Incidence of cognitively defined late-onset Alzheimer's dementia subgroups from a prospective cohort study

Abstract 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 memo...

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Bibliographic Details
Published in:Alzheimer's & dementia 2017-12, Vol.13 (12), p.1307-1316
Main Authors: 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 E, Gibbons, Laura E, Mez, Jesse
Format: Article
Language:English
Subjects:
Alzheimer's disease
Cognition
Endophenotypes
Genetics
Heterogeneity
Neurology
Neuropathology
Subgroups
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Summary:Abstract 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 , 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.
ISSN:1552-5260
1552-5279
DOI:10.1016/j.jalz.2017.04.011