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P4‐066: Depressive Symptoms Associated to Cognitive Decline and Sociodemographic Factors in Community‐dwelling Elderly Non‐Demented Subjects
Author(s) -
Barcelos-Ferreira Ricardo,
Nakano Eduardo Yoshio,
Lopes Marcos Antônio,
Campos Bottio Cássio Machado
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.2010.08.126
Subject(s) - dementia , cognitive decline , gerontology , socioeconomic status , depression (economics) , geriatric depression scale , cognition , psychology , multivariate analysis , activities of daily living , medicine , late life depression , disease , depressive symptoms , psychiatry , population , environmental health , economics , macroeconomics
type). In this study, we sought to determine the utility and informativeness of different classes of biomarkers and cognitive markers at various stages of disease progression, including a preclinical phase, and their ability to predict an important change in diagnostic status from Mild Cognitive Impairment (MCI) to Alzheimer’s disease (AD). Methods: We chose to interrogate the ADNI public database and therefore studied three groups: Healthy Controls (HC) (N 1⁄4 197), MCI patients who converted to AD (N 1⁄4 116), and MCI patients who did not covert (N 1⁄4 204). We determined the predictive utility of 25 variables from all classes of markers and biomarkers in predicting MCI to AD conversion over a two year period in a series of multiple regression models. Results: In an unbiased stepwise logistic regression that thus included variables from all classes of markers, the following predicted anytime conversion within a two year period: everyday functional activities questionnaire (FAQ), delayed verbal memory, and left middle temporal lobe volume. Cox regression survival analyses were consistent with these results. Next, in an effect size analysis, we observed that change scores for biomarkers were relatively modest over a one year period, but a change in FAQ was considerably larger (ES1⁄4.44 at 12 months, .84 at 24 months). FAQ decline and trailmaking b decline accounted for nearly 50% of the predictive variance in conversion from MCI to AD. Conclusions: Predictors of conversion have obvious utility for clinical decision making, understanding the nature of neurobiological changes at a critical phase in the illness, and assessment of response to treatment. In logistic stepwise regressions, cognitive, functional, and volumetric markers were significant predictors of conversion from MCI to AD. Strikingly and unexpectedly, this was driven less by changes in neurobiological variables over two years than by a sharp decline in functional ability. This set of findings has implications for interpreting neurodegeneration in the MCI-AD transitional phase.