Faster cognitive and functional decline in Dysexecutive versus amnestic Alzheimer's subgroups: a longitudinal analysis of the National Alzheimer's Coordinating Center (NACC) database.

<h4>Objective</h4>To compare the rate of cognitive and functional decline in dysexecutive, typical and amnestic subgroups of Alzheimer's disease.<h4>Methods</h4>943 participants from the National Alzheimer's Coordinating Center (NACC) database who had a diagnosis of...

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Autores principales:	Jesse Mez, Stephanie Cosentino, Adam M Brickman, Edward D Huey, Jennifer J Manly, Richard Mayeux
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/d1cfa1ecb142446db0480e87196fdd1c
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spelling	oai:doaj.org-article:d1cfa1ecb142446db0480e87196fdd1c2021-11-18T07:43:09ZFaster cognitive and functional decline in Dysexecutive versus amnestic Alzheimer's subgroups: a longitudinal analysis of the National Alzheimer's Coordinating Center (NACC) database.1932-620310.1371/journal.pone.0065246https://doaj.org/article/d1cfa1ecb142446db0480e87196fdd1c2013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23755200/pdf/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Objective</h4>To compare the rate of cognitive and functional decline in dysexecutive, typical and amnestic subgroups of Alzheimer's disease.<h4>Methods</h4>943 participants from the National Alzheimer's Coordinating Center (NACC) database who had a diagnosis of probable AD were followed for a mean of 2.3 years. A dysexecutive subgroup (n = 165) was defined as having executive performance >1.5 SD worse than memory performance, an amnestic subgroup (n = 157) was defined as having memory performance >1.5 SD worse than executive performance and a typical subgroup (n = 621) was defined as having a difference in executive and memory performance of <1.5 SD. Generalized estimating equations (GEE) were used to model decline on the Folstein Mini Mental Status Exam (MMSE), rise on the Clinical Dementia Rating (CDR) sum of boxes and rise on the total Functional Assessment Questionnaire (FAQ).<h4>Results</h4>Compared with the amnestic subgroup, the dysexecutive subgroup declined 2.2X faster on the Folstein MMSE (p<.001), rose 42% faster on the CDR sum of boxes (p = .03) and rose 33% faster on the total FAQ (p = .01). Rate of change for the typical subgroup fell between that of the amnestic and dysexecutive subgroups for the MMSE, CDR sum of boxes and total FAQ. Among a subset of participants (n = 129) who underwent autopsy, the dysexecutive, amnestic and typical subgroups did not differ in odds of having an AD pathologic diagnosis, suggesting that variation in non-AD pathologies across subtypes did not lead to the observed differences.<h4>Conclusions</h4>A dysexecutive subgroup of AD has a unique disease course in addition to cognitive phenotype.Jesse MezStephanie CosentinoAdam M BrickmanEdward D HueyJennifer J ManlyRichard MayeuxPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 6, p e65246 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jesse Mez Stephanie Cosentino Adam M Brickman Edward D Huey Jennifer J Manly Richard Mayeux Faster cognitive and functional decline in Dysexecutive versus amnestic Alzheimer's subgroups: a longitudinal analysis of the National Alzheimer's Coordinating Center (NACC) database.
description	<h4>Objective</h4>To compare the rate of cognitive and functional decline in dysexecutive, typical and amnestic subgroups of Alzheimer's disease.<h4>Methods</h4>943 participants from the National Alzheimer's Coordinating Center (NACC) database who had a diagnosis of probable AD were followed for a mean of 2.3 years. A dysexecutive subgroup (n = 165) was defined as having executive performance >1.5 SD worse than memory performance, an amnestic subgroup (n = 157) was defined as having memory performance >1.5 SD worse than executive performance and a typical subgroup (n = 621) was defined as having a difference in executive and memory performance of <1.5 SD. Generalized estimating equations (GEE) were used to model decline on the Folstein Mini Mental Status Exam (MMSE), rise on the Clinical Dementia Rating (CDR) sum of boxes and rise on the total Functional Assessment Questionnaire (FAQ).<h4>Results</h4>Compared with the amnestic subgroup, the dysexecutive subgroup declined 2.2X faster on the Folstein MMSE (p<.001), rose 42% faster on the CDR sum of boxes (p = .03) and rose 33% faster on the total FAQ (p = .01). Rate of change for the typical subgroup fell between that of the amnestic and dysexecutive subgroups for the MMSE, CDR sum of boxes and total FAQ. Among a subset of participants (n = 129) who underwent autopsy, the dysexecutive, amnestic and typical subgroups did not differ in odds of having an AD pathologic diagnosis, suggesting that variation in non-AD pathologies across subtypes did not lead to the observed differences.<h4>Conclusions</h4>A dysexecutive subgroup of AD has a unique disease course in addition to cognitive phenotype.
format	article
author	Jesse Mez Stephanie Cosentino Adam M Brickman Edward D Huey Jennifer J Manly Richard Mayeux
author_facet	Jesse Mez Stephanie Cosentino Adam M Brickman Edward D Huey Jennifer J Manly Richard Mayeux
author_sort	Jesse Mez
title	Faster cognitive and functional decline in Dysexecutive versus amnestic Alzheimer's subgroups: a longitudinal analysis of the National Alzheimer's Coordinating Center (NACC) database.
title_short	Faster cognitive and functional decline in Dysexecutive versus amnestic Alzheimer's subgroups: a longitudinal analysis of the National Alzheimer's Coordinating Center (NACC) database.
title_full	Faster cognitive and functional decline in Dysexecutive versus amnestic Alzheimer's subgroups: a longitudinal analysis of the National Alzheimer's Coordinating Center (NACC) database.
title_fullStr	Faster cognitive and functional decline in Dysexecutive versus amnestic Alzheimer's subgroups: a longitudinal analysis of the National Alzheimer's Coordinating Center (NACC) database.
title_full_unstemmed	Faster cognitive and functional decline in Dysexecutive versus amnestic Alzheimer's subgroups: a longitudinal analysis of the National Alzheimer's Coordinating Center (NACC) database.
title_sort	faster cognitive and functional decline in dysexecutive versus amnestic alzheimer's subgroups: a longitudinal analysis of the national alzheimer's coordinating center (nacc) database.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/d1cfa1ecb142446db0480e87196fdd1c
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Faster cognitive and functional decline in Dysexecutive versus amnestic Alzheimer's subgroups: a longitudinal analysis of the National Alzheimer's Coordinating Center (NACC) database.

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