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Cognition and Amyloid-β in Older Veterans: Characterization and Longitudinal Outcomes of Data-Derived Phenotypes.
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- Additional Information
- Corporate Authors:
- Source:
Publisher: IOS Press Country of Publication: Netherlands NLM ID: 9814863 Publication Model: Print Cited Medium: Internet ISSN: 1875-8908 (Electronic) Linking ISSN: 13872877 NLM ISO Abbreviation: J Alzheimers Dis Subsets: MEDLINE
- Publication Information:
Original Publication: Amsterdam ; Washington : IOS Press, c1998-
- Subject Terms:
- Abstract:
Background: Within older Veterans, multiple factors may contribute to cognitive difficulties. Beyond Alzheimer's disease (AD), psychiatric (e.g., PTSD) and health comorbidities (e.g., TBI) may also impact cognition.
Objective: This study aimed to derive subgroups based on objective cognition, subjective cognitive decline (SCD), and amyloid burden, and then compare subgroups on clinical characteristics, biomarkers, and longitudinal change in functioning and global cognition.
Methods: Cluster analysis of neuropsychological measures, SCD, and amyloid PET was conducted on 228 predominately male Vietnam-Era Veterans from the Department of Defense-Alzheimer's Disease Neuroimaging Initiative. Cluster-derived subgroups were compared on baseline characteristics as well as 1-year changes in everyday functioning and global cognition.
Results: The cluster analysis identified 3 groups. Group 1 (n = 128) had average-to-above average cognition with low amyloid burden. Group 2 (n = 72) had the lowest memory and language, highest SCD, and average amyloid burden; they also had the most severe PTSD, pain, and worst sleep quality. Group 3 (n = 28) had the lowest attention/executive functioning, slightly low memory and language, elevated amyloid and the worst AD biomarkers, and the fastest rate of everyday functioning and cognitive decline.
Conclusions: Psychiatric and health factors likely contributed to Group 2's low memory and language performance. Group 3 was most consistent with biological AD, yet attention/executive function was the lowest score. The complexity of older Veterans' co-morbid conditions may interact with AD pathology to show attention/executive dysfunction (rather than memory) as a prominent early symptom. These results could have important implications for the implementation of AD-modifying drugs in older Veterans.
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- Grant Information:
K01 AG030514 United States AG NIA NIH HHS; I01 CX001842 United States CX CSRD VA; U01 AG024904 United States AG NIA NIH HHS; P30 AG062429 United States AG NIA NIH HHS; R01 AG063782 United States AG NIA NIH HHS; P30 AG010129 United States AG NIA NIH HHS; RF1 AG082726 United States AG NIA NIH HHS; IK2 CX001865 United States CX CSRD VA; R03 AG070435 United States AG NIA NIH HHS
- Contributed Indexing:
Keywords: Alzheimer’s disease; PTSD; Veterans; amyloid; cognition; phenotypes
- Accession Number:
0 (Amyloid beta-Peptides)
- Publication Date:
Date Created: 20240426 Date Completed: 20240503 Latest Revision: 20240922
- Publication Date:
20240922
- Accession Number:
PMC11412577
- Accession Number:
10.3233/JAD-240077
- Accession Number:
38669550
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