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Comparing measures of decline to dementia in amnestic MCI subjects in the National Alzheimer's Coordinating Center (NACC) Uniform Data Set

Published online by Cambridge University Press:  16 April 2012

Sarah E. Monsell ,
Danping Liu ,
Sandra Weintraub  and
Walter A. Kukull
Sarah E. Monsell*
Affiliation:
National Alzheimer's Coordinating Center, University of Washington, Seattle, Washington, USA
Danping Liu
Affiliation:
National Alzheimer's Coordinating Center, University of Washington, Seattle, Washington, USA
Sandra Weintraub
Affiliation:
Cognitive Neurology and Alzheimer's Disease Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA
Walter A. Kukull
Affiliation:
National Alzheimer's Coordinating Center, University of Washington, Seattle, Washington, USA Department of Epidemiology, University of Washington, Seattle, Washington, USA
*
Correspondence should be addressed to: Sarah E. Monsell, MS, National Alzheimer's Coordinating Center, University of Washington, 4311 11th Ave NE #300, Campus box 354983 Seattle, WA 98105, USA. Phone: +1 206-616-6208; Fax: +1 206-616-5927. Email: [email protected].
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Abstract

Background: Many studies have investigated factors associated with the rate of decline and evolution from mild cognitive impairment (MCI) to Alzheimer's disease (AD) dementia in elderly patients. In this analysis, we compared the rates of decline to dementia estimated from three common global measures of cognition: Mini-Mental State Examination (MMSE) score, Clinical Dementia Rating sum of boxes (CDR-SB) score, and a neuropsychological tests composite score (CS).

Methods: A total of 2,899 subjects in the National Alzheimer's Coordinating Center Uniform Data Set aged 65+ years diagnosed with amnestic mild cognitive impairment (aMCI) were included in this analysis. Population-averaged decline to dementia rates was estimated and compared for standardized MMSE, CDR-SB, and CS using Generalized Estimating Equations (GEE). Associations between rate of decline and several potential correlates of decline were also calculated and compared across measures.

Results: The CDR-SB had the steepest estimated slope, with a decline of 0.49 standard deviations (SD) per year, followed by the MMSE with 0.22 SD per year, and finally the CS with 0.07 SD per year. The rate of decline of the three measures differed significantly in a global test for differences (p < 0.0001). Age at visit, body mass index (BMI) at visit, Apolipoprotein E (APOE) ɛ4 allele status, and race (black vs. white) had significantly different relationships with rate of decline in a global test for difference among the three measures.

Conclusions: These results suggest that both the rate of decline and the effects of AD risk factors on decline to dementia can vary depending on the evaluative measure used.

Keywords

neuropsychological testingAlzheimer's diseasecognitive assessmentaging
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 10 , October 2012 , pp. 1553 - 1560
Copyright
Copyright © International Psychogeriatric Association 2012

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