Heterogeneity and Factorial Structure in Alzheimer’s Disease: A Cognitive Perspective
| Autor: | Gianmarco Altoè, Andrea Zangrossi, Sara Mondini, Sonia Montemurro |
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| Rok vydání: | 2021 |
| Předmět: |
Male
precision medicine Alzheimer’s disease factor mixture analysis heterogeneity precision medicine Neuropsychological Tests Logistic regression Cognition Alzheimer Disease Memory Humans Aged General Neuroscience factor mixture analysis Perspective (graphical) General Medicine Impaired memory Precision medicine Cognitive test Comprehension Psychiatry and Mental health Clinical Psychology Phenotype Female heterogeneity Geriatrics and Gerontology Psychology Alzheimer’s disease Neurocognitive Cognitive psychology |
| Zdroj: | Journal of Alzheimer's Disease. 83:1341-1351 |
| ISSN: | 1875-8908 1387-2877 |
| Popis: | Background: Alzheimer’s disease (AD) patients show heterogeneous cognitive profiles which suggest the existence of cognitive subgroups. A deeper comprehension of this heterogeneity could contribute to move toward a precision medicine perspective. Objective: In this study, we aimed 1) to investigate AD cognitive heterogeneity as a product of the combination of within- (factors) and between-patients (sub-phenotypes) components, and 2) to promote its assessment in clinical practice by defining a small set of critical tests for this purpose. Methods: We performed factor mixture analysis (FMA) on neurocognitive assessment results of N = 230 patients with a clinical diagnosis of AD. This technique allowed to investigate the structure of cognitive heterogeneity in this sample and to characterize the core features of cognitive sub-phenotypes. Subsequently, we performed a tests selection based on logistic regression to highlight the best tests to detect AD patients in our sample. Finally, the accuracy of the same tests in the discrimination of sub-phenotypes was evaluated. Results: FMA revealed a structure characterized by five latent factors and four groups, which were identifiable by means of a few cognitive tests and were mainly characterized by memory deficits with visuospatial difficulties (“Visuospatial AD”), typical AD cognitive pattern (“Typical AD”), less impaired memory (“Mild AD”), and language/praxis deficits with relatively spared memory (“Nonamnestic AD”). Conclusion: The structure of cognitive heterogeneity in our sample of AD patients, as studied by FMA, could be summarized by four sub-phenotypes with distinct cognitive characteristics easily identifiable in clinical practice. Clinical implications under the precision medicine framework are discussed. |
| Databáze: | OpenAIRE |
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