam, Netherlands Amsterdam Netherlands
| | - Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
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13
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Jutten RJ, Amariglio RE, Properzi MJ, Buckley RF, Maruff PT, Stark CE, Yassa MA, Johnson KA, Sperling RA, Rentz DM, Papp KV. Monthly computerized at‐home assessments to detect cognitive change in preclinical Alzheimer’s disease. Alzheimers Dement 2021. [DOI: 10.1002/alz.056055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Roos J. Jutten
- Massachusetts General Hospital Boston MA USA
- Harvard Medical School Boston MA USA
| | - Rebecca E. Amariglio
- Harvard Medical School Boston MA USA
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Michael J Properzi
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Rachel F. Buckley
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital/Harvard Medical School Boston MA USA
- Melbourne School of Psychological Sciences, University of Melbourne Melbourne VIC Australia
| | - Paul T Maruff
- Cogstate Ltd. Melbourne VIC Australia
- The Florey Institute of Neuroscience and Mental Health Melbourne VIC Australia
| | | | | | - Keith A. Johnson
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Reisa A. Sperling
- Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Boston MA USA
| | - Dorene M. Rentz
- Harvard Medical School Boston MA USA
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Kate V. Papp
- Massachusetts General Hospital Boston MA USA
- Harvard Medical School Boston MA USA
- Brigham and Women's Hospital Boston MA USA
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Verrijp M, Dubbelman MA, Visser LN, Jutten RJ, Nijhuis EW, Van Hout HPJ, Scheltens P, van der Flier WM, Sikkes SA. Everyday functioning in a community‐based volunteer population: Factors associated with concordance between participant and study partner—Report. Alzheimers Dement 2021. [DOI: 10.1002/alz.055576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Merike Verrijp
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Mark A. Dubbelman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Leonie N.C. Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet Stockholm Sweden
| | - Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Elke W Nijhuis
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Hein PJ Van Hout
- Amsterdam Public Health Research Institute, Amsterdam University Medical Center, Vrije Universiteit Amsterdam Netherlands
| | | | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
- Faculty of Behavioural and Movement Sciences, Clinical Developmental Psychology & Clinical Neuropsychology, Vrije Universiteit Amsterdam Amsterdam Netherlands
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15
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Foldi NS, Tommet D, Rabin L, Lamar M, Jones RN, Mungas DM, Choi S, Grandoit E, Mukherjee S, Jutten RJ, Sikkes SA, Zhu R, Crane PK. Animal fluency improvements and confrontation naming declines over 6 months are associated with differential conversion from MCI to AD in ADNI. Alzheimers Dement 2021. [DOI: 10.1002/alz.055507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Nancy S. Foldi
- City University of New York
- Queens College & Graduate Center Queens NY USA
- NYU Langone Health Mineola NY USA
| | | | | | - Melissa Lamar
- Rush Alzheimer's Disease Center Chicago IL USA
- Rush University Medical Center Chicago IL USA
| | | | - Dan M. Mungas
- University of California, Davis School of Medicine Sacramento CA USA
| | | | | | | | | | - Sietske A.M. Sikkes
- VU University, Department of Clinical, Neuro and Developmental Psychology Amsterdam Netherlands
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Ryoui Zhu
- University of Washington Seattle WA USA
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16
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Ulugut H, Stek S, Wagemans LEE, Jutten RJ, Keulen MA, Bouwman FH, Prins ND, Lemstra AW, Krudop W, Teunissen CE, van Berckel BNM, Ossenkoppele R, Barkhof F, van der Flier WM, Scheltens P, Pijnenburg YAL. The natural history of primary progressive aphasia: beyond aphasia. J Neurol 2021; 269:1375-1385. [PMID: 34216263 PMCID: PMC8857134 DOI: 10.1007/s00415-021-10689-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 06/15/2021] [Accepted: 06/24/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Primary progressive aphasia (PPA) is divided into three prototypical subtypes that are all characterized by their single core symptom of aphasia. Although later in their course, other cognitive, behavioral, and motor domains may become involved, little is known about the progression profile of each subtype relative to the other subtypes. METHODS In this longitudinal retrospective cohort study, based on the recent biomarker-supported diagnostic criteria, 24 subjects diagnosed with semantic variant (svPPA), 22 with non-fluent variant (nfvPPA), and 18 with logopenic variant (lvPPA) were collected and followed up for 1-6 years. Symptom distribution, cognitive test and neuropsychiatric inventory scores, and progression into another syndrome were assessed. RESULTS Over time, lvPPA progressed with broader language problems (PPA-extended) and nfvPPA progressed to mutism, whereas semantic impairment remained the major problem in svPPA. Apart from linguistic problems, svPPA developed pronounced behavioral disturbances, whereas lvPPA exhibited a greater cognitive decline. By contrast, in nfvPPA motor deficits were more common. Furthermore, within 5 years (IQR = 2.5) after clinical onset, 65.6% of the patients additionally fulfilled the clinical criteria for another neurodegenerative syndrome (PPA-plus). Fourteen out of 24 (58%) svPPA patients additionally met the diagnostic criteria of behavioral variant frontotemporal dementia (5.1 years, IQR = 1.1), whereas the clinical features of 15/18 (83%) lvPPA patients were consistent with Alzheimer disease dementia (4.5 years IQR = 3.4). Furthermore, 12/22 (54%) of the subjects with the nfvPPA progressed to meet the diagnostic criteria of corticobasal syndrome, progressive supranuclear palsy, or motor neuron disease (5.1 years IQR = 3.4). DISCUSSION Despite aphasia being the initial and unique hallmark of the syndrome, our longitudinal results showed that PPA is not a language limited disorder and progression differs widely for each subtype, both with respect to the nature of symptoms and disease duration.
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Affiliation(s)
- Hulya Ulugut
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands.
| | - Simone Stek
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Lianne E E Wagemans
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Roos J Jutten
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Maria Antoinette Keulen
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Femke H Bouwman
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Niels D Prins
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Afina W Lemstra
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Welmoed Krudop
- Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Charlotte E Teunissen
- Neurological Laboratory Clinical Chemistry, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bart N M van Berckel
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Rik Ossenkoppele
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Clinical Memory Research Unit, Lund University, Lund, Sweden
| | - Frederik Barkhof
- Department of Radiology and Nuclear Medicine, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- UCL Institutes of Neurology and Healthcare Engineering, University College London, London, UK
| | - Wiesje M van der Flier
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
- Department of Epidemiology and Biostatistics, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Philip Scheltens
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
| | - Yolande A L Pijnenburg
- Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, De Boelelaan 1118, 1081 HZ, Amsterdam, The Netherlands
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17
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Jutten RJ, Sikkes SAM, Van der Flier WM, Scheltens P, Visser PJ, Tijms BM. Finding Treatment Effects in Alzheimer Trials in the Face of Disease Progression Heterogeneity. Neurology 2021; 96:e2673-e2684. [PMID: 34550903 PMCID: PMC8205463 DOI: 10.1212/wnl.0000000000012022] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Accepted: 03/03/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To investigate the influence of heterogeneity in disease progression for detecting treatment effects in Alzheimer disease (AD) trials, using a simulation study. METHODS Individuals with an abnormal amyloid PET scan, diagnosis of mild cognitive impairment or dementia, baseline Mini-Mental State Examination (MMSE) score ≥24, global Clinical Dementia Rating (CDR) score of 0.5, and ≥1 follow-up cognitive assessment were selected from the Alzheimer's Disease Neuroimaging Initiative database (n = 302, age 73 ± 6.7; 44% female; 16.1 ± 2.7 years of education; 69% APOE ε4 carrier). We simulated a clinical trial by randomly assigning individuals to a "placebo" and "treatment" group and subsequently computed group differences on the CDR-sum of boxes (CDR-SB), Alzheimer's Disease Assessment Scale-cognitive subscale-13 and MMSE after 18 months follow-up. We repeated this simulation 10,000 times to determine the 95% range of effect sizes. We further studied the influence of known AD risk factors (age, sex, education, APOE ε4 status, CSF total tau levels) on the variability in effect sizes. RESULTS Individual trajectories on all cognitive outcomes were highly variable, and the 95% ranges of possible effect sizes at 18 months were broad (e.g., ranging from 0.35 improvement to 0.35 decline on the CDR-SB). Results of recent anti-amyloid trials mostly fell within these 95% ranges of effect sizes. APOE ε4 carriers and individuals with abnormal baseline tau levels showed faster decline at group level, but also greater within-group variability, as illustrated by broader 95% effect size ranges (e.g., ±0.70 points for the CDR-SB). CONCLUSIONS Individuals with early AD show heterogeneity in disease progression, which increases when stratifying on risk factors associated with progression. We provide guidance for a priori effect sizes on cognitive outcomes for detecting true change, which is crucial for future AD trials.
