Neuropsychological predictors of rapidly progressive Alzheimer's disease. (22nd April 2015)

• Record Type: Journal Article
• Authors: Tosto, G.; Gasparini, M.; Brickman, A. M.; Letteri, F.; Renie', R.; Piscopo, P.; Talarico, G.; Canevelli, M.; Confaloni, A.; Bruno, G.
• Is Part Of: Acta neurologica Scandinavica. Volume 132:Number 6(2015:Dec.)
• Page Start: 417
• Page End: 422
• Publication Date: 2015-04-22
• Subjects: Neurology -- Periodicals; 616.8
• DOI: 10.1111/ane.12415
• Languages: English
• ISSNs: 0001-6314

Abstract

<abstract abstract-type="main" id="ane12415-abs-0001"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ane12415-sec-0001" sec-type="section"> <title>Objective</title> <p>Alzheimer's disease (AD), the most common cause of dementia, typically shows a slow clinical progression over time. 'Rapidly progressive' AD, a variant of the disease characterized by an aggressive course, exhibits distinct clinical, biological, and neuropathological features. Here, we investigate neuropsychological predictors of rapid decline in a group of mild patients with AD.</p> </sec> <sec id="ane12415-sec-0002" sec-type="section"> <title>Methods</title> <p>One hundred fifty‐three mild patients with AD admitted to a memory disorder clinic and followed for up to 3 years were included in this study. A comprehensive neuropsychological (NP) battery was performed at the time of enrollment. Patients were defined as 'rapidly progressive' if they exhibited a drop of 6 or more points on the Mini Mental State Examination (MMSE) between two consecutive annual visits. This event defined the main outcome in multiple analyses of variance and Cox proportional hazards models that investigated the impact of NP predictors. Categorical principal component analysis (CATPCA) was also employed in order to delineate clusters of NP tests and to test their effect on the outcome.</p> </sec> <sec id="ane12415-sec-0003" sec-type="section"> <title>Results</title> <p>Of 153 subjects, thirty‐seven (24%) were classified as 'rapidly progressive'; those subjects showed younger age of symptoms onset compared to slow decliners (68 vs 71.5 years old). Baseline lower performance on a neuropsychological test of naming predicted a rapid decline over the follow‐up (<italic>P</italic> = 0.001). Three clusters of NP were defined by CATPCA: (i) executive/language, (ii) visuospatial memory, and (iii) verbal memory. The executive/language component predicted a rapid decline over the follow‐up (<italic>P</italic> = 0.016).</p> </sec> <sec id="ane12415-sec-0004" sec-type="section"> <title>Conclusion</title> <p>Early executive/language impairment is highly predictive of a rapid progression of AD.</p> </sec> </abstract>