Quantifying cognitive resilience in Alzheimer's Disease: The Alzheimer's Disease Cognitive Resilience Score

Even though there is a clear link between Alzheimer's Disease (AD) related neuropathology and cognitive decline, numerous studies have observed that healthy cognition can exist in the presence of extensive AD pathology, a phenomenon sometimes called Cognitive Resilience (CR). To better understa...

Full description

Saved in:
Bibliographic Details
Published in:PloS one 2020-11, Vol.15 (11), p.e0241707-e0241707
Main Authors: Yao, Tianyi, Sweeney, Elizabeth, Nagorski, John, Shulman, Joshua M, Allen, Genevera I
Format: Article
Language:English
Subjects:
Aging
Alzheimer Disease - diagnosis
Alzheimer Disease - physiopathology
Alzheimer's disease
Apolipoprotein E
Autopsy
Basal ganglia
Biology and Life Sciences
Brain research
Central nervous system diseases
Clinical trials
Cognition
Cognition & reasoning
Cognitive ability
Cognitive Dysfunction - diagnosis
Cognitive Dysfunction - physiopathology
Cognitive tests
Cohort Studies
Computer and Information Sciences
Dementia
Education
Evaluation
Exercise
Health aspects
Humans
Learning algorithms
Longitudinal Studies
Machine learning
Magnetic resonance imaging
Mathematical analysis
Medicine
Medicine and Health Sciences
Memory
Methods
Movement disorders
Neurodegenerative diseases
Neuropathology
Pathology
Public health
Resilience
Sweeney, John
Variables
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Even though there is a clear link between Alzheimer's Disease (AD) related neuropathology and cognitive decline, numerous studies have observed that healthy cognition can exist in the presence of extensive AD pathology, a phenomenon sometimes called Cognitive Resilience (CR). To better understand and study CR, we develop the Alzheimer's Disease Cognitive Resilience Score (AD-CR Score), which we define as the difference between the observed and expected cognition given the observed level of AD pathology. Unlike other definitions of CR, our AD-CR Score is a fully non-parametric, stand-alone, individual-level quantification of CR that is derived independently of other factors or proxy variables. Using data from two ongoing, longitudinal cohort studies of aging, the Religious Orders Study (ROS) and the Rush Memory and Aging Project (MAP), we validate our AD-CR Score by showing strong associations with known factors related to CR such as baseline and longitudinal cognition, non AD-related pathology, education, personality, APOE, parkinsonism, depression, and life activities. Even though the proposed AD-CR Score cannot be directly calculated during an individual's lifetime because it uses postmortem pathology, we also develop a machine learning framework that achieves promising results in terms of predicting whether an individual will have an extremely high or low AD-CR Score using only measures available during the lifetime. Given this, our AD-CR Score can be used for further investigations into mechanisms of CR, and potentially for subject stratification prior to clinical trials of personalized therapies.
ISSN:1932-6203
1932-6203
DOI:10.1371/journal.pone.0241707