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Affiliation(s)
- Roos J Jutten
- From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC (R.J.J., S.A.M.S., W.M.V.d.F., P.S., P.J.V., B.M.T.), and Clinical Developmental Psychology & Clinical Neuropsychology (S.A.M.S.), VU University; Alzheimer Center Limburg, School for Mental Health and Neuroscience (P.J.V.), Maastricht University, the Netherlands; and Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics (P.J.V.), Karolinska Institutet, Stockholm, Sweden.
| | - Sietske A M Sikkes
- From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC (R.J.J., S.A.M.S., W.M.V.d.F., P.S., P.J.V., B.M.T.), and Clinical Developmental Psychology & Clinical Neuropsychology (S.A.M.S.), VU University; Alzheimer Center Limburg, School for Mental Health and Neuroscience (P.J.V.), Maastricht University, the Netherlands; and Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics (P.J.V.), Karolinska Institutet, Stockholm, Sweden
| | - Wiesje M Van der Flier
- From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC (R.J.J., S.A.M.S., W.M.V.d.F., P.S., P.J.V., B.M.T.), and Clinical Developmental Psychology & Clinical Neuropsychology (S.A.M.S.), VU University; Alzheimer Center Limburg, School for Mental Health and Neuroscience (P.J.V.), Maastricht University, the Netherlands; and Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics (P.J.V.), Karolinska Institutet, Stockholm, Sweden
| | - Philip Scheltens
- From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC (R.J.J., S.A.M.S., W.M.V.d.F., P.S., P.J.V., B.M.T.), and Clinical Developmental Psychology & Clinical Neuropsychology (S.A.M.S.), VU University; Alzheimer Center Limburg, School for Mental Health and Neuroscience (P.J.V.), Maastricht University, the Netherlands; and Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics (P.J.V.), Karolinska Institutet, Stockholm, Sweden
| | - Pieter Jelle Visser
- From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC (R.J.J., S.A.M.S., W.M.V.d.F., P.S., P.J.V., B.M.T.), and Clinical Developmental Psychology & Clinical Neuropsychology (S.A.M.S.), VU University; Alzheimer Center Limburg, School for Mental Health and Neuroscience (P.J.V.), Maastricht University, the Netherlands; and Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics (P.J.V.), Karolinska Institutet, Stockholm, Sweden
| | - Betty M Tijms
- From the Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC (R.J.J., S.A.M.S., W.M.V.d.F., P.S., P.J.V., B.M.T.), and Clinical Developmental Psychology & Clinical Neuropsychology (S.A.M.S.), VU University; Alzheimer Center Limburg, School for Mental Health and Neuroscience (P.J.V.), Maastricht University, the Netherlands; and Department of Neurobiology, Care Sciences and Society, Division of Neurogeriatrics (P.J.V.), Karolinska Institutet, Stockholm, Sweden
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18
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Zwan MD, van der Flier WM, Cleutjens S, Schouten TC, Vermunt L, Jutten RJ, van Maurik IS, Sikkes SA, Flenniken D, Howell T, Weiner MW, Scheltens P, Prins ND. Dutch Brain Research Registry for study participant recruitment: Design and first results. Alzheimers Dement (N Y) 2021; 7:e12132. [PMID: 33614897 PMCID: PMC7882519 DOI: 10.1002/trc2.12132] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Accepted: 11/11/2020] [Indexed: 12/12/2022]
Abstract
INTRODUCTION The Dutch Brain Research Registry aims to facilitate online recruitment of participants for brain disease studies. METHODS Registrants were primarily recruited through an online social media campaign. The registration process included a short questionnaire, which was subsequently used in the prescreening process to match participants to studies. RESULTS In the first 18 months, 17,218 registrants signed up (58±11 years old, 78% female). Out of 34,696 study invitations that were sent, 36% were accepted by registrants, of which 50% to 84% were finally enrolled, resulting in 10,661 participants in 28 studies. Compared to non-participants, study participants were more often older, male, more highly educated, retired or unemployed, non-smoking, healthier, and more often had a family member with dementia. DISCUSSION The Dutch Brain Research Registry facilitates effective matching of participants to brain disease studies. Participant factors related to study enrollment may reflect facilitators or barriers for participation, which is useful for improving recruitment strategies.
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Affiliation(s)
- Marissa D. Zwan
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Wiesje M. van der Flier
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
- Department of Epidemiology and BiostatisticsAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Solange Cleutjens
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Tamara C Schouten
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Lisa Vermunt
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
- Department of Clinical ChemistryNeurochemistry LaboratoryAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Roos J. Jutten
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Ingrid S. van Maurik
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
- Department of Epidemiology and BiostatisticsAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Sietske A.M. Sikkes
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Derek Flenniken
- Center for Imaging of Neurodegenerative Diseases (CIND)San Francisco Veterans Affair Medical CenterSan FranciscoCaliforniaUSA
| | - Taylor Howell
- Center for Imaging of Neurodegenerative Diseases (CIND)San Francisco Veterans Affair Medical CenterSan FranciscoCaliforniaUSA
| | - Michael W. Weiner
- Center for Imaging of Neurodegenerative Diseases (CIND)San Francisco Veterans Affair Medical CenterSan FranciscoCaliforniaUSA
- Department of Radiology and Biomedical ImagingUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Philip Scheltens
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
| | - Niels D. Prins
- Department of NeurologyAlzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam University Medical CenterAmsterdamthe Netherlands
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19
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Sikkes SA, Tang Y, Jutten RJ, Wesselman LM, Turkstra LS, Brodaty H, Clare L, Cassidy-Eagle E, Cox KL, Chételat G, Dautricourt S, Dhana K, Dodge H, Dröes RM, Hampstead BM, Holland T, Lampit A, Laver K, Lutz A, Lautenschlager NT, McCurry SM, Meiland FJM, Morris MC, Mueller KD, Peters R, Ridel G, Spector A, van der Steen JT, Tamplin J, Thompson Z, Bahar-Fuchs A. Toward a theory-based specification of non-pharmacological treatments in aging and dementia: Focused reviews and methodological recommendations. Alzheimers Dement 2021; 17:255-270. [PMID: 33215876 PMCID: PMC7970750 DOI: 10.1002/alz.12188] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2020] [Revised: 07/28/2020] [Accepted: 05/03/2020] [Indexed: 12/16/2022]
Abstract
INTRODUCTION Non-pharmacological treatments (NPTs) have the potential to improve meaningful outcomes for older people at risk of, or living with dementia, but research often lacks methodological rigor and continues to produce mixed results. METHODS In the current position paper, experts in NPT research have specified treatment targets, aims, and ingredients using an umbrella framework, the Rehabilitation Treatment Specification System. RESULTS Experts provided a snapshot and an authoritative summary of the evidence for different NPTs based on the best synthesis efforts, identified main gaps in knowledge and relevant barriers, and provided directions for future research. Experts in trial methodology provide best practice principles and recommendations for those working in this area, underscoring the importance of prespecified protocols. DISCUSSION We conclude that the evidence strongly supports various NPTs in relation to their primary targets, and discuss opportunities and challenges associated with a unifying theoretical framework to guide future efforts in this area.
