PT  - JOURNAL ARTICLE
AU  - Nienke M E Scheltens
AU  - Francisca Galindo-Garre
AU  - Yolande A L Pijnenburg
AU  - Annelies E van der Vlies
AU  - Lieke L Smits
AU  - Teddy Koene
AU  - Charlotte E Teunissen
AU  - Frederik Barkhof
AU  - Mike P Wattjes
AU  - Philip Scheltens
AU  - Wiesje M van der Flier
TI  - The identification of cognitive subtypes in Alzheimer's disease dementia using latent class analysis
AID  - 10.1136/jnnp-2014-309582
DP  - 2016 Mar 01
TA  - Journal of Neurology, Neurosurgery & Psychiatry
PG  - 235--243
VI  - 87
IP  - 3
4099  - http://jnnp.bmj.com/content/87/3/235.short
4100  - http://jnnp.bmj.com/content/87/3/235.full
SO  - J Neurol Neurosurg Psychiatry2016 Mar 01; 87
AB  - Objective Alzheimer's disease (AD) is a heterogeneous disorder with complex underlying neuropathology that is still not completely understood. For better understanding of this heterogeneity, we aimed to identify cognitive subtypes using latent class analysis (LCA) in a large sample of patients with AD dementia. In addition, we explored the relationship between the identified cognitive subtypes, and their demographical and neurobiological characteristics.Methods We performed LCA based on neuropsychological test results of 938 consecutive probable patients with AD dementia using Mini-Mental State Examination as the covariate. Subsequently, we performed multinomial logistic regression analysis with cluster membership as dependent variable and dichotomised demographics, APOE genotype, cerebrospinal fluid biomarkers and MRI characteristics as independent variables.Results LCA revealed eight clusters characterised by distinct cognitive profile and disease severity. Memory-impaired clusters—mild-memory (MILD-MEM) and moderate-memory (MOD-MEM)—included 43% of patients. Memory-spared clusters mild-visuospatial-language (MILD-VILA), mild-executive (MILD-EXE) and moderate-visuospatial (MOD-VISP) —included 29% of patients. Memory-indifferent clusters mild-diffuse (MILD-DIFF), moderate-language (MOD-LAN) and severe-diffuse (SEV-DIFF) —included 28% of patients. Cognitive clusters were associated with distinct demographical and neurobiological characteristics. In particular, the memory-spared MOD-VISP cluster was associated with younger age, APOE e4 negative genotype and prominent atrophy of the posterior cortex.Conclusions Using LCA, we identified eight distinct cognitive subtypes in a large sample of patients with AD dementia. Cognitive clusters were associated with distinct demographical and neurobiological characteristics.