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Neuropsychological decline up to 20 years before incident mild cognitive impairment
Author(s) -
Caselli Richard J.,
Langlais Blake T.,
Dueck Amylou C.,
Chen Yinghua,
Su Yi,
Locke Dona E. C.,
Woodruff Bryan K.,
Reiman Eric M.
Publication year - 2020
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.2019.09.085
Subject(s) - neuropsychology , cognition , biomarker , cognitive decline , inflection point , cohort , psychology , medicine , audiology , disease , dementia , neuroscience , biology , biochemistry , geometry , mathematics
Some Alzheimer's disease biomarker studies found amyloid changes 20 years or more in advance of expected symptoms, while cognitive changes lagged for more than a decade, but this apparent lag might reflect the sensitivities of the biomarker and cognitive assays used. How far in advance of incident amnestic mild cognitive impairment (MCI) does cognition begin to decline? Methods Longitudinal neuropsychological study of an apolipoprotein E e4 enriched cohort of cognitively normal individuals at entry. Linear mixed models for MCI converters (n = 65) and nonconverters (n = 719) fitted for each neuropsychological measure; annual changes compared between groups before and after linear model intersections (inflection points). Results 34 of 35 cognitive measures and 9 of 18 behavioral measures declined faster post‐inflection in the MCI converters; the earliest cognitive inflection point was nearly 20 years in advance of MCI diagnosis. Discussion The preclinical duration of cognitive and behavioral changes approaches the earliest reported biomarker changes.