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Affiliation(s)
- Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, VU University, Amsterdam, the Netherlands
| | - Yi Tang
- Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Disorders, Beijing, China
| | - Roos J. Jutten
- Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, VU University, Amsterdam, the Netherlands
| | - Linda M.P. Wesselman
- Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam University Medical Center, VU University Amsterdam, Amsterdam, the Netherlands
- Department of Clinical, Neuro- and Developmental Psychology, VU University, Amsterdam, the Netherlands
| | - Lyn S. Turkstra
- School of Rehabilitation Science, McMaster University, Hamilton, Ontario, Canada
| | - Henry Brodaty
- Centre for Healthy Brain Ageing and Dementia Centre for Research Collaboration, School of Psychiatry, UNSW, Sydney, Australia
| | - Linda Clare
- Centre for Research in Ageing and Cognitive Health, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Erin Cassidy-Eagle
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California, USA
| | - Kay L. Cox
- Medical School, University of Western Australia, Perth, Western Australia, Australia
| | - Gaël Chételat
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,”Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Sophie Dautricourt
- Normandie Univ, UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,”Institut Blood and Brain @ Caen-Normandie, Cyceron, Caen, France
| | - Klodian Dhana
- Section on Nutrition and Nutritional Epidemiology, Department of Internal Medicine, Rush University, Chicago, Illinois, USA
| | - Hiroko Dodge
- Department of Neurology, Oregon Health and Science University, Portland, Oregon, USA
- Department of Neurology, University of Michigan,Ann Arbor, Michigan, USA
| | - Rose-Marie Dröes
- Department of Psychiatry, Amsterdam University Medical Center, VUmc, Amsterdam, the Netherlands
| | - Benjamin M. Hampstead
- Department of Psychiatry, University of Michigan and VA Ann Arbor Healthcare System, Ann Arbor, Michigan, USA
| | - Thomas Holland
- Section on Nutrition and Nutritional Epidemiology, Department of Internal Medicine, Rush University, Chicago, Illinois, USA
| | - Amit Lampit
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Kate Laver
- Department of Rehabilitation, Aged and Extended Care, College of Medicine and Public Health Flinders University, Adelaide, Australia
| | - Antoine Lutz
- Lyon Neuroscience Research Center INSERM U1028, CNRS UMR5292, Lyon University, Lyon, France
| | - Nicola T. Lautenschlager
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
- NorthWestern Mental Health, Melbourne Health, Melbourne, Australia
| | - Susan M. McCurry
- Department of Child, Family, and Population Health Nursing, University of Washington, Seattle, Washington, USA
| | - Franka J. M. Meiland
- Department of Psychiatry, Amsterdam University Medical Center, VUmc, Amsterdam, the Netherlands
| | - Martha Clare Morris
- Section on Nutrition and Nutritional Epidemiology, Department of Internal Medicine, Rush University, Chicago, Illinois, USA
| | - Kimberly D. Mueller
- Wisconsin Alzheimer’s Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Ruth Peters
- Department of Psychology, University of New South Wales, Randwick, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | | | - Aimee Spector
- Department of Clinical, Educational & Health Psychology, University College London, London, UK
| | - Jenny T. van der Steen
- Department of Public Health and Primary Care, Leiden University Medical Center, Leiden, the Netherlands
- Department of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Jeanette Tamplin
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, Victoria, Australia
| | - Zara Thompson
- Faculty of Fine Arts and Music, University of Melbourne, Melbourne, Victoria, Australia
| | - Alex Bahar-Fuchs
- Academic Unit for Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
- Centre for Research on Ageing, Health, and Wellbeing, Research School of Population Health, The Australian National University, Canberra, Australia
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20
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Choi S, Mukherjee S, Gibbons LE, Sanders RE, Jones RN, Tommet D, Mez J, Trittschuh EH, Saykin A, Lamar M, Rabin L, Foldi NS, Sikkes S, Jutten RJ, Grandoit E, Mac Donald C, Risacher S, Groot C, Ossenkoppele R, Crane PK. Development and validation of language and visuospatial composite scores in ADNI. Alzheimers Dement (N Y) 2020; 6:e12072. [PMID: 33313380 PMCID: PMC7718716 DOI: 10.1002/trc2.12072] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 07/28/2020] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Composite scores may be useful to summarize overall language or visuospatial functioning in studies of older adults. METHODS We used item response theory to derive composite measures for language (ADNI-Lan) and visuospatial functioning (ADNI-VS) from the cognitive battery administered in the Alzheimer's Disease Neuroimaging Initiative (ADNI). We evaluated the scores among groups of people with normal cognition, mild cognitive impairment (MCI), and Alzheimer's disease (AD) in terms of responsiveness to change, association with imaging findings, and ability to differentiate between MCI participants who progressed to AD dementia and those who did not progress. RESULTS ADNI-Lan and ADNI-VS were able to detect change over time and predict conversion from MCI to AD. They were associated with most of the pre-specified magnetic resonance imaging measures. ADNI-Lan had strong associations with a cerebrospinal fluid biomarker pattern. DISCUSSION ADNI-Lan and ADNI-VS may be useful composites for language and visuospatial functioning in ADNI.
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Affiliation(s)
- Seo‐Eun Choi
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | | | - Laura E. Gibbons
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | | | - Richard N. Jones
- Department of NeurologyBrown UniversityProvidenceRhode IslandUSA
| | - Douglas Tommet
- Department of NeurologyBrown UniversityProvidenceRhode IslandUSA
| | - Jesse Mez
- Department of NeurologyBoston UniversityBostonMassachusettsUSA
| | - Emily H. Trittschuh
- Department of PsychiatryUniversity of WashingtonSeattleWashingtonUSA
- Puget Sound Veterans AdministrationGeriatric Research Education and Clinical CenterVA Puget Sound Health Care SystemSeattleWashingtonUSA
| | - Andrew Saykin
- Department of Radiology and Alzheimer's Research CenterIndiana UniversityIndianapolisIndianaUSA
| | - Melissa Lamar
- Rush Alzheimer's Disease Center and Department of Behavioral Sciences and PsychiatryRush University Medical CenterChicagoIllinoisUSA
| | - Laura Rabin
- Department of PsychologyCity University of New York–BrooklynNew YorkUSA
| | - Nancy S. Foldi
- Department of PsychologyCity University of New York–Queens CollegeNew YorkUSA
| | - Sietske Sikkes
- Alzheimer CenterAmsterdam UMC ‐ VU University Medical CenterAmsterdamthe Netherlands
| | - Roos J. Jutten
- Alzheimer CenterAmsterdam UMC ‐ VU University Medical CenterAmsterdamthe Netherlands
| | - Evan Grandoit
- Department of PsychologyNorthwestern UniversityEvanstonIllinoisUSA
| | | | - Shannon Risacher
- Department of Radiology and Alzheimer's Research CenterIndiana UniversityIndianapolisIndianaUSA
| | - Colin Groot
- Alzheimer CenterAmsterdam UMC ‐ VU University Medical CenterAmsterdamthe Netherlands
| | - Rik Ossenkoppele
- Alzheimer CenterAmsterdam UMC ‐ VU University Medical CenterAmsterdamthe Netherlands
- Clinical Memory Research UnitLund UniversityLundSweden
| | | | - Paul K. Crane
- Department of MedicineUniversity of WashingtonSeattleWashingtonUSA
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Erkoyun HU, Stek S, Wagemans L, Jutten RJ, Scheltens P, Pijnenburg YA. Beyond aphasia: Natural history of the aphasia onset dementia syndromes. Alzheimers Dement 2020. [DOI: 10.1002/alz.042105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
| | - Simone Stek
- Alzheimer Centrum Amsterdam VuMC Amsterdam Netherlands
| | | | - Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Philip Scheltens
- Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
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Dubbelman MA, Jutten RJ, Farias ST, Amariglio R, Buckley RF, Visser PJ, Rentz DM, Johnson KA, Properzi MJ, Schultz AP, Donovan N, Gatchel JR, Teunissen CE, Van Berckel BN, van Der Flier W, Sperling RA, Papp KV, Scheltens P, Marshall GA, Sikkes SA. Trajectories of decline in cognitively complex everyday activities across the Alzheimer’s disease continuum. Alzheimers Dement 2020. [DOI: 10.1002/alz.044787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Mark A. Dubbelman
- Alzheimer Center Amsterdam, Department of Neurology Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam University Medical Center Amsterdam Netherlands
| | - Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam Netherlands
| | | | | | - Rachel F. Buckley
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | | | - Dorene M. Rentz
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Keith A. Johnson
- Division of Nuclear Medicine and Molecular Imaging, Department of Radiology Massachusetts General Hospital/Harvard Medical School Boston MA USA
| | | | - Aaron P. Schultz
