Longitudinal assessment of cognitive decline and resilience in high-level
Alzheimer disease neuropathologic change
#MMPMID41339920
Richardson TE
; Kandoi S
; Almeida FC
; Rohde SK
; Marx GA
; Canbeldek L
; Hiya S
; Maldonado-Díaz C
; Samanamud J
; Clare K
; Slocum CC
; Kulumani Mahadevan LS
; Chiu LY
; Farrell K
; Crary JF
; Daoud EV
; White CL 3rd
; Espinoza SE
; Gonzales MM
; Oliveira TG
; Walker JM
Alzheimers Res Ther
2025[Dec]; 17
(1
): 257
PMID41339920
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BACKGROUND: Alzheimer disease neuropathologic change (ADNC) is the most common
pathology underlying cognitive impairment and dementia in the aging population,
but there is significant variation in outcome between affected individuals.
Moreover, other common neurodegenerative processes are often concurrent and may
significantly worsen cognition, but the degree to which these processes interact
and affect the rate of cognitive decline remains unclear. Herein, we aim to
investigate features influencing cognitive trajectories over the final 15 years
of life in individuals with high-level ADNC. METHODS: We performed a
cross-sectional cohort study of 586 participants from the National Alzheimer?s
Coordinating Center (NACC) database, who were ??65 years of age and displayed
high-level ADNC at autopsy, and who had available longitudinal cognitive data and
Clinical Dementia Rating (CDR) performed within the final 24 months of life. This
cohort was subdivided into ?resilient? individuals/those with minimal progression
of cognitive decline (MinP; n?=?75), intermediate/moderate progression of
cognitive decline (ModP; n?=?255), and rapid/maximal progression of cognitive
decline (MaxP; n?=?256) as determined by global cognitive performance and the
rate of cognitive decline. Demographic, neuropathologic, genetic, and clinical
features were evaluated using multivariable logistic regression analysis.
RESULTS: Individuals with rapid progression were more likely to have at least one
APOE ?4 allele (OR: 2.08 [95% CI: 1.16?3.74], p?
free
free
free
