An exploration of cognitive subgroups in Alzheimers disease

Julie E. Davidson, Michael C. Irizarry, Bethany Cara Bray, Sally Wetten, Nicholas Galwey, Rachel Gibson, Michael Borrie, Richard Delisle, Howard H. Feldman, Ging Yuek Hsiung, Luis Fornazzari, Serge Gauthier, Danilo Guzman, Inge Loy-English, Ron Keren, Andrew Kertesz, Peter St George-Hyslop, John Wherrett, Andreas U. Monsch

Research output: Contribution to journalArticle

24 Citations (Scopus)

Abstract

Heterogeneity is observed in the patterns of cognition in Alzheimer's disease (AD). Such heterogeneity might suggest the involvement of different etiological pathways or different host responses to pathology. A total of 627 subjects with mild/moderate AD underwent cognitive assessment with the Mini-Mental State Examination (MMSE) and the Dementia Rating Scale-2 (DRS-2). Latent class analysis (LCA) was performed on cognition subscale data to identify and characterize cognitive subgroups. Clinical, demographic, and genetic factors were explored for association with class membership. LCA suggested the existence of four subgroups; one group with mild and another with severe global impairment across the cognitive domains, one group with primary impairments in attention and construction, and another group with primary deficits in memory and orientation. Education, disease duration, age, Apolipoprotein E- ε4 ( APOE ε4) status, gender, presence of grasp reflex, white matter changes, and early or prominent visuospatial impairment were all associated with class membership. Our results support the existence of heterogeneity in patterns of cognitive impairment in AD. Our observation of classes characterized by predominant deficits in attention/construction and memory respectively deserves further exploration as does the association between membership in the attention/ construction class and APOE ε4 negative status.

Original languageEnglish (US)
Pages (from-to)233-243
Number of pages11
JournalJournal of the International Neuropsychological Society
Volume16
Issue number2
DOIs
StatePublished - Mar 1 2010

Fingerprint

Apolipoprotein E4
Alzheimer Disease
Cognition
Memory Disorders
Hand Strength
Reflex
Dementia
Observation
Demography
Pathology
Education
Cognitive Dysfunction
White Matter

All Science Journal Classification (ASJC) codes

  • Neuroscience(all)
  • Clinical Psychology
  • Clinical Neurology
  • Psychiatry and Mental health

Cite this

Davidson, J. E., Irizarry, M. C., Bray, B. C., Wetten, S., Galwey, N., Gibson, R., ... Monsch, A. U. (2010). An exploration of cognitive subgroups in Alzheimers disease. Journal of the International Neuropsychological Society, 16(2), 233-243. https://doi.org/10.1017/S1355617709991160
Davidson, Julie E. ; Irizarry, Michael C. ; Bray, Bethany Cara ; Wetten, Sally ; Galwey, Nicholas ; Gibson, Rachel ; Borrie, Michael ; Delisle, Richard ; Feldman, Howard H. ; Hsiung, Ging Yuek ; Fornazzari, Luis ; Gauthier, Serge ; Guzman, Danilo ; Loy-English, Inge ; Keren, Ron ; Kertesz, Andrew ; George-Hyslop, Peter St ; Wherrett, John ; Monsch, Andreas U. / An exploration of cognitive subgroups in Alzheimers disease. In: Journal of the International Neuropsychological Society. 2010 ; Vol. 16, No. 2. pp. 233-243.
@article{1b649849de574bcbb694674679cf6d8a,
title = "An exploration of cognitive subgroups in Alzheimers disease",
abstract = "Heterogeneity is observed in the patterns of cognition in Alzheimer's disease (AD). Such heterogeneity might suggest the involvement of different etiological pathways or different host responses to pathology. A total of 627 subjects with mild/moderate AD underwent cognitive assessment with the Mini-Mental State Examination (MMSE) and the Dementia Rating Scale-2 (DRS-2). Latent class analysis (LCA) was performed on cognition subscale data to identify and characterize cognitive subgroups. Clinical, demographic, and genetic factors were explored for association with class membership. LCA suggested the existence of four subgroups; one group with mild and another with severe global impairment across the cognitive domains, one group with primary impairments in attention and construction, and another group with primary deficits in memory and orientation. Education, disease duration, age, Apolipoprotein E- ε4 ( APOE ε4) status, gender, presence of grasp reflex, white matter changes, and early or prominent visuospatial impairment were all associated with class membership. Our results support the existence of heterogeneity in patterns of cognitive impairment in AD. Our observation of classes characterized by predominant deficits in attention/construction and memory respectively deserves further exploration as does the association between membership in the attention/ construction class and APOE ε4 negative status.",
author = "Davidson, {Julie E.} and Irizarry, {Michael C.} and Bray, {Bethany Cara} and Sally Wetten and Nicholas Galwey and Rachel Gibson and Michael Borrie and Richard Delisle and Feldman, {Howard H.} and Hsiung, {Ging Yuek} and Luis Fornazzari and Serge Gauthier and Danilo Guzman and Inge Loy-English and Ron Keren and Andrew Kertesz and George-Hyslop, {Peter St} and John Wherrett and Monsch, {Andreas U.}",
year = "2010",
month = "3",
day = "1",
doi = "10.1017/S1355617709991160",
language = "English (US)",
volume = "16",
pages = "233--243",
journal = "Journal of the International Neuropsychological Society",
issn = "1355-6177",
publisher = "Cambridge University Press",
number = "2",