- Massachusetts General Hospital, Harvard Medical School Boston MA USA
| | - Nancy Donovan
- Department of Neurology Brigham and Women’s Hospital, Harvard Medical School Boston, MA, United States Boston MA USA
| | | | - Charlotte E. Teunissen
- Neurochemistry Laboratory and Biobank, Department of Clinical Chemistry Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | | | | | | | - Kathryn V. Papp
- Brigham and Women's Hospital, Harvard Medical School Boston MA USA
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Gad A. Marshall
- Center for Alzheimer Research and Treatment Brigham and Women's Hospital Boston MA USA
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Choi S, Mukherjee S, Gibbons LE, Sanders RE, Jones RN, Tommet D, Mez J, Trittschuh EH, Saykin AJ, Lamar M, Rabin L, Foldi N, Sikkes SA, Jutten RJ, Grandoit E, MacDonald C, Risacher SL, Groot C, Ossenkoppele R, Crane PK. Development and validation of composite scores for language and visuospatial functioning in ADNI. Alzheimers Dement 2020. [DOI: 10.1002/alz.045508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | | | | | - Richard N. Jones
- Warren Alpert Medical School of Brown University Providence RI USA
| | - Douglas Tommet
- Warren Alpert Medical School Brown University Providence RI USA
| | - Jesse Mez
- Boston University Alzheimer's Disease Center Boston MA USA
| | | | | | | | - Laura Rabin
- Brooklyn College of the City, University of New York Brooklyn NY USA
| | | | | | - Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Amsterdam UMC, Vrije Universiteit Amsterdam Amsterdam Netherlands
| | | | | | | | - Colin Groot
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience VU University Medical Center Amsterdam Netherlands
| | - Rik Ossenkoppele
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
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Tommet D, Choi S, Rabin L, Sikkes SA, Jutten RJ, Grandoit E, Foldi N, Jones RN, Lamar M, Gibbons LE, Mukherjee S, Lee ML, Sanders RE, Saykin AJ, Trittschuh EH, Mez J, Risacher SL, Crane PK. Six‐month decline in language, but not other cognitive domains, identifies increased risk of conversion from MCI to AD in ADNI. Alzheimers Dement 2020. [DOI: 10.1002/alz.045357] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Douglas Tommet
- Warren Alpert Medical School Brown University Providence RI USA
| | | | - Laura Rabin
- Brooklyn College of the City University of New York New York NY USA
| | | | - Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC Vrije Universiteit Amsterdam Amsterdam Netherlands
| | | | | | - Richard N. Jones
- Warren Alpert Medical School of Brown University Providence RI USA
| | | | | | | | | | | | | | | | - Jesse Mez
- Boston University Alzheimer's Disease Center Boston MA USA
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25
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Jutten RJ, Sikkes SA, Papp KV, Van Berckel BN, Teunissen CE, van Der Flier W, Scheltens P, Tijms BM. Identifying and predicting heterogeneity in cognitive decline among individuals with prodromal Alzheimer's disease using a latent class analysis. Alzheimers Dement 2020. [DOI: 10.1002/alz.045829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC Vrije Universiteit Amsterdam, Netherlands Amsterdam Netherlands
| | - Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC Vrije Universiteit Amsterdam, Netherlands Amsterdam Netherlands
| | - Kathryn V. Papp
- Brigham and Women's Hospital Harvard Medical School Boston MA USA
| | - Bart N.M. Van Berckel
- Department of Radiology & Nuclear Medicine, Amsterdam Neuroscience Vrije Universiteit Amsterdam, Amsterdam UMC Amsterdam Netherlands
| | - Charlotte E. Teunissen
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC Vrije Universiteit Amsterdam, Netherlands Amsterdam Netherlands
| | - Wiesje van Der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC Vrije Universiteit Amsterdam, Netherlands Amsterdam Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC Vrije Universiteit Amsterdam, Netherlands Amsterdam Netherlands
| | - Betty M. Tijms
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC Vrije Universiteit Amsterdam, Netherlands Amsterdam Netherlands
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Zwan MD, van Der Flier W, Cleutjens S, Vermunt L, Jutten RJ, van Maurik IS, Sikkes SAM, Weiner MW, Scheltens P, Prins ND. Dutch Brain Research Registry for online study participant recruitment: Design and first results. Alzheimers Dement 2020. [DOI: 10.1002/alz.044738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Marissa D Zwan
- Amsterdam University Medical Centers Amsterdam Netherlands
| | - Wiesje van Der Flier
- Alzheimer Center Amsterdam Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | | | - Lisa Vermunt
- Alzheimer Center Amsterdam Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Roos J. Jutten
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Ingrid S van Maurik
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | | | - Michael W Weiner
- UCSF Department of Radiology and Biomedical Imaging San Francisco CA USA
| | - Philip Scheltens
- Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Niels D Prins
- Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
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27
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Verrijp M, Dubbelman MA, Nijhuis EW, Visser LNC, Zwan MD, Jutten RJ, Van Hout HPJ, van Der Flier W, Scheltens P, Sikkes SAM. Study partner‐ and self‐reported difficulties in cognitively complex everyday activities in participants without objective cognitive impairment. Alzheimers Dement 2020. [DOI: 10.1002/alz.046015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Merike Verrijp
- Alzheimer Center VU University Medical Center Amsterdam Netherlands
| | - Mark A Dubbelman
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam University Medical Center Amsterdam Netherlands
| | - Elke W Nijhuis
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Vrije Universiteit Amsterdam Amsterdam UMC Amsterdam Netherlands
| | - Leonie NC Visser
- Academic Medical Center/University of Amsterdam Amsterdam Netherlands
| | | | - Roos J Jutten
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Netherlands
| | | | - Wiesje van Der Flier
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Netherlands
| | | | - Sietske AM Sikkes
- Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience Amsterdam UMC Vrije Universiteit Amsterdam Netherlands
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28
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Dubbelman MA, Jutten RJ, Tomaszewski Farias SE, Amariglio RE, Buckley RF, Visser PJ, Rentz DM, Johnson KA, Properzi MJ, Schultz A, Donovan N, Gatchell JR, Teunissen CE, Van Berckel BNM, Van der Flier WM, Sperling RA, Papp KV, Scheltens P, Marshall GA, Sikkes SAM. Decline in cognitively complex everyday activities accelerates along the Alzheimer's disease continuum. Alzheimers Res Ther 2020; 12:138. [PMID: 33121534 PMCID: PMC7597034 DOI: 10.1186/s13195-020-00706-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 10/12/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Impairment in daily functioning is a clinical hallmark of dementia. Difficulties with "instrumental activities of daily living" (IADL) seem to increase gradually over the course of Alzheimer's disease (AD), before dementia onset. However, it is currently not well established how difficulties develop along the preclinical and prodromal stages of AD. We aimed to investigate the trajectories of decline in IADL performance, as reported by a study partner, along the early stages of AD. METHODS In a longitudinal multicenter study, combining data from community-based and memory clinic cohorts, we included 1555 individuals (mean age 72.5 ± 7.8 years; 50% female) based on availability of amyloid biomarkers, longitudinal IADL data, and clinical information at baseline. Median follow-up duration was 2.1 years. All amyloid-positive participants (n = 982) were classified into the National Institute on Aging-Alzheimer's Association (NIA-AA) clinical stages ranging from preclinical AD (1) to overt dementia (4+). Cognitively normal amyloid-negative individuals (n = 573) served as a comparison group. The total scores of three study-partner reported IADL questionnaires were standardized. RESULTS The rate of decline in cognitively normal (stage 1) individuals with and without abnormal amyloid did not differ (p = .453). However, from stage 2 onwards, decline was significantly faster in individuals on the AD continuum (B [95%CI] = - 0.32 [- 0.55, - 0.09], p = .007). The rate of decline increased with each successive stage: one standard deviation (SD) unit per year in stage 3 (- 1.06 [- 1.27, - 0.85], p < .001) and nearly two SD units per year in stage 4+ (1.93 [- 2.19, - 1.67], p < .001). Overall, results were similar between community-based and memory clinic study cohorts. CONCLUSIONS Our results suggest that the rate of functional decline accelerates along the AD continuum, as shown by steeper rates of decline in each successive NIA-AA clinical stage. These results imply that incremental changes in function are a meaningful measure for early disease monitoring. Combined with the low-cost assessment, this advocates the use of these functional questionnaires for capturing the effects of early AD-related cognitive decline on daily life.
