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Longitudinal Trajectories of Informant-Reported Daily Functioning in Empirically Defined Subtypes of Mild Cognitive Impairment

Published online by Cambridge University Press:  10 May 2017

Kelsey R. Thomas
Affiliation:
Veterans Affairs San Diego Healthcare System, San Diego, California Department of Psychiatry, University of California, San Diego, La Jolla, California
Emily C. Edmonds
Affiliation:
Veterans Affairs San Diego Healthcare System, San Diego, California Department of Psychiatry, University of California, San Diego, La Jolla, California
Lisa Delano-Wood
Affiliation:
Veterans Affairs San Diego Healthcare System, San Diego, California Department of Psychiatry, University of California, San Diego, La Jolla, California
Mark W. Bondi*
Affiliation:
Veterans Affairs San Diego Healthcare System, San Diego, California Department of Psychiatry, University of California, San Diego, La Jolla, California
*
Correspondence and reprint requests to: Mark W. Bondi, VA San Diego Healthcare System, 3350 La Jolla Village Drive (116B), San Diego, CA 92161. E-mail: mbondi@ucsd.edu

Abstract

Objectives: Within the Alzheimer’s Disease Neuroimaging Initiative (ADNI)’s mild cognitive impairment (MCI) cohort, we previously identified MCI subtypes as well as participants initially diagnosed with MCI but found to have normal neuropsychological, biomarker, and neuroimaging profiles. We investigated the functional change over time in these empirically derived MCI subgroups. Methods: ADNI MCI participants (n=654) were classified using cluster analysis as Amnestic MCI (single-domain memory impairment), Dysnomic MCI (memory+language impairments), Dysexecutive/Mixed MCI (memory+language+attention/executive impairments), or Cluster-Derived Normal (CDN). Robust normal control participants (NCs; n=284) were also examined. The Functional Activities Questionnaire (FAQ) was administered at baseline through 48-month follow-up. Multilevel modeling examined FAQ trajectories by cognitive subgroup. Results: The Dysexecutive/Mixed group demonstrated the fastest rate of decline across all groups. Amnestic and Dysnomic groups showed steeper rates of decline than CDNs. While CDNs had more functional difficulty than NCs across visits, both groups’ mean FAQ scores remained below its suggested cutoff at all visits. Conclusions: Results (a) show the importance of executive dysfunction in the context of other impaired cognitive domains when predicting functional decline in at-risk elders, and (b) support our previous work demonstrating that ADNI’s MCI criteria may have resulted in false-positive MCI diagnoses, given the CDN’s better FAQ trajectory than those of the cognitively impaired MCI groups. (JINS, 2017, 23, 521–527)

Type
Brief Communication
Copyright
Copyright © The International Neuropsychological Society 2017 

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Footnotes

*

Data used in preparation of this article were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf

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