Subtypes Based on Neuropsychological Performance Predict Incident Dementia: Findings from the Rush Memory and Aging Project

Article type: Research Article

Authors: Zammit, Andrea R.^{a; b; *} | Muniz-Terrera, Graciela^c | Katz, Mindy J.^{a; b} | Hall, Charles B.^{a; b; d} | Ezzati, Ali^{a; b} | Bennett, David A.^e | Lipton, Richard B.^{a; b; c}

Affiliations: [a] Saul B. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA | [b] Einstein Aging Study, Albert Einstein College of Medicine, Bronx, NY, USA | [c] The University of Edinburgh, Scotland, UK | [d] Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, USA | [e] Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA

Correspondence: [*] Correspondence to: Andrea R. Zammit, Saul B. Korey, Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Van Etten Building, Rm 3C9A, Bronx, NY 10461, USA. Tel.: +1 718 430 3831; E-mail: [email protected].

Abstract: Background:In a previous report, we used latent class analysis (LCA) to identify natural subgroups of older adults in the Einstein Aging Study (EAS) based on neuropsychological performance. These subgroups differed in demographics, genetic profile, and prognosis. Herein, we assess the generalizability of these findings to an independent sample, the Rush Memory and Aging Project (MAP), which used an overlapping, but distinct neuropsychological battery. Objective:Our aim was to identify the association of natural subgroups based on neuropsychological performance in the MAP cohort with incident dementia and compare them with the associations identified in the EAS. Methods:MAP is a community-dwelling cohort of older adults living in the northeastern Illinois, Chicago. Latent class models were applied to baseline scores of 10 neuropsychological measures across 1,662 dementia-free MAP participants. Results were compared to prior findings from the EAS. Results:LCA resulted in a 5-class model: Mixed-Domain Impairment (n = 71, 4.3%), Memory-specific-Impairment (n = 274, 16.5%), Average (n = 767, 46.1%), Frontal Impairment (n = 222, 13.4%), and a class of Superior Cognition (n = 328, 19.7%). Similar to the EAS, the Mixed-Domain Impairment, the Memory-Specific Impairment, and the Frontal Impairment classes had higher risk of incident Alzheimer’s disease when compared to the Average class. By contrast, the Superior Cognition had a lower risk of Alzheimer’s disease when compared to the Average class. Conclusions:Natural cognitive subgroups in MAP are similar to those identified in EAS. These similarities, despite study differences in geography, sampling strategy, and cognitive tests, suggest that LCA is capable of identifying classes that are not limited to a single sample or a set of cognitive tests.

Keywords: Alzheimer’s disease, dementia, latent class analysis, neuropsychological profiles

DOI: 10.3233/JAD-180737

Journal: Journal of Alzheimer's Disease, vol. 67, no. 1, pp. 125-135, 2019