P1‐174: Stability and prediction of future dementia for multiple transitional cognitive states: The cache county study
Year: 2008
Type: article
Abstract: It is frequently assumed that individuals with MCI or other related syndromes will decline to dementia. Although this is often the case, many individuals may return to ‘normal’. Transitional cognitive states' stability remains mostly unexplored. Additionally, prediction of conversion to dementia based on neuropsychological anddemographic variables has long been an aim of AD research. Previously we compared definitions of algorithmically-derived constructs (cognitive impairment no dementia [CIND], age-associated cognitive decline [AACD], mild cognitive impairment [MCI-functional and MCI-amnestic], and prodromal AD [prAD]). Here, we evaluated the stability and predictive utility of these constructs to determine the best predictor of dementia and AD. The analysis sample included non-demented Cache County Memory Study (CCMS) participants who completed at least seven of 14 tests in the baseline neuropsychological evaluation (n=661). Stability was evaluated by comparing the frequencies of those who remained constant or declined to dementia with those who subsequently met criteria for ‘normal’ at follow-up three years later. Logistic regression was employed to determine which constructs were associated with later dementia and AD. Areas under the curve (AUCs) were compared to investigate whether any construct was superior. Rates of reversion to ‘normal’ were higher (28–50%) than rates of remaining stable or declining to dementia (17–37%) in most transitional cognitive constructs, especially those specifically focused on memory. In contrast, constructs incorporating functional impairment (fMCI, prAD) were more stable over time (i.e. 8–16% reverted to normal). Relative to cognitively normal individuals, prAD, fMCI, AACD, and CIND were significant predictors of later dementia and AD (OR 2.3–8.4). When AUCs were compared, prAD was statistically superior in the prediction of later dementia compared to the other significant predictors (z's ranging from 2.08–2.59). No construct was statistically superior for prediction of later AD. Individuals demonstrating mild functional impairment are less likely to revert to ‘normal.’ Constructs that rely on multiple cognitive domains or functional impairment are more highly associated with later development of dementia or AD than those that rely solely on memory. PrAD, which includes memory impairment and/or functional impairment, was statistically superior at predicting later dementia, but not AD.
Source: Alzheimer s & Dementia
Language: English
Subfield: Psychiatry and Mental health
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
OpenAlex ID: W2001571756