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Affiliation(s)
- Mark A Dubbelman
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.
| | - Roos J Jutten
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | | | - Rebecca E Amariglio
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Rachel F Buckley
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Pieter Jelle Visser
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Dorene M Rentz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith A Johnson
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Michael J Properzi
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Aaron Schultz
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Nancy Donovan
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Jennifer R Gatchell
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Charlotte E Teunissen
- Neurochemistry Laboratory, Department of Clinical Chemistry, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Bart N M Van Berckel
- Department of Radiology and Nuclear Medicine, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Wiesje M Van der Flier
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Reisa A Sperling
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kathryn V Papp
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Philip Scheltens
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
| | - Gad A Marshall
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Sietske A M Sikkes
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, location VUmc, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands
- Department of Clinical, Neuro- & Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Bruderer-Hofstetter M, Dubbelman MA, Meichtry A, Koehn F, Münzer T, Jutten RJ, Scheltens P, Sikkes SAM, Niedermann K. Cross-cultural adaptation and validation of the Amsterdam Instrumental Activities of Daily Living questionnaire short version German for Switzerland. Health Qual Life Outcomes 2020; 18:323. [PMID: 33008394 PMCID: PMC7530958 DOI: 10.1186/s12955-020-01576-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 09/23/2020] [Indexed: 01/18/2023] Open
Abstract
Background Instrumental Activities of Daily Living (IADL) limitations are associated with reduced health-related quality of life for people with mild cognitive impairment (MCI). For these people, the assessment of IADL is crucial to the diagnostic process, as well as for the evaluation of new interventions addressing MCI. The Amsterdam IADL Questionnaire Short Version (A-IADL-Q-SV) is an established assessment tool with good psychometric properties that has been shown to be robust to cultural differences in Western countries. The aims of this study were to: (1) cross-culturally adapt and validate the A-IADL-Q-SV for the German-speaking population of Switzerland; (2) investigate its cultural comparability; and (3) evaluate further psychometric properties. Methods The A-IADL-Q-SV German was pretested on clinicians and participants in a memory clinic setting. The psychometric properties and cultural comparability of the questionnaire were investigated in memory clinic settings including participants with MCI or mild dementia, as well as participants with normal cognition recruited from the community. Item response theory (IRT) was applied to investigate measurement invariance by means of differential item functioning to assess item bias. Additionally, the test–retest reliability on scale level, the construct validity through hypothesis testing and the discriminant validity of the A-IADL-Q-SV German were evaluated. Results Ninety-six informants of participants with normal cognition, MCI or mild dementia completed the A-IADL-Q-SV German. The basic assumptions for IRT scoring were met. No meaningful differential item functioning for culture was detected between the Swiss and Dutch reference samples. High test–retest reliability on scale level (ICC 0.93; 95% CI 0.9–0.96) was found. More than 75% of the observed correlations between the A-IADL-Q-SV German and clinical measures of cognition and functional status were found to be in the direction and of the magnitude hypothesized. The A-IADL-Q-SV German was shown to be able to discriminate between participants with normal cognition and MCI, as well as MCI and mild dementia. Conclusions The A-IADL-Q-SV German is a psychometrically robust measurement tool for a Swiss population with normal cognition, MCI and mild dementia. Thus, it provides a valuable tool to assess IADL functioning in clinical practices and research settings in Switzerland. Trial registration This study was registered retrospectively in July 2019 on ClinicalTrials.gov (NCT04012398).
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Affiliation(s)
- Marina Bruderer-Hofstetter
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland. .,Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland.
| | - Mark A Dubbelman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - André Meichtry
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland
| | - Florian Koehn
- Geriatrische Klinik St. Gallen, St. Gallen, Switzerland
| | - Thomas Münzer
- Geriatrische Klinik St. Gallen, St. Gallen, Switzerland.,Department of Geriatrics and Aging Research, University Hospital and University of Zurich, Zurich, Switzerland
| | - Roos J Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Sietske A M Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Karin Niedermann
- School of Health Professions, Institute of Physiotherapy, Zurich University of Applied Sciences, Katharina-Sulzer-Platz 9, 8401, Winterthur, Switzerland
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Jutten RJ, Grandoit E, Foldi NS, Sikkes SAM, Jones RN, Choi S, Lamar ML, Louden DKN, Rich J, Tommet D, Crane PK, Rabin LA. Lower practice effects as a marker of cognitive performance and dementia risk: A literature review. Alzheimers Dement (Amst) 2020; 12:e12055. [PMID: 32671181 PMCID: PMC7346865 DOI: 10.1002/dad2.12055] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 12/31/2022]
Abstract
BACKGROUND Practice effects (PEs) are improvements in performance after repeated exposure to test materials, and typically viewed as a source of bias in repeated cognitive assessments. We aimed to determine whether characterizing PEs could also provide a useful marker of early cognitive decline. METHODS We conducted a systematic review of the literature, searching PsycInfo (Ebsco) and PubMed databases for articles studying PEs in aging and dementia populations. Articles published between 1920 and 2019 were included. RESULT We identified 259 articles, of which 27 studied PEs as markers of cognitive performance. These studies consistently showed that smaller, less-robust PEs were associated with current diagnostic status and/or future cognitive decline. In addition, lower PEs were associated with Alzheimer's disease risk factors and neurodegeneration biomarkers. CONCLUSION PEs provide a potentially useful marker of cognitive decline, and could prove valuable as part of a cost-effective strategy to select individuals who are at-risk for dementia for future interventions.
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Affiliation(s)
- Roos J. Jutten
- Alzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam UMCVrije UniversiteitAmsterdamthe Netherlands
| | | | - Nancy S. Foldi
- Queens College and The Graduate Center of The City University of New YorkQueensNew YorkUSA
| | - Sietske A. M. Sikkes
- Alzheimer Center AmsterdamAmsterdam NeuroscienceAmsterdam UMCVrije UniversiteitAmsterdamthe Netherlands
| | - Richard N. Jones
- Warren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Seo‐Eun Choi
- School of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Melissa L. Lamar
- Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | | | - Joanne Rich
- University Libraries, University of WashingtonSeattleWashingtonUSA
| | - Douglas Tommet
- Warren Alpert Medical School of Brown UniversityProvidenceRhode IslandUSA
| | - Paul K. Crane
- School of MedicineUniversity of WashingtonSeattleWashingtonUSA
| | - Laura A. Rabin
- Brooklyn College and The Graduate Center of The City University of New YorkBrooklynNew YorkUSA
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Jutten RJ, Harrison JE, Brunner A, Vreeswijk R, van Deelen R, de Jong FJ, Opmeer EM, Ritchie CW, Aleman A, Scheltens P, Sikkes SA. The Cognitive-Functional Composite is sensitive to clinical progression in early dementia: Longitudinal findings from the Catch-Cog study cohort. Alzheimers Dement (N Y) 2020; 6:e12020. [PMID: 32313832 PMCID: PMC7164406 DOI: 10.1002/trc2.12020] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 03/06/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION In an attempt to capture clinically meaningful cognitive decline in early dementia, we developed the Cognitive-Functional Composite (CFC). We investigated the CFC's sensitivity to decline in comparison to traditional clinical endpoints. METHODS This longitudinal construct validation study included 148 participants with subjective cognitive decline, mild cognitive impairment, or mild dementia. The CFC and traditional tests were administered at baseline, 3, 6, and 12 months. Sensitivity to change was investigated using linear mixed models and r 2 effect sizes. RESULTS CFC scores declined over time (β = -.16, P < .001), with steepest decline observed in mild Alzheimer's dementia (β = -.25, P < .001). The CFC showed medium-to-large effect sizes at succeeding follow-up points (r 2 = .08-.42), exhibiting greater change than the Clinical Dementia Rating scale (r 2 = .02-.12). Moreover, change on the CFC was significantly associated with informant reports of cognitive decline (β = .38, P < .001). DISCUSSION By showing sensitivity to decline, the CFC could enhance the monitoring of disease progression in dementia research and clinical practice.
