A Latent Transition Analysis Model to Assess Change in Cognitive States over Three Occasions: Results from the Rush Memory and Aging Project

Zammit, Andrea R.; Bennett, David A.; Hall, Charles B.; Lipton, Richard B.; Katz, Mindy J.; Muniz-Terrera, Graciela

Abstract

Background: Conceptualizing cognitive aging as a step-sequential process is useful in identifying particular stages of cognitive function and impairment. Objective: We applied latent transition analysis (LTA) to determine 1) whether the underlying structure of cognitive profiles found at every measurement occasion are uniform across three waves of assessment, 2) whether class-instability is predictive of distal outcomes, and 3) whether class-reversions from impaired to non-impaired using latent modelling is lower than when using clinical criteria of mild cognitive impairment (MCI). Methods: A mover-stayer LTA model with dementia as a distal outcome was specified to model transitions of ten neuropsychological measures over three annual waves in the Rush Memory and Aging Project (n = 1,661). The predictive validity of the mover-stayer status for incident Alzheimer's disease (AD) was then assessed. Results: We identified a five-class model across the three time-points: Mixed-Domain Impairment, Memory-Specific Impairment, Frontal Impairment, Average, and Superior Cognition. None of the individuals in the Impairment classes reverted to the Average or Superior classes. Conventional MCI classification identified 26.4% and 14.1% at Times 1 and 2 as false-positive cases. "Movers" had 87% increased risk of developing dementia compared to those classified as "Stayers". Conclusion: Our findings support the use of latent variable modelling that incorporates comprehensive neuropsychological assessment to identify and classify cognitive impairment.

Más información

Título según WOS: ID WOS:000512319400020 Not found in local WOS DB
Título de la Revista: JOURNAL OF ALZHEIMERS DISEASE
Volumen: 73
Número: 3
Editorial: IOS Press
Fecha de publicación: 2020
Página de inicio: 1063
Página final: 1073
DOI:

10.3233/JAD-190778

Notas: ISI