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. 2017 Dec;13(12):1307-1316.
doi: 10.1016/j.jalz.2017.04.011. Epub 2017 Jun 15.

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

Paul K Crane  1 , Emily Trittschuh  2 , Shubhabrata Mukherjee  3 , Andrew J Saykin  4 , R Elizabeth Sanders  3 , Eric B Larson  5 , Susan M McCurry  6 , Wayne McCormick  3 , James D Bowen  7 , Thomas Grabowski  8 , Mackenzie Moore  9 , Julianna Bauman  9 , Alden L Gross  10 , C Dirk Keene  11 , Thomas D Bird  12 , Laura E Gibbons  3 , Jesse Mez  13 ; Executive Prominent Alzheimer's Disease: Genetics and Risk Factors (EPAD:GRF) Investigators
Affiliations

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

Paul K Crane et al. Alzheimers Dement. 2017 Dec.

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 allele, 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.

Keywords: Alzheimer's disease; Cognition; Endophenotypes; Genetics; Heterogeneity; Neuropathology; Subgroups.

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Figures

Figure 1
Figure 1
Derivation of the analytic sample.
See this image and copyright information in PMC

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