Paper
An Initial Empirical Operationalization of the Earliest Stages of the Alzheimer's Continuum.
Published Sep 21, 2020 · Andrew M. Kiselica, A. Kaser, J. Benge
Alzheimer Disease & Associated Disorders
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Abstract
PURPOSE The Alzheimer's Continuum (AC) includes 2 preclinical stages defined by subjective cognitive complaints, transitional cognitive declines, and neurobehavioral symptoms. Operationalization of these stages is necessary for them to be applied in research. METHODS Cognitively normal individuals with known amyloid biomarker status were selected from the National Alzheimer's Coordinating Center Uniform Data Set. Participants and their caregivers provided information on subjective cognitive complaints, neurobehavioral features, and objective cognitive functioning. PATIENTS The sample included 101 amyloid positive (A+) and 447 amyloid negative (A-) individuals. RESULTS Rates of subjective cognitive complaints (A+: 34.90%, A-: 29.90%) and neurobehavioral symptoms (A+: 22.40%, A-: 22.40%) did not significantly differ between A+/- individuals. However, the frequency of transitional cognitive decline was significantly higher among A+ (38.00%) than A- participants (24.90%). We explored various empirical definitions for defining the early stages of the AC among A+ participants. Rates of classification into AC stage 1 versus AC stage 2 varied depending on the number of symptoms required: 57.40% versus 42.60% (1 symptom), 28.70% versus 71.30% (2 symptoms), and 6.90% versus 93.10% (all 3 symptoms). CONCLUSION The presence of 2 of the proposed symptom classes to separate AC stage 2 from stage 1 seems to provide a good empirical balance.
Observational StudyThe presence of 2 symptom classes to separate Alzheimer's Continuum stage 2 from stage 1 provides a good empirical balance.
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