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Affiliation(s)
- Roos J. Jutten
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam Neuroscience, AmsterdamAmsterdam UMCthe Netherlands
| | - John E. Harrison
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam Neuroscience, AmsterdamAmsterdam UMCthe Netherlands
- Metis Cognition LtdWiltshireUK
- Institute of PsychiatryPsychology & NeuroscienceKing's College LondonLondonUK
| | - A.J. Brunner
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam Neuroscience, AmsterdamAmsterdam UMCthe Netherlands
| | - R. Vreeswijk
- Department of GeriatricsSpaarne GasthuisHaarlemthe Netherlands
| | | | - Frank Jan de Jong
- Department of NeurologyErasmus Medical CenterRotterdamthe Netherlands
| | - Esther M. Opmeer
- Department of NeurosciencesUniversity of GroningenUniversity Medical Center GroningenGroningenthe Netherlands
- Department of Health and Social WorkUniversity of Applied Sciences WindesheimZwollethe Netherlands
| | - Craig W. Ritchie
- Centre for Dementia PreventionUniversity of EdinburghEdinburghUK
| | - André Aleman
- Department of NeurosciencesUniversity of GroningenUniversity Medical Center GroningenGroningenthe Netherlands
| | - Philip Scheltens
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam Neuroscience, AmsterdamAmsterdam UMCthe Netherlands
| | - Sietske A.M. Sikkes
- Alzheimer Center AmsterdamDepartment of NeurologyAmsterdam Neuroscience, AmsterdamAmsterdam UMCthe Netherlands
- Department of Clinical, Neuro‐ & Developmental PsychologyVrije Universiteit AmsterdamAmsterdamthe Netherlands
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Facal D, Carabias MAR, Pereiro AX, Lojo-Seoane C, Campos-Magdaleno M, Jutten RJ, Sikkes SAM, Juncos-Rabadán O. Assessing Everyday Activities Across the Dementia Spectrum with the Amsterdam IADL Questionnaire. Curr Alzheimer Res 2019; 15:1261-1266. [PMID: 30251604 DOI: 10.2174/1567205015666180925113411] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2018] [Revised: 08/19/2018] [Accepted: 09/17/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND Instrumental activities of daily living (IADL) are complex activities which involve multiple cognitive processes, and which are expected to be susceptible to the early effects of cognitive impairment. Informant-based questionnaires are the most common tools used to assess IADL performance in dementia, but must be adjusted for use in early stages of impairment. OBJECTIVE To investigate the differences in IADL on the continuum of cognitive decline (i.e. no cognitive decline - subjective cognitive decline - mild cognitive impairment- mild dementia - moderate dementia) using the Spanish version of the Amsterdam IADL Questionnaire (A-IADL-Q). METHODS A total of 500 volunteer participants were included: 88 participants with no signs of cognitive decline, 109 participants with subjective cognitive complaints, 114 participants with mild cognitive impairment (MCI), 81 participants with mild dementia and 108 participants with moderate dementia. IADL was assessed with the A-IADL-Q, a computerized and adaptive questionnaire that calculates scores according to the specific pattern of responses of each participant. The data were examined by ANOVAs and regression analysis. Multinomial logistic regression analysis was used to evaluate the capacity of the A-IADL-Q to distinguish between diagnostic groups. RESULTS Participants with no cognitive decline and those with subjective cognitive decline obtained higher A-IADL-Q scores than MCI participants, and participants with MCI obtained higher scores than patients with dementia. The A-IADL-Q showed excellent discrimination between non-cognitive impairment and dementia, and significant but low discrimination between non-cognitive impairment and MCI. CONCLUSION A-IADL-Q can discriminate IADL functioning between groups across the dementia spectrum.
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Affiliation(s)
- David Facal
- Department of Developmental Psychology, University de Santiago de Compostela, A Coruna, Galicia, Spain
| | | | - Arturo X Pereiro
- Department of Developmental Psychology, University de Santiago de Compostela, A Coruna, Galicia, Spain
| | - Cristina Lojo-Seoane
- Department of Developmental Psychology, University de Santiago de Compostela, A Coruna, Galicia, Spain
| | - María Campos-Magdaleno
- Department of Developmental Psychology, University de Santiago de Compostela, A Coruna, Galicia, Spain
| | - Roos J Jutten
- VU University Medical Center, Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, Amsterdam, Netherlands
| | - Sietske A M Sikkes
- VU University Medical Center, Department of Neurology, Alzheimer Center, Amsterdam Neuroscience, Amsterdam, Netherlands.,Massachusetts General Hospital, Department of Neurology, Boston, MA, United States
| | - Onésimo Juncos-Rabadán
- Department of Developmental Psychology, University de Santiago de Compostela, A Coruna, Galicia, Spain
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Rabin L, Choi SE, Foldi N, Grandoit E, Jones R, Jutten RJ, Lamar M, Louden DK, Rich J, Sikkes SA, Tommet D, Crane PK. P2-456: PRACTICE EFFECTS AS A MARKER OF COGNITIVE PERFORMANCE AND DEMENTIA RISK: A SYSTEMATIC LITERATURE REVIEW. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.2863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Laura Rabin
- Brooklyn College of the City University of New York; Brooklyn NY USA
| | | | | | | | | | - Roos J. Jutten
- Alzheimer Center and Department of Neurology, Amsterdam Neuroscience; VU University Medical Center; Amsterdam Netherlands
| | - Melissa Lamar
- Rush Alzheimer's Disease Center; Rush University Medical Center; Chicago IL USA
| | | | - Joanne Rich
- Health Sciences Library, University Libraries; University of Washington; Seattle WA USA
| | - Sietske A.M. Sikkes
- VU University Medical Center; Alzheimer Center, Amsterdam Neuroscience; Amsterdam Netherlands
| | - Douglas Tommet
- Warren Alpert Medical School; Brown University; Providence RI USA
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Jutten RJ, Sikkes SA, Amariglio R, Buckley RF, Properzi MJ, Marshall GA, Rentz DM, Johnson KA, van der Flier WM, Scheltens P, Sperling RA, Papp KV. F2-03-02: OPTIMIZING COGNITIVE OUTCOMES FOR BIOMARKER POSITIVE INDIVIDUALS AT DIFFERENT CLINICAL STAGES OF ALZHEIMER'S DISEASE ACCORDING TO THE NIA-AA RESEARCH FRAMEWORK. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.4425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | - Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
- Harvard Medical School; Boston MA USA
- Massachusetts General Hospital; Boston MA USA
| | - Rebecca Amariglio
- Harvard Medical School; Boston MA USA
- Massachusetts General Hospital; Boston MA USA
- Brigham and Women's Hospital; Boston MA USA
| | - Rachel F. Buckley
- Harvard Medical School; Boston MA USA
- Massachusetts General Hospital; Boston MA USA
| | | | - Gad A. Marshall
- Harvard Medical School; Boston MA USA
- Massachusetts General Hospital; Boston MA USA
- Brigham and Women's Hospital; Boston MA USA
| | - Dorene M. Rentz
- Harvard Medical School; Boston MA USA
- Massachusetts General Hospital; Boston MA USA
- Brigham and Women's Hospital; Boston MA USA
| | - Keith A. Johnson
- Harvard Medical School; Boston MA USA
- Massachusetts General Hospital; Boston MA USA
- Brigham and Women's Hospital; Boston MA USA
| | - Wiesje M. van der Flier
- Alzheimer center Amsterdam, Department of Neurology, Amsterdam Neuroscience; VU University Medical Center, Amsterdam UMC; Amsterdam Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | - Reisa A. Sperling
- Harvard Medical School; Boston MA USA
- Massachusetts General Hospital; Boston MA USA
- Brigham and Women's Hospital; Boston MA USA
| | - Kate V. Papp
- Harvard Medical School; Boston MA USA
- Massachusetts General Hospital; Boston MA USA
- Brigham and Women's Hospital; Boston MA USA
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Jutten RJ, Harrison J, Vreeswijk R, van Deelen BA, Opmeer EM, Aleman A, Jan de Jong F, Ritchie CW, Scheltens P, Sikkes SA. P3-028: THE COGNITIVE-FUNCTIONAL COMPOSITE IS SENSITIVE TO DISEASE PROGRESSION IN MILD COGNITIVE IMPAIRMENT AND EARLY DEMENTIA: LONGITUDINAL FINDINGS FROM THE CATCH-COG STUDY COHORT. Alzheimers Dement 2019. [DOI: 10.1016/j.jalz.2019.06.3054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Roos J. Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | - John Harrison
- King's College - Institute of Psychiatry, Psychology and Neuroscience; London United Kingdom
- Metis Cognition Ltd.; Kilmington United Kingdom
