Alzheimer's & dementia : the journal of the Alzheimer's Association · 2017
Incidence of cognitively defined late-onset Alzheimer's dementia subgroups from a prospective cohort study.
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Crane Paul K, Trittschuh Emily, Mukherjee Shubhabrata, Saykin Andrew J, Sanders R Elizabeth, Larson Eric B, McCurry Susan M, McCormick Wayne, Bowen James D, Grabowski Thomas, Moore Mackenzie, Bauman Julianna, Gross Alden L, Keene C Dirk, Bird Thomas D, Gibbons Laura E, Mez Jesse, Executive Prominent Alzheimer's Disease: Genetics and Risk Factors (EPAD:GRF) Investigators
Аннотация
INTRODUCTION: There may be biologically relevant heterogeneity within typical late-onset Alzheimer's dementia.
METHODS: We analyzed cognitive data from people with incident late-onset Alzheimer's dementia from a prospective cohort study. We determined individual averages across memory, visuospatial functioning, language, and executive functioning. We identified domains with substantial impairments relative to that average. We compared demographic, neuropathology, and genetic findings across groups defined by relative impairments.
RESULTS: During 32,286 person-years of follow-up, 869 people developed Alzheimer's dementia. There were 393 (48%) with no domain with substantial relative impairments. Some participants had isolated relative impairments in memory (148, 18%), visuospatial functioning (117, 14%), language (71, 9%), and executive functioning (66, 8%). The group with isolated relative memory impairments had higher proportions with ≥ APOE ε4 allele, more extensive Alzheimer's-related neuropathology, and higher proportions with other Alzheimer's dementia genetic risk variants.
DISCUSSION: A cognitive subgrouping strategy may identify biologically distinct subsets of people with Alzheimer's dementia.
METHODS: We analyzed cognitive data from people with incident late-onset Alzheimer's dementia from a prospective cohort study. We determined individual averages across memory, visuospatial functioning, language, and executive functioning. We identified domains with substantial impairments relative to that average. We compared demographic, neuropathology, and genetic findings across groups defined by relative impairments.
RESULTS: During 32,286 person-years of follow-up, 869 people developed Alzheimer's dementia. There were 393 (48%) with no domain with substantial relative impairments. Some participants had isolated relative impairments in memory (148, 18%), visuospatial functioning (117, 14%), language (71, 9%), and executive functioning (66, 8%). The group with isolated relative memory impairments had higher proportions with ≥ APOE ε4 allele, more extensive Alzheimer's-related neuropathology, and higher proportions with other Alzheimer's dementia genetic risk variants.
DISCUSSION: A cognitive subgrouping strategy may identify biologically distinct subsets of people with Alzheimer's dementia.