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Semantic intrusion errors as a function of age, amyloid, and volumetric loss: a confirmatory path analysis

Published online by Cambridge University Press:  18 January 2021

D. Diane Zheng
Affiliation:
Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
Rosie E. Curiel Cid
Affiliation:
Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA 1Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
Ranjan Duara
Affiliation:
1Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA Wien Center for Alzheimer’s Disease and Memory Disorders, Mount Sinai Medical Center, Miami Beach, FL, USA
Marcela Kitaigorodsky
Affiliation:
Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
Elizabeth Crocco
Affiliation:
Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
David A. Loewenstein*
Affiliation:
Center for Cognitive Neuroscience and Aging, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA 1Florida Alzheimer’s Disease Research Center, Miami Beach, FL, USA
*
Correspondence should be addressed to: David A. Loewenstein, Professor of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1695 NW 9th Avenue, Suite 3202, Miami, Florida33136, USA. Phone: (305) 355-9080; Fax: 1 (305) 355-9076. Email: [email protected].

Abstract

Objective:

To examine the direct and indirect effects of age, APOE ϵ4 genotype, amyloid positivity, and volumetric reductions in AD-prone brain regions as it relates to semantic intrusion errors reflecting proactive semantic interference (PSI) and the failure to recover from proactive semantic interference (frPSI) on the Loewenstein-Acevedo Scales of Semantic Interference and Learning (LASSI-L), a cognitive stress test that has been consistently more predictive of preclinical and prodromal Alzheimer’s disease (AD) than traditional list-learning tests.

Design:

Cross-sectional study.

Setting:

1Florida Alzheimer’s Disease Research Center baseline study.

Participants:

Two-hundred and twelve participants with Mini-Mental State Examination (MMSE) score above 16 and a broad array of cognitive diagnoses ranging from cognitively normal (CN) to dementia, of whom 58% were female, mean age of 72.1 (SD 7.9).

Measures:

Participants underwent extensive clinical and neuropsychological evaluations, MR and amyloid Positron Emission Tomography/Computer/Computer Tomography (PET/CT) imaging, and analyses of APOE ϵ4 genotype. Confirmatory path analyses were conducted in the structural equation modeling framework that estimated multiple equations simultaneously while controlling for important covariates such as sex, education, language of evaluation, and global cognitive impairment.

Results:

Both amyloid positivity and decreased brain volumes in AD-prone regions were directly related to LASSI-L Cued B1 and Cued B2 intrusions (sensitive to PSI and frPSI effects) even after controlling for covariates. APOE ϵ4 status did not evidence direct effects on these LASSI-L cognitive markers, but rather exerted their effects on amyloid positivity, which in turn related to PSI and frPSI. Similarly, age did not have a direct relationship with LASSI-L scores, but exerted its effects indirectly through amyloid positivity and volumes of AD-prone brain regions.

Conclusions:

Our study provides insight into the relationships among age, APOE ϵ4, amyloid, and brain volumetric reductions as it relates to semantic intrusion errors. The investigation expands our understanding of the underpinnings of PSI and frPSI intrusions in a large cohort.

Type
Original Research Article
Copyright
© International Psychogeriatric Association 2021

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