Potential factors associated with cognitive improvement of individuals diagnosed with mild cognitive impairment or dementia in longitudinal studies
Author(s)
Hadjichrysanthou, Christoforos
McRae-McKee, Kevin
Evans, Stephanie
de Wolf, Frank
Anderson, Roy M
Type
Journal Article
Abstract
Despite the progressive nature of Alzheimer’s disease and other dementias, it is observed that many individuals that are diagnosed with mild cognitive impairment (MCI) in one clinical assessment, may return back to normal cognition (CN) in a subsequent assessment. Less frequently, such ‘back-transitions’ are also observed in people that had already been diagnosed with later stages of dementia. In this study, an analysis was performed on two longitudinal cohort datasets provided by 1) the Alzheimer’s Disease Neuroimaging Initiative (ADNI) and 2) the National Alzheimer’s Coordinating Centre (NACC). The focus is on the observed improvement of individuals’ clinical condition recorded in these datasets to explore potential associations with different factors. It is shown that, in both datasets, transitions from MCI to CN are significantly associated with younger age, better cognitive function, and the absence of ApoE ɛ4 alleles. Better cognitive function and in some cases the absence of ApoE ɛ4 alleles are also significantly associated with transitions from types of dementia to less severe clinical states. The effect of gender and education is not clear-cut in these datasets, although highly educated people who reach MCI tend to be more likely to show an improvement in their clinical state. The potential effect of other factors such as changes in symptoms of depression is also discussed. Although improved clinical outcomes can be associated with many factors, better diagnostic tools are required to provide insight into whether such improvements are a result of misdiagnosis, and if they are not, whether they are linked to improvements in the underlying neuropathological condition.
Date Issued
2018-10-30
Date Acceptance
2018-08-17
Citation
Journal of Alzheimer's Disease, 2018, 66 (2), pp.587-600
ISSN
1387-2877
Publisher
IOS Press
Start Page
587
End Page
600
Journal / Book Title
Journal of Alzheimer's Disease
Volume
66
Issue
2
Copyright Statement
© 2018 – IOS Press and the authors. This article is published online with Open Access and distributed under the terms of the Creative Commons Attribution Non-Commercial License (CC BY-
NC 4.0 - https://creativecommons.org/licenses/by-nc/4.0/).
NC 4.0 - https://creativecommons.org/licenses/by-nc/4.0/).
Sponsor
Janssen Vaccines & Prevention B.V
Identifier
http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000451224700016&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=1ba7043ffcc86c417c072aa74d649202
Grant Number
P22539540R
Subjects
Science & Technology
Life Sciences & Biomedicine
Neurosciences
Neurosciences & Neurology
Alzheimer's disease
back-transitions
clinical states
dementia
longitudinal studies
mild cognitive impairment
misdiagnosis
ALZHEIMERS-DISEASE
NATIONAL INSTITUTE
TRANSITION-PROBABILITIES
CLINICAL-DIAGNOSIS
BRAIN RESERVE
PROGRESSION
ACCURACY
CENTERS
SCALE
Publication Status
Published
Date Publish Online
2018-10-30