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Cognitive Function during the Prodromal Stage of Alzheimer’s Disease in Down Syndrome: Comparing Models

Accurate identification of the prodromal stage of Alzheimer’s disease (AD), known as mild cognitive impairment (MCI), in adults with Down syndrome (MCI-DS) has been challenging because there are no established diagnostic criteria that can be applied for people with lifelong intellectual disabilities...

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Autores principales: Hom, Christy L., Kirby, Katharine A., Ricks-Oddie, Joni, Keator, David B., Krinsky-McHale, Sharon J., Pulsifer, Margaret B., Rosas, Herminia Diana, Lai, Florence, Schupf, Nicole, Lott, Ira T., Silverman, Wayne
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8471085/
https://www.ncbi.nlm.nih.gov/pubmed/34573242
http://dx.doi.org/10.3390/brainsci11091220
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author Hom, Christy L.
Kirby, Katharine A.
Ricks-Oddie, Joni
Keator, David B.
Krinsky-McHale, Sharon J.
Pulsifer, Margaret B.
Rosas, Herminia Diana
Lai, Florence
Schupf, Nicole
Lott, Ira T.
Silverman, Wayne
author_facet Hom, Christy L.
Kirby, Katharine A.
Ricks-Oddie, Joni
Keator, David B.
Krinsky-McHale, Sharon J.
Pulsifer, Margaret B.
Rosas, Herminia Diana
Lai, Florence
Schupf, Nicole
Lott, Ira T.
Silverman, Wayne
author_sort Hom, Christy L.
collection PubMed
description Accurate identification of the prodromal stage of Alzheimer’s disease (AD), known as mild cognitive impairment (MCI), in adults with Down syndrome (MCI-DS) has been challenging because there are no established diagnostic criteria that can be applied for people with lifelong intellectual disabilities (ID). As such, the sequence of cognitive decline in adults with DS has been difficult to ascertain, and it is possible that domain constructs characterizing cognitive function in neurotypical adults do not generalize to this high-risk population. The present study examined associations among multiple measures of cognitive function in adults with DS, either prior to or during the prodromal stage of AD to determine, through multiple statistical techniques, the measures that reflected the same underlying domains of processing. Participants included 144 adults with DS 40–82 years of age, all enrolled in a larger, multidisciplinary study examining biomarkers of AD in adults with DS. All participants had mild or moderate lifelong intellectual disabilities. Overall AD-related clinical status was rated for each individual during a personalized consensus conference that considered performance as well as health status, with 103 participants considered cognitively stable (CS) and 41 to have MCI-DS. Analyses of 17 variables derived from 10 tests of cognition indicated that performance reflected three underlying factors: language/executive function, memory, and visuomotor. All three domain composite scores significantly predicted MCI-DS status. Based upon path modeling, the language/executive function composite score was the most affected by prodromal AD. However, based upon structural equation modeling, tests assessing the latent construct of memory were the most impacted, followed by those assessing visuomotor, and then those assessing language/executive function. Our study provides clear evidence that cognitive functioning in older adults with DS can be characterized at the cognitive domain level, but the statistical methods selected and the inclusion or exclusion of certain covariates may lead to different conclusions. Best practice requires investigators to understand the internal structure of their variables and to provide evidence that their variables assess their intended constructs.
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spelling pubmed-84710852021-09-27 Cognitive Function during the Prodromal Stage of Alzheimer’s Disease in Down Syndrome: Comparing Models Hom, Christy L. Kirby, Katharine A. Ricks-Oddie, Joni Keator, David B. Krinsky-McHale, Sharon J. Pulsifer, Margaret B. Rosas, Herminia Diana Lai, Florence Schupf, Nicole Lott, Ira T. Silverman, Wayne Brain Sci Article Accurate identification of the prodromal stage of Alzheimer’s disease (AD), known as mild cognitive impairment (MCI), in adults with Down syndrome (MCI-DS) has been challenging because there are no established diagnostic criteria that can be applied for people with lifelong intellectual disabilities (ID). As such, the sequence of cognitive decline in adults with DS has been difficult to ascertain, and it is possible that domain constructs characterizing cognitive function in neurotypical adults do not generalize to this high-risk population. The present study examined associations among multiple measures of cognitive function in adults with DS, either prior to or during the prodromal stage of AD to determine, through multiple statistical techniques, the measures that reflected the same underlying domains of processing. Participants included 144 adults with DS 40–82 years of age, all enrolled in a larger, multidisciplinary study examining biomarkers of AD in adults with DS. All participants had mild or moderate lifelong intellectual disabilities. Overall AD-related clinical status was rated for each individual during a personalized consensus conference that considered performance as well as health status, with 103 participants considered cognitively stable (CS) and 41 to have MCI-DS. Analyses of 17 variables derived from 10 tests of cognition indicated that performance reflected three underlying factors: language/executive function, memory, and visuomotor. All three domain composite scores significantly predicted MCI-DS status. Based upon path modeling, the language/executive function composite score was the most affected by prodromal AD. However, based upon structural equation modeling, tests assessing the latent construct of memory were the most impacted, followed by those assessing visuomotor, and then those assessing language/executive function. Our study provides clear evidence that cognitive functioning in older adults with DS can be characterized at the cognitive domain level, but the statistical methods selected and the inclusion or exclusion of certain covariates may lead to different conclusions. Best practice requires investigators to understand the internal structure of their variables and to provide evidence that their variables assess their intended constructs. MDPI 2021-09-16 /pmc/articles/PMC8471085/ /pubmed/34573242 http://dx.doi.org/10.3390/brainsci11091220 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Hom, Christy L.
Kirby, Katharine A.
Ricks-Oddie, Joni
Keator, David B.
Krinsky-McHale, Sharon J.
Pulsifer, Margaret B.
Rosas, Herminia Diana
Lai, Florence
Schupf, Nicole
Lott, Ira T.
Silverman, Wayne
Cognitive Function during the Prodromal Stage of Alzheimer’s Disease in Down Syndrome: Comparing Models
title Cognitive Function during the Prodromal Stage of Alzheimer’s Disease in Down Syndrome: Comparing Models
title_full Cognitive Function during the Prodromal Stage of Alzheimer’s Disease in Down Syndrome: Comparing Models
title_fullStr Cognitive Function during the Prodromal Stage of Alzheimer’s Disease in Down Syndrome: Comparing Models
title_full_unstemmed Cognitive Function during the Prodromal Stage of Alzheimer’s Disease in Down Syndrome: Comparing Models
title_short Cognitive Function during the Prodromal Stage of Alzheimer’s Disease in Down Syndrome: Comparing Models
title_sort cognitive function during the prodromal stage of alzheimer’s disease in down syndrome: comparing models
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8471085/
https://www.ncbi.nlm.nih.gov/pubmed/34573242
http://dx.doi.org/10.3390/brainsci11091220
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