Classification, Prediction, and Concordance of Cognitive and Functional Progression in Patients with Mild Cognitive Impairment in the United States: A Latent Class Analysis.
J Alzheimers Dis
; 82(4): 1667-1682, 2021.
Article
in En
| MEDLINE
| ID: mdl-34219723
ABSTRACT
BACKGROUND:
Progression trajectories of patients with mild cognitive impairment (MCI) are currently not well understood.OBJECTIVE:
To classify patients with incident MCI into different latent classes of progression and identify predictors of progression class.METHODS:
Participants with incident MCI were identified from the US National Alzheimer's Coordinating Center Uniform Data Set (09/2005-02/2019). Clinical Dementia Rating (CDR®) Dementia Staging Instrument-Sum of Boxes (CDR-SB), Functional Activities Questionnaire (FAQ), and Mini-Mental State Examination (MMSE) score longitudinal trajectories from MCI diagnosis were fitted using growth mixture models. Predictors of progression class were identified using multivariate multinomial logistic regression models; odds ratios (ORs) and 95% confidence intervals (CIs) were reported.RESULTS:
In total, 21%, 22%, and 57% of participants (Nâ=â830) experienced fast, slow, and no progression on CDR-SB, respectively; for FAQ, these figures were 14%, 23%, and 64%, respectively. CDR-SB and FAQ class membership was concordant for most participants (77%). Older age (≥86 versus≤70 years, OR [95% CI]â=â5.26 [1.78-15.54]), one copy of APOE É4 (1.94 [1.08-3.47]), higher baseline CDR-SB (2.46 [1.56-3.88]), lower baseline MMSE (0.85 [0.75-0.97]), and higher baseline FAQ (1.13 [1.02-1.26]) scores were significant predictors of fast progression versus no progression based on CDR-SB (all pâ<â0.05). Predictors of FAQ class membership were largely similar.CONCLUSION:
Approximately a third of participants experienced progression based on CDR-SB or FAQ during the 4-year follow-up period. CDR-SB and FAQ class assignment were concordant for the vast majority of participants. Identified predictors may help the selection of patients at higher risk of progression in future trials.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Models, Statistical
/
Cognition
/
Disease Progression
/
Cognitive Dysfunction
/
Physical Functional Performance
Type of study:
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Humans
Country/Region as subject:
America do norte
Language:
En
Journal:
J Alzheimers Dis
Journal subject:
GERIATRIA
/
NEUROLOGIA
Year:
2021
Document type:
Article
Affiliation country: