Longitudinal trajectories of cognitive change in preclinical Alzheimer's disease:: A growth mixture modeling analysis
Longitudinal trajectories of cognitive change in preclinical Alzheimer's disease:: A growth mixture modeling analysis
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DOI：
10.1016/s0010-9452(08)70682-8
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发表时间：
2007-10-01
期刊：
影响因子：
3.6
通讯作者：
Baeckman, Lars
中科院分区：
文献类型：
--
作者：
Small, Brent J.;Baeckman, Lars
临床前阿尔茨海默病（AD）是指诊断前的一段时间，在此期间，将继续接受AD诊断的个体中存在认知缺陷。人们对描述临床前阶段认知变化的性质非常感兴趣，无论是以线性方式下降到诊断，还是表现出一定的功能稳定性，然后迅速丧失性能。在目前的研究中，我们应用增长混合模型的数据从Kungsholmen项目，以评估是否在AD的临床前阶段的简易精神状态检查（MMSE）评分下降遵循线性或二次函数。在7年随访期结束时。一些个体将被诊断患有AD（n = 71），而其他个体将保持无痴呆（n = 457）。结果表明，两组二次下降模型提供了最佳的统计拟合测量，以及灵敏度（67%）和特异性（86%）的最大估计。MMSE评分的差异在基线时是明显的，但临床前AD组在诊断前三年开始经历急剧下降。最后，被错误归类为临床前AD的人在基线时的受教育年限较少，MMSE评分较差。
Preclinical Alzheimer's disease (AD) refers to a period of time prior to diagnosis during which cognitive deficits among individuals who will go on to receive a diagnosis of AD are present. There is great interest in describing the nature of cognitive change during the preclinical period, in terms of whether persons decline in a linear fashion to diagnosis, or exhibit some stability of functioning, followed by rapid losses in performance. In the current study we apply Growth Mixture Modeling to data from The Kungsholmen Project to evaluate whether decline in Mini Mental State Examination (MMSE) scores during the preclinical period of AD follows a linear or quadratic function. At the end of a 7-year follow-up period. some individuals would be diagnosed with AD (n = 71), whereas others would remain free of dementia (n = 457). The results indicated that a two-group quadratic model of decline provided the best statistical fit measures, as well as the Greatest estimates of sensitivity (67%) and specificity (86%). Differences in MMSE scores were apparent at baseline, but the preclinical AD group began to experience precipitous declines three years prior to diagnosis. Finally, persons who were misclassified as preclinical AD had fewer years of education and poorer MMSE scores at baseline.