Laboratory of Behavioral Neuroscience, Intramural Research Program, National Institute on Aging, Baltimore, MD, USA.
Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, USA, Madison, WI, USA.
J Alzheimers Dis. 2017;59(4):1335-1347. doi: 10.3233/JAD-170448.
Investigation of the temporal trajectories of currently used neuropsychological tests is critical to identifying earliest changing measures on the path to dementia due to Alzheimer's disease (AD). We used the Progression Score (PS) method to characterize the temporal trajectories of measures of verbal memory, executive function, attention, processing speed, language, and mental status using data spanning normal cognition, mild cognitive impairment, and AD from 1,661 participants with a total of 7,839 visits (age at last visit 77.6 SD 9.2) in the Baltimore Longitudinal Study of Aging (BLSA) and 1510 participants with a total of 3,473 visits (age at last visit 59.5 SD 7.4) in the Wisconsin Registry for Alzheimer's Prevention (WRAP). This method aligns individuals in time based on the similarity of their longitudinal measurements to reveal temporal trajectories. As a validation of our methodology, we explored the associations between the individualized cognitive progression scores (Cog-PS) computed by our method and clinical diagnosis. Digit span tests were the first to show declines in both data sets, and were detected mainly among cognitively normal individuals. These were followed by tests of verbal memory, which were in turn followed by Trail Making Tests, Boston Naming Test, and Mini-Mental State Examination. Differences in Cog-PS across the clinical diagnosis and APOEɛ4 groups were statistically significant, highlighting the potential use of Cog-PS as individualized indicators of disease progression. Identifying cognitive measures that are changing in preclinical AD can lead to the development of novel cognitive tests that are finely tuned to detecting earliest changes.
研究当前使用的神经心理学测试的时间轨迹对于识别由于阿尔茨海默病（AD）导致痴呆的最早变化测量指标至关重要。我们使用进展评分（PS）方法，使用来自巴尔的摩纵向衰老研究（BLSA）的 1661 名参与者（最后一次访问时的年龄为 77.6±9.2）和威斯康星州阿尔茨海默病预防登记处（WRAP）的 1510 名参与者（最后一次访问时的年龄为 59.5±7.4）的数据，来描述言语记忆、执行功能、注意力、处理速度、语言和精神状态的测量指标的时间轨迹，这些数据涵盖了正常认知、轻度认知障碍和 AD。在 BLSA 中，该方法基于个体纵向测量的相似性对个体进行时间上的对齐，以揭示时间轨迹。作为我们方法验证的一部分，我们探讨了通过我们的方法计算的个体化认知进展评分（Cog-PS）与临床诊断之间的关联。数字跨度测试在两个数据集中最早显示出下降，并且主要在认知正常的个体中检测到。紧随其后的是言语记忆测试，然后是追踪测试、波士顿命名测试和简易精神状态检查。Cog-PS 在临床诊断和 APOEɛ4 组之间的差异具有统计学意义，突出了 Cog-PS 作为疾病进展个体化指标的潜在用途。识别出在临床前 AD 中发生变化的认知测量指标可以导致开发出针对检测最早变化进行精细调整的新型认知测试。
