RT Journal Article
SR Electronic
T1 The identification of cognitive subtypes in Alzheimer's disease dementia using latent class analysis
JF Journal of Neurology, Neurosurgery & Psychiatry
JO J Neurol Neurosurg Psychiatry
FD BMJ Publishing Group Ltd
SP 235
OP 243
DO 10.1136/jnnp-2014-309582
VO 87
IS 3
A1 Nienke M E Scheltens
A1 Francisca Galindo-Garre
A1 Yolande A L Pijnenburg
A1 Annelies E van der Vlies
A1 Lieke L Smits
A1 Teddy Koene
A1 Charlotte E Teunissen
A1 Frederik Barkhof
A1 Mike P Wattjes
A1 Philip Scheltens
A1 Wiesje M van der Flier
YR 2016
UL http://jnnp.bmj.com/content/87/3/235.abstract
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.