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC; Vrije Universiteit Amsterdam; Amsterdam Netherlands
| | | | | | | | - André Aleman
- University Medical Center Groningen; Groningen Netherlands
| | - Frank Jan de Jong
- Department of Neurology and Alzheimer Center Erasmus MC; Erasmus Medical Center; Rotterdam Netherlands
| | | | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
| | - Sietske A.M. Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience; Vrije Universiteit Amsterdam, Amsterdam UMC; Amsterdam Netherlands
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Jutten RJ, Harrison JE, Lee Meeuw Kjoe PR, Ingala S, Vreeswijk R, van Deelen RAJ, de Jong FJ, Opmeer EM, Aleman A, Ritchie CW, Scheltens P, Sikkes SAM. Assessing cognition and daily function in early dementia using the cognitive-functional composite: findings from the Catch-Cog study cohort. Alzheimers Res Ther 2019; 11:45. [PMID: 31092277 PMCID: PMC6521452 DOI: 10.1186/s13195-019-0500-5] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/28/2019] [Indexed: 12/15/2022]
Abstract
Background The cognitive-functional composite (CFC) was designed to improve the measurement of clinically relevant changes in predementia and early dementia stages. We have previously demonstrated its good test-retest reliability and feasibility of use. The current study aimed to evaluate several quality aspects of the CFC, including construct validity, clinical relevance, and suitability for the target population. Methods Baseline data of the Capturing Changes in Cognition study was used: an international, prospective cohort study including participants with subjective cognitive decline (SCD), mild cognitive impairment (MCI), Alzheimer’s disease (AD) dementia, and dementia with Lewy bodies (DLB). The CFC comprises seven existing cognitive tests focusing on memory and executive functions (EF) and the informant-based Amsterdam Instrumental Activities of Daily Living Questionnaire (A-IADL-Q). Construct validity and clinical relevance were assessed by (1) confirmatory factor analyses (CFA) using all CFC subtests and (2) linear regression analyses relating the CFC score (independent) to reference measures of disease severity (dependent), correcting for age, sex, and education. To assess the suitability for the target population, we compared score distributions of the CFC to those of traditional tests (Alzheimer’s Disease Assessment Scale–Cognitive subscale, Alzheimer’s Disease Cooperative Study–Activities of Daily Living scale, and Clinical Dementia Rating scale). Results A total of 184 participants were included (age 71.8 ± 8.4; 42% female; n = 14 SCD, n = 80 MCI, n = 78 AD, and n = 12 DLB). CFA showed that the hypothesized three-factor model (memory, EF, and IADL) had adequate fit (CFI = .931, RMSEA = .091, SRMR = .06). Moreover, worse CFC performance was associated with more cognitive decline as reported by the informant (β = .61, p < .001), poorer quality of life (β = .51, p < .001), higher caregiver burden (β = − .51, p < .001), more apathy (β = − .36, p < .001), and less cortical volume (β = .34, p = .02). Whilst correlations between the CFC and traditional measures were moderate to strong (ranging from − .65 to .83, all p < .001), histograms showed floor and ceiling effects for the traditional tests as compared to the CFC. Conclusions Our findings illustrate that the CFC has good construct validity, captures clinically relevant aspects of disease severity, and shows no range restrictions in scoring. It therefore provides a more useful outcome measure than traditional tests to evaluate cognition and function in MCI and mild AD. Electronic supplementary material The online version of this article (10.1186/s13195-019-0500-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Roos J Jutten
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
| | - John E Harrison
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Metis Cognition Ltd, Park House, Kilmington Common, Wiltshire, UK.,Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Philippe R Lee Meeuw Kjoe
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Silvia Ingala
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Radiology and Nuclear Medicine Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - R Vreeswijk
- Department of Geriatrics, Spaarne Gasthuis, Haarlem, The Netherlands
| | - R A J van Deelen
- Department of Geriatrics, Spaarne Gasthuis, Haarlem, The Netherlands
| | - Frank Jan de Jong
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Esther M Opmeer
- Department of Biomedical Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.,Department of Health and Social Work, University of Applied Sciences Windesheim, Zwolle, The Netherlands
| | - André Aleman
- Department of Biomedical Sciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Craig W Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Sietske A M Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.,Department of Epidemiology & Biostatistics, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Jutten RJ, Dicks E, Vermaat L, Barkhof F, Scheltens P, Tijms BM, Sikkes SA. Impairment in complex activities of daily living is related to neurodegeneration in Alzheimer's disease–specific regions. Neurobiol Aging 2019; 75:109-116. [DOI: 10.1016/j.neurobiolaging.2018.11.018] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2018] [Revised: 09/26/2018] [Accepted: 11/17/2018] [Indexed: 10/27/2022]
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Jutten RJ, Harrison J, Opmeer EM, Aleman A, Vreeswijk R, Deelen BA, Jan de Jong F, Ritchie CW, Scheltens P, Sikkes SA. P4‐113: COMPARING THE COGNITIVE‐FUNCTIONAL COMPOSITE WITH TRADITIONAL TESTS OF COGNITION AND FUNCTION: FINDINGS FROM THE CATCH‐COG STUDY COHORT. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.2517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Roos J. Jutten
- Alzheimer Center and Department of Neurology, Amsterdam NeuroscienceVU University Medical CenterAmsterdamNetherlands
| | - John Harrison
- Alzheimer CenterVU University Medical CenterAmsterdamNetherlands
- King's College-Institute of PsychiatryPsychology and NeuroscienceLondonUnited Kingdom
- Metis Cognition Ltd.KilmingtonUnited Kingdom
| | | | - André Aleman
- University Medical Center GroningenGroningenNetherlands
| | | | | | - Frank Jan de Jong
- Department of Neurology and Alzheimer Center Erasmus MCErasmus Medical CenterRotterdamNetherlands
| | | | - Philip Scheltens
- VU University Medical CenterAlzheimer Center, Amsterdam NeuroscienceAmsterdamNetherlands
| | - Sietske A.M. Sikkes
- VU University Medical CenterAlzheimer Center, Amsterdam NeuroscienceAmsterdamNetherlands
- Department of Epidemiology and BiostatisticsVU University Medical CenterAmsterdamNetherlands
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Jutten RJ, Harrison J, Lee Meeuw Kjoe PR, Opmeer EM, Schoonenboom NSM, de Jong FJ, Ritchie CW, Scheltens P, Sikkes SAM. A novel cognitive-functional composite measure to detect changes in early Alzheimer's disease: Test-retest reliability and feasibility. Alzheimers Dement (Amst) 2017; 10:153-160. [PMID: 29780863 PMCID: PMC5956799 DOI: 10.1016/j.dadm.2017.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Introduction To improve the detection of changes in Alzheimer's disease (AD), we designed the cognitive-functional composite (CFC). As a first validation step, we investigated its test–retest reliability and feasibility of use. Methods We performed a test–retest study with 2–3 weeks between assessments, including patients with mild cognitive impairment (MCI) or mild AD dementia and cognitively healthy participants. We calculated intraclass correlation coefficients (ICCs) type absolute agreement for all CFC measures and compared baseline and retest scores using paired-samples t-tests. We evaluated feasibility by interviewing participants. Results Forty-three patients (40% female, mean age = 69.9) and 30 controls (50% female, mean age = 65) were included. Subtest intraclass correlation coefficients ranged from .70 to .96. We found negligible improvements after retesting on only two subtests. Overall, patients perceived the administration of the CFC as feasible. Discussion The CFC is a stable and feasible measure in MCI and mild AD dementia, and thereby meets important quality metrics for clinically meaningful outcome measures. We investigated stability and feasibility of the cognitive-functional composite (CFC). We demonstrated good test–retest reliability for all CFC subtests. We only found negligible practice effects on two CFC subtests. Overall, patients experienced the administration of the CFC as feasible.
