期刊
NEUROPSYCHOLOGY
卷 33, 期 5, 页码 599-608出版社
AMER PSYCHOLOGICAL ASSOC
DOI: 10.1037/neu0000532
关键词
mild cognitive impairment; neuropsychological assessment; variability; everyday functioning; neurodegeneration
资金
- U.S. Department of Veterans Affairs Clinical Sciences Research and Development Service, National Institutes of Health
- Alzheimer's Association
- Dana Foundation - Alzheimer's Disease Neuroimaging Initiative (ADNI) [U01 AG024904]
- Department of Defense (DoD) ADNI [W81XWH-12-2-001.2]
- National Institute on Aging
- National Institute of Biomedical Imaging and Bioengineering
- Alzheimer's Dnig Discovery Foundation
- Araclon Biotech
- CereSpir
- Cogstate
- Eisai
- Elan Pharmaceuticals
- Eli Lilly and Company
- Fujirebio
- GE Health care, IXICO
- Johnson & Johnson Pharmaceutical Research & Development, Lumosity
- Meso Scale Diagnostics
- Novartis Pharmaceuticals
- Canadian Institutes of Health Research
- ADNI clinical sites in Canada
- Foundation for the National Institutes of Health
- Northern California Institute for Research and Education
Objective: Intraindividual cognitive variability (IIV), a measure of within-person variability across cognitive measures at a single time point, is associated with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Little is known regarding brain changes underlying IIV, or the relationship between IIV and functional ability. Therefore, we investigated the association between IIV and cerebral atrophy in AD-vulnerable regions and everyday functioning in nondemented older adults. Method: 736 Alzheimer's Disease Neuroimaging Initiative (ADNI) participants (285 cognitively normal [CN]; 451 MCI) underwent neuropsychological testing and serial MRI over 2 years. Linear mixed effects models examined the association between baseline IIV and chance in entorhinal cortex thickness, hippocampal volume, and everyday functioning. Results: Adjusting for age, sex, apolipoprotein E genotype, amyloid-beta positivity. and mean level of cognitive performance, higher baseline IIV predicted faster rates of entorhinal and hippocampal atrophy, as well as functional decline. Higher IIV was associated with both entorhinal and hippocampal atrophy among MCI participants but selective vulnerability of the entorhinal cortex among CN individuals. Conclusions: IIV was associated with more widespread medial temporal lobe (MTL) atrophy in individuals with MCI relative to CN. suggesting that IIV may be tracking advancing MTL pathologic changes across the continuum of aging, MCI, and dementia. Findings suggest that cognitive dispersion may be a sensitive marker of neurodegeneration and functional decline in nondemented older adults.
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