TY - JOUR
T1 - An exploration of cognitive subgroups in Alzheimers disease
AU - Davidson, Julie E.
AU - Irizarry, Michael C.
AU - Bray, Bethany C.
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
Y1 - 2010/3
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.
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U2 - 10.1017/S1355617709991160
DO - 10.1017/S1355617709991160
M3 - Article
C2 - 19958568
AN - SCOPUS:77952549820
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 -