Profiles of cognitive change in preclinical Alzheimer's disease using change-point analysis
Williams, O. A.; An, Y.; Armstrong, N. M.; Kitner-Triolo, M.; Ferrucci, L.; Resnick, S. M.
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IntroductionChange-point analyses are increasingly used to identify the temporal stages of accelerated cognitive decline in the preclinical stages of Alzheimers Disease (AD). However, statistical comparisons of change-points between specific cognitive measures have not been reported. Methods165 older adults (baseline age range: 61.1-91.2) from the Baltimore Longitudinal Study of Aging developed AD during follow-up. Linear and non-linear mixed models were fit for 11 cognitive measures to determine change-points in rates of decline before AD diagnosis. Bootstrapping was used to compare the timing of change-points across cognitive measures. ResultsChange-points followed by accelerated decline ranged from 15.5 years (Card Rotations) to 1.9 years (Trail-Making A) before AD diagnosis. Accelerated decline in Card Rotations occurred significantly earlier than all other measures, including learning and memory measures. DiscussionResults suggest that visuospatial ability, as assessed by Card Rotations, may have the greatest utility as an early predictive tool in identifying preclinical AD.
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