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

NEUROBIOLOGY OF DISEASE

卷:117

Article

Hanfelt, John J.^1,3  Peng, Limin¹  Goldstein, Felicia C.^2,3  Lah, James J.^2,3 

[1] Emory Univ, Rollins Sch Publ Hlth, Dept Biostat & Bioinformat, 1518 Clifton Rd NE, Atlanta, GA 30322 USA

[2] Emory Univ, Sch Med, Dept Neurol, 12 Execut Pk Dr NE, Atlanta, GA 30329 USA

[3] Emory Alzheimers Dis Res Ctr, Atlanta, GA USA

关键词: Alzheimer's disease;    Competing risks;    Frontotemporal lobar degeneration;    Latent class analysis;    Lewy bodies;    Mild cognitive impairment;    Prodromal dementia;    Survival analysis;    Vascular dementia;   

DOI  :  10.1016/j.nbd.2018.05.025

来源: Elsevier

【 摘 要 】

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.

【 授权许可】

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