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P2‐188: Lateral temporal atrophy in mild cognitive impairment
Author(s) -
Cho Soo-Jin,
Minn Yang-Ki,
Kwon Ki-Han
Publication year - 2010
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2010.05.1236
Subject(s) - atrophy , temporal lobe , dementia , magnetic resonance imaging , medicine , epilepsy , neuropsychology , psychology , audiology , cognitive impairment , cardiology , cognition , disease , pathology , neuroscience , radiology
decline is a hallmark of Alzheimer’s disease (AD), describing both risks and benefits in terms of changes in function is a logical choice for such an exercise and requires understanding the temporal relationship of changes in cognition and function. The objective of this study was to co-vary the individual items with Disability Assessment in Dementia (DAD) with measures of cognition and time to identify the temporal order associated with disease progression. Methods: 337 subjects (196 AD, 70 mild cognitive impairment, 71 cognitively healthy volunteers) were enrolled at 40 study sites across the US and Europe during 2006 and 2007 for an 18-month non-interventional study (ELN-AIP-901), sponsored by Elan Pharmaceuticals and Wyeth Research. Recruitment criteria were similar to those used in the ADNI study. DAD was performed at baseline and at 6-months intervals. DAD item scale scores were co-varied with Mini-Mental State Examination (MMSE) score using survival analysis. Results: Using median MMSE survival, patients were unable to perform activities for all items of the sub-domains for finance, medication, and outings at higher scores than for items in other sub-domains. The specific activities ‘‘organize finance’’ and ‘‘adequately organize correspondence’’ exhibited the shortest MMSE survival, ie, ‘‘lost’’ earlier in the course of the disease. The inability to perform items in the sub-domains of personal hygiene, dressing, eating, and continence occurred at lowest MMSE survivals, ie, ‘‘lost’’ at the later stages of AD progression. Seven items ‘‘lost’’ late in the course of the disease, lowest median MMSE survival, were from 3 of the 10 sub-domains, specifically dressing (4 items), eating (2 items), and continence (1 item). Conclusions: Inability to perform instrumental functional activities occurred earlier in the course of the disease, as measured by MMSE score, than basic functional activities. DAD items exhibit a hierarchical loss progression associated with cognitive decline, by MMSE. These findings support the use of DAD items that correlate with AD progression as a method for characterizing benefit and risk.