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. 2019 Oct 8:5:553-562.
doi: 10.1016/j.trci.2019.08.009. eCollection 2019.

Latent class analysis identifies functional decline with Amsterdam IADL in preclinical Alzheimer's disease

Sarah-Christine Villeneuve  1   2 , Marion Houot  1 , Federica Cacciamani  3   4   5   6   7 , Merike Verrijp  8 , Bruno Dubois  1   3   4   5   6 , Sietske Sikkes  8   9 , Stéphane Epelbaum  1   3   4   5   6   7 ; MEMENTO study group and the INSIGHT-preAD study group
Collaborators, Affiliations

Latent class analysis identifies functional decline with Amsterdam IADL in preclinical Alzheimer's disease

Sarah-Christine Villeneuve et al. Alzheimers Dement (N Y). .

Abstract

Introduction: Trials in Alzheimer's disease (AD) now include participants at the earliest stages to prevent further decline. However, the lack of tools sensitive to subtle functional changes in early-stage AD hinders the development of new therapies as it is difficult to prove their clinical relevance.

Methods: We assessed functional changes over three years in 289 elderly memory complainers from the Investigation of Alzheimer's Predictors in subjective memory complainers cohort using the Amsterdam Instrumental-Activities-of-Daily-Living questionnaire (A-IADL-Q).

Results: No overall functional decline related to AD imaging markers was evidenced. However, five distinct classes of A-IADL-Q trajectories were identified. The largest class (212 [73.4%]) had stable A-IADL-Q scores over 3 years. A second group (23 [8.0%]) showed a persistent functional decline, higher amyloid load (P = .0005), and lower education (P = .0392).

Discussion: The A-IADL-Q identified a subtle functional decline in asymptomatic at-risk AD individuals. This could have important implications in the field of early intervention in AD.

Keywords: Alzheimer's disease; Amsterdam-IADL; Autonomy; Latent class analysis; Linear mixed model.

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Figures

Fig. 1
Fig. 1
(A) Individual evolution of the A-IADL-Q scores in the 289 INSIGHT-preAD cohort participants over three years. (B) The five mean A-IADL-Q trajectories identified by the LCLMM. (C) Individuals' A-IADL-Q trajectory according to the group of evolution identified by the LCLMM [Group 1: n = 20 (6.9%); Group 2: n = 212 (73.4%); Group 3: n = 7 (2.4%); Group 4: n = 23 (8.0%); Group 5: n = 27 (9.3%)]. Abbreviations: A-IADL-Q, Amsterdam Instrumental Activities of Daily Living Questionnaire; INSIGHT-preAD, Investigation of Alzheimer's Predictors in subjective memory complainers; LCLMM, latent class linear mixed model.
Fig. 2
Fig. 2
Estimated marginal probabilities of class belonging using a multinomial logistic model. Group 2 is the reference class with stable A-IADL-Q scores over 3 years according to (A) gender status, (B) educational level, (C) age at baseline, (D) amyloid-PET SUVr, and (E) FDG-PET SUVr in AD-related ROIs. Abbreviations: A-IADL-Q, Amsterdam Instrumental Activities of Daily Living Questionnaire; FDG, 18F-fluorodeoxyglucose; PET, positron emission tomography; SUVr, standardized uptake value ratio.
See this image and copyright information in PMC

References

    1. Cummings J., Ritter A., Zhong K. Clinical trials for disease-modifying therapies in Alzheimer's disease: a primer, lessons learned, and a blueprint for the future. J Alzheimers Dis. 2018;64:S3–S22. - PMC - PubMed
    1. Jekel K., Damian M., Wattmo C., Hausner L., Bullock R., Connelly P.J. Mild cognitive impairment and deficits in instrumental activities of daily living: a systematic review. Alzheimer's Res Ther. 2015;7:17. - PMC - PubMed
    1. Marshall G.A., Amariglio R.E., Sperling R.A., Rentz D.M. Activities of daily living: where do they fit in the diagnosis of Alzheimer's disease? Neurodegener Dis Manag. 2012;2:483–491. - PMC - PubMed
    1. Sikkes S.A., Visser P.J., Knol D.L., de Lange-de Klerk E.S., Tsolaki M., Frisoni G.B. Do instrumental activities of daily living predict dementia at 1-and 2-year follow-up? Findings from the development of screening guidelines and diagnostic criteria for predementia Alzheimer's disease study. J Am Geriatr Soc. 2011;59:2273–2281. - PubMed
    1. Farias S.T., Chou E., Harvey D.J., Mungas D., Reed B., DeCarli C. Longitudinal trajectories of everyday function by diagnostic status. Psychol Aging. 2013;28:1070. - PMC - PubMed