Latent Cognitive Profiles Differ Between Incipient Alzheimer’s Disease and Dementia with Subcortical Vascular Lesions in a Memory Clinic Population

Article type: Research Article

Authors: Göthlin, Mattias^{a; *} | Eckerström, Marie^a | Lindwall, Magnus^b | Rolstad, Sindre^a | Eckerström, Carl^a | Jonsson, Michael^a | Kettunen, Petronella^a | Svensson, Johan^c | Wallin, Anders^a

Affiliations: [a] Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Mölndal, Sweden | [b] Department of Psychology, University of Gothenburg, Gothenburg, Sweden | [c] Department of Internal Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Sweden

Correspondence: [*] Correspondence to: Mattias Göthlin, Wallinsgatan 6, 431 41 Mölndal, Sweden. Tel.: +31640998840; E-mail: [email protected].

Abstract: Background:It is unclear if latent cognitive profiles can distinguish between dementia with subcortical vascular lesions and Alzheimer’s disease (AD) at the incipient stage, and if they differ in performance from the Petersen subtypes. Objective:To identify latent cognitive profiles in a naturalistic population of patients from a memory clinic sample, and investigate the derived classes not only in terms of conversion to AD, but also in terms of conversion to dementia with subcortical vascular lesions. Another objective was to compare the derived classes to the Petersen subtypes. Methods:We performed a latent profile analysis (LPA) on standardized neuropsychological test scores from 476 memory clinic patients (age 64±8) without dementia, and analyzed progression to dementia after 2 years. Results:The LPA resulted in two classes with impaired cognition (Amnestic and Slow/Dysexecutive) and two classes with normal cognition (Normal-Low and Normal-High cognition). Belonging to the Amnestic class predicted progression to all-cause dementia and to AD; belonging to the Slow/Dysexecutive class predicted progression to all-cause dementia, AD, and dementia with subcortical vascular lesions. Of the Petersen MCI subtypes, only amnestic multi-domain MCI predicted progression to all-cause dementia, AD, and dementia with subcortical vascular lesions. Conclusion:Latent cognitive profiles separated between AD and dementia with subcortical vascular lesions, while the Petersen subtypes did not. However, similar to the Petersen subtypes, LPA classes work better for ruling out progression to dementia than for case finding.

Keywords: Alzheimer’s disease, mild cognitive impairment, mild neurocognitive disorder, observational study, subcortical vascular dementia

DOI: 10.3233/JAD-190515

Journal: Journal of Alzheimer's Disease, vol. 73, no. 3, pp. 955-966, 2020