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Affiliation(s)
- Roos J Jutten
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - John Harrison
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Metis Cognition Ltd, Park House, Kilmington Common, Wiltshire, United Kingdom.,Institute of Psychiatry, Psychology & Neuroscience, King's College, London, United Kingdom
| | - Philippe R Lee Meeuw Kjoe
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Esther M Opmeer
- Department of Neurosciences, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Frank Jan de Jong
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Craig W Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom
| | - Philip Scheltens
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Sietske A M Sikkes
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
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Jutten RJ, Peeters CFW, Leijdesdorff SMJ, Visser PJ, Maier AB, Terwee CB, Scheltens P, Sikkes SAM. Detecting functional decline from normal aging to dementia: Development and validation of a short version of the Amsterdam IADL Questionnaire. Alzheimers Dement (Amst) 2017; 8:26-35. [PMID: 28462387 PMCID: PMC5403784 DOI: 10.1016/j.dadm.2017.03.002] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Introduction Detecting functional decline from normal aging to dementia is relevant for diagnostic and prognostic purposes. Therefore, the Amsterdam IADL Questionnaire (A-IADL-Q) was developed: a 70-item proxy-based tool with good psychometric properties. We aimed to design a short version while preserving its psychometric quality. Methods Study partners of subjects (n = 1355), ranging from cognitively normal to dementia subjects, completed the original A-IADL-Q. We selected the short version items using a stepwise procedure combining missing data, Item Response Theory, and input from respondents and experts. We investigated internal consistency of the short version and concordance with the original version. To assess its construct validity, we additionally investigated concordance between the short version and the Mini–Mental State Examination (MMSE) and Disability Assessment for Dementia (DAD). Finally, we investigated differences in instrumental activities of daily living (IADL) scores between diagnostic groups across the dementia spectrum. Results We selected 30 items covering the entire spectrum of IADL functioning. Internal consistency (0.98) and concordance with the original version (0.97) were very high. Concordance with the MMSE (0.72) and DAD (0.87) scores was high. IADL impairment scores increased across the spectrum from normal cognition to dementia. Discussion The A-IADL-Q short version (A-IADL-Q-SV) consists of 30 items and has maintained the psychometric quality of the original A-IADL-Q. As such, the A-IADL-Q-SV is a concise measure of functional decline.
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Affiliation(s)
- Roos J Jutten
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Carel F W Peeters
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | | | - Pieter Jelle Visser
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Alzheimer Center, School for Mental Health and Neuroscience, University Medical Centre Maastricht, Maastricht, The Netherlands
| | - Andrea B Maier
- MOVE Research Institute Amsterdam, Department of Human Movement Sciences, VU University of Amsterdam, Amsterdam, The Netherlands.,Department of Medicine and Aged Care, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia
| | - Caroline B Terwee
- Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Sietske A M Sikkes
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Department of Epidemiology & Biostatistics, Amsterdam Public Health Research Institute, VU University Medical Center, Amsterdam, The Netherlands
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Jutten RJ, Harrison J, de Jong FJ, Aleman A, Ritchie CW, Scheltens P, Sikkes SAM. A composite measure of cognitive and functional progression in Alzheimer's disease: Design of the Capturing Changes in Cognition study. Alzheimers Dement (N Y) 2017; 3:130-138. [PMID: 29067324 PMCID: PMC5651369 DOI: 10.1016/j.trci.2017.01.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Cognitive testing in Alzheimer's disease (AD) is essential for establishing diagnosis, monitoring progression, and evaluating treatments. Assessments should ideally be brief, reliable, valid, and reflect clinically meaningful changes. There is a lack of instruments that meet all these criteria. In the Capturing Changes in Cognition (Catch-Cog) study, we seek to correct these deficiencies through the development and validation of a composite measure combining cognition and function: the cognitive-functional composite (CFC). We expect that the CFC is able to detect clinically relevant changes over time in early dementia stages of AD. METHODS/DESIGN We will include patients (n = 350) with mild cognitive impairment or mild dementia due to AD from memory clinics in the Netherlands and the United Kingdom. We will include cognitively healthy volunteers (n = 30) as a control group. The CFC is based on the "cognitive composite" and the Amsterdam instrumental activities of daily living questionnaire. We will investigate test-retest reliability with baseline and 2- to 3-week follow-up assessments (n = 50 patients and n = 30 healthy controls). We will involve experts and participants to evaluate the initial feasibility and refine the CFC if needed. Subsequently, we will perform a longitudinal construct validation study in a prospective cohort (n = 300) with baseline, 3-, 6-, and 12-month follow-up assessments. The main outcome is cognitive and functional progression measured by the CFC. Reference measures for progression include traditional cognitive and functional tests, disease burden measures, and brain imaging methods. Using linear mixed modeling, we will investigate longitudinal changes on the CFC and relate these to the reference measures. Using linear regression analyses, we will evaluate the influence of possible confounders such as age, gender, and education on the CFC. DISCUSSION By performing an independent longitudinal construct validation, the Catch-Cog study of the novel CFC will contribute to the improvement of disease monitoring and treatment evaluation in early dementia stages of AD.
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Affiliation(s)
- Roos J Jutten
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - John Harrison
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Metis Cognition Ltd, Kilmington Common, Warminster, United Kingdom
| | - Frank Jan de Jong
- Department of Neurology, Erasmus Medical Center, Rotterdam, The Netherlands
| | - André Aleman
- Department of Neurosciences, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Craig W Ritchie
- Centre for Dementia Prevention, University of Edinburgh, Edinburgh, United Kingdom
| | - Philip Scheltens
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Sietske A M Sikkes
- Alzheimer Center, Department of Neurology, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands.,Department of Epidemiology & Biostatistics, VU University Medical Center, Amsterdam, The Netherlands
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Jutten RJ, Peeters CF, Terwee CB, Maier AB, Binnekade TT, Visser PJ, Leijdesdorff SM, Scheltens P, Sikkes SA. P1‐238: When Less is More: Detecting Functional Decline Using a Short Version of the Amsterdam Iadl Questionnaire. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Roos J. Jutten
- Alzheimer Center, VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | | | | | | | | | | | | | - Philip Scheltens
- Alzheimer Center, VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
| | - Sietske A.M. Sikkes
- Alzheimer Center, VU University Medical CenterAmsterdamNetherlands
- Neuroscience Campus AmsterdamAmsterdamNetherlands
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Sikkes SA, Jutten RJ, Harrison J, Jan de Jong F, Aleman A, Ritchie CW, Scheltens P. P2‐300: Capturing Changes in Cognition: The Needs and Wishes of Dementia Researchers and Clinicians. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.06.1560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Sietske A.M. Sikkes
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- Alzheimer Center, VU University Medical CenterAmsterdamNetherlands
| | - Roos J. Jutten
- Alzheimer Center, VU University Medical CenterAmsterdamNetherlands
| | - John Harrison
- Metis Cognition Ltd.KilmingtonUnited Kingdom
- VU University Medical Center, Alzheimer CenterAmsterdamNetherlands
| | | | - Andre Aleman
- University Medical Center GroningenGroningenNetherlands
| | | | - Philip Scheltens
- Neuroscience Campus AmsterdamAmsterdamNetherlands
- Alzheimer Center, VU University Medical CenterAmsterdamNetherlands
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