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Validity Evidence for the Research Category, “Cognitively Unimpaired – Declining,” as a Risk Marker for Mild Cognitive Impairment and Alzheimer’s Disease
While clinically significant cognitive impairment is the key feature of the symptomatic stages of the Alzheimer’s disease (AD) continuum, subtle cognitive decline is now known to occur years before a clinical diagnosis of mild cognitive impairment (MCI) or dementia due to AD is made. The primary aim...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Frontiers Media S.A.
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8350058/ https://www.ncbi.nlm.nih.gov/pubmed/34381351 http://dx.doi.org/10.3389/fnagi.2021.688478 |
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author | Langhough Koscik, Rebecca Hermann, Bruce P. Allison, Samantha Clark, Lindsay R. Jonaitis, Erin M. Mueller, Kimberly D. Betthauser, Tobey J. Christian, Bradley T. Du, Lianlian Okonkwo, Ozioma Birdsill, Alex Chin, Nathaniel Gleason, Carey Johnson, Sterling C. |
author_facet | Langhough Koscik, Rebecca Hermann, Bruce P. Allison, Samantha Clark, Lindsay R. Jonaitis, Erin M. Mueller, Kimberly D. Betthauser, Tobey J. Christian, Bradley T. Du, Lianlian Okonkwo, Ozioma Birdsill, Alex Chin, Nathaniel Gleason, Carey Johnson, Sterling C. |
author_sort | Langhough Koscik, Rebecca |
collection | PubMed |
description | While clinically significant cognitive impairment is the key feature of the symptomatic stages of the Alzheimer’s disease (AD) continuum, subtle cognitive decline is now known to occur years before a clinical diagnosis of mild cognitive impairment (MCI) or dementia due to AD is made. The primary aim of this study was to examine criterion validity evidence for an operational definition of “cognitively unimpaired-declining” (CU-D) in the Wisconsin Registry for Alzheimer’s Prevention (WRAP), a longitudinal cohort study following cognition and risk factors from mid-life and on. Cognitive status was determined for each visit using a consensus review process that incorporated internal norms and published norms; a multi-disciplinary panel reviewed cases first to determine whether MCI or dementia was present, and subsequently whether CU-D was present, The CU-D group differed from CU-stable (CU-S) and MCI on concurrent measures of cognition, demonstrating concurrent validity. Participants who changed from CU-S to CU-D at the next study visit demonstrated greater declines than those who stayed CU-S. In addition, those who were CU-D were more likely to progress to MCI or dementia than those who were CU-S (predictive validity). In a subsample with positron emission tomography (PET) imaging, the CU-D group also differed from the CU-S and MCI/Dementia groups on measures of amyloid and tau burden, indicating that biomarker evidence of AD was elevated in those showing sub-clinical (CU-D) decline. Together, the results corroborate other studies showing that cognitive decline begins long before a dementia diagnosis and indicate that operational criteria can detect subclinical decline that may signal AD or other dementia risk. |
format | Online Article Text |
id | pubmed-8350058 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | Frontiers Media S.A. |
record_format | MEDLINE/PubMed |
spelling | pubmed-83500582021-08-10 Validity Evidence for the Research Category, “Cognitively Unimpaired – Declining,” as a Risk Marker for Mild Cognitive Impairment and Alzheimer’s Disease Langhough Koscik, Rebecca Hermann, Bruce P. Allison, Samantha Clark, Lindsay R. Jonaitis, Erin M. Mueller, Kimberly D. Betthauser, Tobey J. Christian, Bradley T. Du, Lianlian Okonkwo, Ozioma Birdsill, Alex Chin, Nathaniel Gleason, Carey Johnson, Sterling C. Front Aging Neurosci Neuroscience While clinically significant cognitive impairment is the key feature of the symptomatic stages of the Alzheimer’s disease (AD) continuum, subtle cognitive decline is now known to occur years before a clinical diagnosis of mild cognitive impairment (MCI) or dementia due to AD is made. The primary aim of this study was to examine criterion validity evidence for an operational definition of “cognitively unimpaired-declining” (CU-D) in the Wisconsin Registry for Alzheimer’s Prevention (WRAP), a longitudinal cohort study following cognition and risk factors from mid-life and on. Cognitive status was determined for each visit using a consensus review process that incorporated internal norms and published norms; a multi-disciplinary panel reviewed cases first to determine whether MCI or dementia was present, and subsequently whether CU-D was present, The CU-D group differed from CU-stable (CU-S) and MCI on concurrent measures of cognition, demonstrating concurrent validity. Participants who changed from CU-S to CU-D at the next study visit demonstrated greater declines than those who stayed CU-S. In addition, those who were CU-D were more likely to progress to MCI or dementia than those who were CU-S (predictive validity). In a subsample with positron emission tomography (PET) imaging, the CU-D group also differed from the CU-S and MCI/Dementia groups on measures of amyloid and tau burden, indicating that biomarker evidence of AD was elevated in those showing sub-clinical (CU-D) decline. Together, the results corroborate other studies showing that cognitive decline begins long before a dementia diagnosis and indicate that operational criteria can detect subclinical decline that may signal AD or other dementia risk. Frontiers Media S.A. 2021-07-26 /pmc/articles/PMC8350058/ /pubmed/34381351 http://dx.doi.org/10.3389/fnagi.2021.688478 Text en Copyright © 2021 Langhough Koscik, Hermann, Allison, Clark, Jonaitis, Mueller, Betthauser, Christian, Du, Okonkwo, Birdsill, Chin, Gleason and Johnson. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. |
spellingShingle | Neuroscience Langhough Koscik, Rebecca Hermann, Bruce P. Allison, Samantha Clark, Lindsay R. Jonaitis, Erin M. Mueller, Kimberly D. Betthauser, Tobey J. Christian, Bradley T. Du, Lianlian Okonkwo, Ozioma Birdsill, Alex Chin, Nathaniel Gleason, Carey Johnson, Sterling C. Validity Evidence for the Research Category, “Cognitively Unimpaired – Declining,” as a Risk Marker for Mild Cognitive Impairment and Alzheimer’s Disease |
title | Validity Evidence for the Research Category, “Cognitively Unimpaired – Declining,” as a Risk Marker for Mild Cognitive Impairment and Alzheimer’s Disease |
title_full | Validity Evidence for the Research Category, “Cognitively Unimpaired – Declining,” as a Risk Marker for Mild Cognitive Impairment and Alzheimer’s Disease |
title_fullStr | Validity Evidence for the Research Category, “Cognitively Unimpaired – Declining,” as a Risk Marker for Mild Cognitive Impairment and Alzheimer’s Disease |
title_full_unstemmed | Validity Evidence for the Research Category, “Cognitively Unimpaired – Declining,” as a Risk Marker for Mild Cognitive Impairment and Alzheimer’s Disease |
title_short | Validity Evidence for the Research Category, “Cognitively Unimpaired – Declining,” as a Risk Marker for Mild Cognitive Impairment and Alzheimer’s Disease |
title_sort | validity evidence for the research category, “cognitively unimpaired – declining,” as a risk marker for mild cognitive impairment and alzheimer’s disease |
topic | Neuroscience |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8350058/ https://www.ncbi.nlm.nih.gov/pubmed/34381351 http://dx.doi.org/10.3389/fnagi.2021.688478 |
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