}

Davidson, JE, Irizarry, MC, Bray, BC, Wetten, S, Galwey, N, Gibson, R, Borrie, M, Delisle, R, Feldman, HH, Hsiung, GY, Fornazzari, L, Gauthier, S, Guzman, D, Loy-English, I, Keren, R, Kertesz, A, George-Hyslop, PS, Wherrett, J & Monsch, AU 2010, 'An exploration of cognitive subgroups in Alzheimers disease', Journal of the International Neuropsychological Society, vol. 16, no. 2, pp. 233-243. https://doi.org/10.1017/S1355617709991160

An exploration of cognitive subgroups in Alzheimers disease. / Davidson, Julie E.; Irizarry, Michael C.; Bray, Bethany Cara; Wetten, Sally; Galwey, Nicholas; Gibson, Rachel; Borrie, Michael; Delisle, Richard; Feldman, Howard H.; Hsiung, Ging Yuek; Fornazzari, Luis; Gauthier, Serge; Guzman, Danilo; Loy-English, Inge; Keren, Ron; Kertesz, Andrew; George-Hyslop, Peter St; Wherrett, John; Monsch, Andreas U.

In: Journal of the International Neuropsychological Society, Vol. 16, No. 2, 01.03.2010, p. 233-243.

Research output: Contribution to journalArticle

TY - JOUR

T1 - An exploration of cognitive subgroups in Alzheimers disease

AU - Davidson, Julie E.

AU - Irizarry, Michael C.

AU - Bray, Bethany Cara

AU - Wetten, Sally

AU - Galwey, Nicholas

AU - Gibson, Rachel

AU - Borrie, Michael

AU - Delisle, Richard

AU - Feldman, Howard H.

AU - Hsiung, Ging Yuek

AU - Fornazzari, Luis

AU - Gauthier, Serge

AU - Guzman, Danilo

AU - Loy-English, Inge

AU - Keren, Ron

AU - Kertesz, Andrew

AU - George-Hyslop, Peter St

AU - Wherrett, John

AU - Monsch, Andreas U.

PY - 2010/3/1

Y1 - 2010/3/1

N2 - Heterogeneity is observed in the patterns of cognition in Alzheimer's disease (AD). Such heterogeneity might suggest the involvement of different etiological pathways or different host responses to pathology. A total of 627 subjects with mild/moderate AD underwent cognitive assessment with the Mini-Mental State Examination (MMSE) and the Dementia Rating Scale-2 (DRS-2). Latent class analysis (LCA) was performed on cognition subscale data to identify and characterize cognitive subgroups. Clinical, demographic, and genetic factors were explored for association with class membership. LCA suggested the existence of four subgroups; one group with mild and another with severe global impairment across the cognitive domains, one group with primary impairments in attention and construction, and another group with primary deficits in memory and orientation. Education, disease duration, age, Apolipoprotein E- ε4 ( APOE ε4) status, gender, presence of grasp reflex, white matter changes, and early or prominent visuospatial impairment were all associated with class membership. Our results support the existence of heterogeneity in patterns of cognitive impairment in AD. Our observation of classes characterized by predominant deficits in attention/construction and memory respectively deserves further exploration as does the association between membership in the attention/ construction class and APOE ε4 negative status.

AB - Heterogeneity is observed in the patterns of cognition in Alzheimer's disease (AD). Such heterogeneity might suggest the involvement of different etiological pathways or different host responses to pathology. A total of 627 subjects with mild/moderate AD underwent cognitive assessment with the Mini-Mental State Examination (MMSE) and the Dementia Rating Scale-2 (DRS-2). Latent class analysis (LCA) was performed on cognition subscale data to identify and characterize cognitive subgroups. Clinical, demographic, and genetic factors were explored for association with class membership. LCA suggested the existence of four subgroups; one group with mild and another with severe global impairment across the cognitive domains, one group with primary impairments in attention and construction, and another group with primary deficits in memory and orientation. Education, disease duration, age, Apolipoprotein E- ε4 ( APOE ε4) status, gender, presence of grasp reflex, white matter changes, and early or prominent visuospatial impairment were all associated with class membership. Our results support the existence of heterogeneity in patterns of cognitive impairment in AD. Our observation of classes characterized by predominant deficits in attention/construction and memory respectively deserves further exploration as does the association between membership in the attention/ construction class and APOE ε4 negative status.

UR - http://www.scopus.com/inward/record.url?scp=77952549820&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=77952549820&partnerID=8YFLogxK

U2 - 10.1017/S1355617709991160

DO - 10.1017/S1355617709991160

M3 - Article

VL - 16

SP - 233

EP - 243

JO - Journal of the International Neuropsychological Society

JF - Journal of the International Neuropsychological Society

SN - 1355-6177

IS - 2

ER -