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Cognitive subtypes of probable Alzheimer's disease robustly identified in four cohorts
Author(s) -
Scheltens Nienke M.E.,
Tijms Betty M.,
Koene Teddy,
Barkhof Frederik,
Teunissen Charlotte E.,
Wolfsgruber Steffen,
Wagner Michael,
Kornhuber Johannes,
Peters Oliver,
CohnSheehy Brendan I.,
Rabinovici Gil D.,
Miller Bruce L.,
Kramer Joel H.,
Scheltens Philip,
Flier Wiesje M.
Publication year - 2017
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.2017.03.002
Subject(s) - disease , cognition , alzheimer's disease , psychology , gerontology , medicine , psychiatry , pathology
Patients with Alzheimer's disease (AD) show heterogeneity in profile of cognitive impairment. We aimed to identify cognitive subtypes in four large AD cohorts using a data‐driven clustering approach. Methods We included probable AD dementia patients from the Amsterdam Dementia Cohort ( n = 496), Alzheimer's Disease Neuroimaging Initiative ( n = 376), German Dementia Competence Network ( n = 521), and University of California, San Francisco ( n = 589). Neuropsychological data were clustered using nonnegative matrix factorization. We explored clinical and neurobiological characteristics of identified clusters. Results In each cohort, a two‐clusters solution best fitted the data (cophenetic correlation >0.9): one cluster was memory‐impaired and the other relatively memory spared. Pooled analyses showed that the memory‐spared clusters (29%–52% of patients) were younger, more often apolipoprotein E ( APOE ) ɛ4 negative, and had more severe posterior atrophy compared with the memory‐impaired clusters (all P < .05). Conclusions We could identify two robust cognitive clusters in four independent large cohorts with distinct clinical characteristics.