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Author Notes:

John J. Hanfelt, PhD, Department of Biostatistics and Bioinformatics, Emory University Rollins School of Public Health, 1518 Clifton Road, N.E., Atlanta, Georgia 30322 Phone: 404-727-2876; Fax: 404-727-1370 jhanfel@emory.edu.

Alternate correspondent: James J. Lah, MD, PhD, Department of Neurology, Emory University School of Medicine, 12 Executive Park Dr., N.E., Atlanta, Georgia 30329 Phone 404-727-3509; Fax: 404-727-3728 jlah@emory.edu.

We also thank the ADC participants for their willingness to devote their time to research.

Declarations of interest: none

Subjects:

Research Funding:

Complete funding list available in full text.

Keywords:

  • Science & Technology
  • Life Sciences & Biomedicine
  • Neurosciences
  • Neurosciences & Neurology
  • Alzheimer's disease
  • Competing risks
  • Frontotemporal lobar degeneration
  • Latent class analysis
  • Lewy bodies
  • Mild cognitive impairment
  • Prodromal dementia
  • Survival analysis
  • Vascular dementia
  • ATRIAL-FIBRILLATION
  • NEUROPSYCHOLOGICAL TESTS
  • DISEASE
  • DEMENTIA
  • POPULATION
  • COMMUNITY
  • SUBTYPES
  • METAANALYSIS
  • SENSITIVITY
  • BIOMARKERS

Latent classes of mild cognitive impairment are associated with clinical outcomes and neuropathology: Analysis of data from the National Alzheimer's Coordinating Center

Tools:

Journal Title:

Neurobiology of Disease

Volume:

Volume 117

Publisher:

, Pages 62-71

Type of Work:

Article | Post-print: After Peer Review

Abstract:

Given the importance of identifying prodromes of dementia with specific etiologies, we assessed whether seven latent classes of mild cognitive impairment (MCI), defined empirically based on cognitive, functional, and neuropsychiatric information at initial visit, are associated with distinct clinical outcomes and neuropathological features. We separated 6034 participants with a baseline diagnosis of MCI into seven latent classes using previously defined criteria. We found that these latent classes of MCI differed significantly in their clinical outcomes, survival time, and neuropathology. Two amnestic multi-domain subgroups, as well as two other subgroups with functional impairments and neuropsychiatric disturbances, were at higher risk of not only a ‘pure’ form of Alzheimer's disease (AD) pathology, but also a ‘mixed’ pathology consisting of both AD and vascular features. Moreover, the seven latent classes had different risks of Lewy bodies, hippocampal sclerosis, and frontotemporal lobar degeneration (FTLD). This study indicates that data-driven subgroups of MCI are clinicopathologically informative and, with refinement, could lead to targeted interventions focused on each etiology.

Copyright information:

© 2018 Elsevier Inc.

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (http://creativecommons.org/licenses/by-nc-nd/4.0/).

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