期刊
ALZHEIMERS & DEMENTIA
卷 11, 期 4, 页码 415-424出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jalz.2014.03.005
关键词
Mild cognitive impairment; MCI; Alzheimer's disease; Dementia; Neuropsychology; Misdiagnosis; Misclassification; Cluster analysis
资金
- NIH [R01 AG012674, K24 AG026431, P50 AG05131, R01 AG16495, P30 AG010129, K01 AG030514]
- Alzheimer's Association [NIRG-13-281806]
- Alzheimer's Disease Neuroimaging Initiative (ADNI) (National Institutes of Health) [U01 AG024904]
- DOD ADNI (Department of Defense) [W81XWH-12-2-0012]
- National Institute on Aging
- National Institute of Biomedical Imaging and Bioengineering
- Pfizer
- Elan
- Balance Pharmaceuticals, Inc.
Background: We assessed whether mild cognitive impairment (MCI) subtypes could be empirically derived within the Alzheimer's Disease Neuroimaging Initiative (ADNI) MCI cohort and examined associated biomarkers and clinical outcomes. Methods: Cluster analysis was performed on neuropsychological data from 825 MCI ADNI participants. Results: Four subtypes emerged: (1) dysnomic (n = 153), (2) dysexecutive (n = 102), (3) amnestic (n = 288), and (4) cluster-derived normal (n = 282) who performed within normal limits on cognitive testing. The cluster-derived normal group had significantly fewer APOE epsilon 4 carriers and fewer who progressed to dementia compared with the other subtypes; they also evidenced cerebrospinal fluid Alzheimer's disease biomarker profiles that did not differ from the normative reference group. Conclusions: Identification of empirically derived MCI subtypes demonstrates heterogeneity in MCI cognitive profiles that is not captured by conventional criteria. The large cluster-derived normal group suggests that conventional diagnostic criteria are susceptible to false-positive errors, with the result that prior MCI studies may be diluting important biomarker relationships. (C) 2015 The Alzheimer's Association. Published by Elsevier Inc. All rights reserved.
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