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Distinct cognitive phenotypes in Alzheimer's disease in older people

Published online by Cambridge University Press:  05 July 2013

Emma R.L.C. Vardy ,
Andrew H. Ford ,
Peter Gallagher ,
Rosie Watson ,
Ian G. McKeith ,
Andrew Blamire  and
John T. O’Brien
Emma R.L.C. Vardy*
Affiliation:
Department of Older Peoples Medicine, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, High Heaton, Newcastle upon Tyne, UK Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
Andrew H. Ford
Affiliation:
Western Australian Centre for Health and Ageing, Centre for Medical Research and School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Australia
Peter Gallagher
Affiliation:
Institute of Neuroscience (Academic Psychiatry), Newcastle University, Newcastle upon Tyne, UK
Rosie Watson
Affiliation:
Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
Ian G. McKeith
Affiliation:
Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
Andrew Blamire
Affiliation:
Institute of Cellular Medicine and Newcastle MR Centre, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
John T. O’Brien
Affiliation:
Institute for Ageing and Health, Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK Department of Psychiatry, Addenbrooke's Hospital, University of Cambridge, Cambridge, UK
*
Correspondence should be addressed to: Dr. Emma R.L.C. Vardy, Department of Older Peoples Medicine, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Freeman Road, High Heaton, Newcastle upon Tyne NE7 7DN, UK. Phone: +0191-248-1317; Fax: +0191-248-1301. Email: emma.vardy@ncl.ac.uk.
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Abstract

Background:

Alzheimer's disease (AD) is considered to be a disorder predominantly affecting memory. It is increasingly recognized that the cognitive profile may be heterogeneous. We hypothesized that it would be possible to define distinct “cognitive phenotypes” in older people with AD.

Methods:

Participants from three individual studies were included, consisting of 109 patients with a diagnosis of probable AD, and 91 age- and gender-matched control participants. All had demographic and cognitive assessment data available, including the Cambridge Cognitive Examination of the Elderly (CAMCOG). The CAMCOG scores and sub-scores were further analyzed using hierarchical cluster analysis and factor analysis.

Results:

Three clusters were identified. The scores loaded onto three factors representing the domains of attention, praxis, calculation, and perception; memory; and language comprehension and executive function. The main difference between the clusters related to degree of memory impairment. The composite score for memory between the clusters remained significantly different despite adjustment for illness duration and age of onset (p < 0.001).

Conclusions:

These data suggest clinical heterogeneity within an older group of people with AD. This may have implications for diagnosis, prognosis, response to currently available treatments, and the development of novel therapies.

Keywords

Alzheimer’s diseasecognitionphenotypesolder peoplelate onset
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 10 , October 2013 , pp. 1659 - 1666
Copyright
Copyright © International Psychogeriatric Association 2013 

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