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Rate of cognitive change in Alzheimer's disease: Methodological approaches using random effects models

Published online by Cambridge University Press:  11 January 2002

ROBERT GOULD ,
IAN ABRAMSON ,
DOUGLAS GALASKO  and
DAVID SALMON
ROBERT GOULD
Affiliation:
Department of Statistics, University of California, Los Angeles
IAN ABRAMSON
Affiliation:
Department of Mathematics, University of California, San Diego
DOUGLAS GALASKO
Affiliation:
Alzheimer's Disease Research Center, University of California, San Diego
DAVID SALMON
Affiliation:
Alzheimer's Disease Research Center, University of California, San Diego
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Abstract

Subtraction of serial scores, Least Squares Estimators, and Best Linear Unbiased Predictors (BLUPs) were compared for estimating rates of cognitive change for Mini-Mental State Exam (MMSE) and Dementia Rating Scale (DRS) scores for 299 probable Alzheimer's disease patients. The BLUPs provided cleaner group estimates of subjects' intercepts and slopes and are preferred. Regression analysis of the BLUP estimates of rate of change indicated that steeper declines were associated with higher levels of education and older age at onset. These effects were much smaller than those due to estimated initial cognitive test score. Differences in longitudinal metric characteristics of the MMSE and DRS were found, with the DRS yielding more precise change estimates. We discuss modeling these longitudinal data, and discuss use of the estimates of rate of change and intercept as data in their own right. (JINS, 2001, 7, 813–824.)

Keywords

BLUPREMLMMSEDRS
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 7 , Issue 7 , November 2001 , pp. 813 - 824
Copyright
© 2001 The International Neuropsychological Society

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