Petkus Andrew J, Sonti Anup N, Montoya Lucy, Rowe Bryan, Sagare Abhay, Ringman John M
Department of Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
J Alzheimers Dis. 2025 Feb;103(4):1150-1160. doi: 10.1177/13872877241312934. Epub 2025 Jan 26.
Understanding the sequential progression of cognitive decline in autosomal dominant Alzheimer's disease (ADAD) in the Latino population is crucial for enhancing early identification for targeted interventions. Given the tablet-based administration and increasing frequency of use in epidemiological research, validating this progression within the NIH Toolbox cognitive battery (NIHTB-CB) is important.
The first aim was to utilize an innovative Event-Based Modeling (EBM) analytic approach to estimate the sequence of cognitive declines in persons at risk for ADAD enriched for being of Latino origin. The second aim was to examine associations between EBM-derived estimates of cognitive disease severity and independent cognitive outcomes within carriers and noncarriers.
This cross-sectional observational study (N = 30) included 16 ADAD mutation carriers and 14 noncarriers who completed the NIHTB-CB in their primary language (n = 8 Spanish; n = 22 English). An EBM was constructed to compare ADAD mutation carriers and noncarriers on NIHTB-CB performance. We utilized linear regression to examine the associations between the EBM-derived cognitive-decline disease stage and independent outcomes (e.g., performance on the Cognitive Abilities Screening Instrument (CASI) and estimated years to dementia diagnosis).
The EBM estimated that tests assessing episodic memory were the first to become abnormal in the sequence of ADAD-related cognitive decline. Each higher estimated cognitive-decline disease stage was associated with approximately a three-point decline in the CASI and two years closer to dementia diagnosis.
Findings support the EBM applied to the tablet-based NIHTB-CB to estimate the likely progression of cognitive decline in Latinos with ADAD.
了解拉丁裔人群常染色体显性遗传性阿尔茨海默病（ADAD）认知衰退的连续进展对于加强早期识别以进行靶向干预至关重要。鉴于基于平板电脑的管理方式以及其在流行病学研究中的使用频率不断增加，在国立卫生研究院工具箱认知成套测验（NIHTB-CB）中验证这种进展很重要。
第一个目标是利用创新的基于事件的建模（EBM）分析方法来估计富含拉丁裔血统的ADAD风险人群认知衰退的顺序。第二个目标是检查EBM得出的认知疾病严重程度估计值与携带者和非携带者内独立认知结果之间的关联。
这项横断面观察性研究（N = 30）包括16名ADAD突变携带者和14名非携带者，他们用母语（n = 8名西班牙语使用者；n = 22名英语使用者）完成了NIHTB-CB。构建了一个EBM以比较ADAD突变携带者和非携带者在NIHTB-CB上的表现。我们利用线性回归来检查EBM得出的认知衰退疾病阶段与独立结果（例如，认知能力筛查工具（CASI）的表现以及到痴呆症诊断的估计年数）之间的关联。
EBM估计，在与ADAD相关的认知衰退序列中，评估情景记忆的测试首先变得异常。估计的认知衰退疾病阶段每升高一级，CASI得分大约下降三分，且距离痴呆症诊断时间缩短约两年。
研究结果支持将EBM应用于基于平板电脑的NIHTB-CB，以估计拉丁裔ADAD患者认知衰退的可能进展。
