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Cited by 90Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsAmyotrophic Lateral Sclerosis Research

Cognitive Decline in a Colombian Kindred With Autosomal Dominant Alzheimer Disease: A Retrospective Cohort Study

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Aguirre-Acevedo, Daniel C., Lopera, Francisco, Henao, Eliana, Tirado, Victoria, Muñoz, Claudia, Giraldo, Margarita, Bangdiwala, Shrikant I., Reiman, Eric M. +4 more·2016·JAMA Neurology
DOI 10.1001/jamaneurol.2015.4851PMC PMC5505685
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Abstract

IMPORTANCE: Data from an autosomal dominant Alzheimer disease (ADAD) kindred were used to track the longitudinal trajectory of cognitive decline associated with preclinical ADAD and explore factors that may modify the rate of cognitive decline. OBJECTIVES: To evaluate the onset and rate of cognitive decline during preclinical ADAD and the effect of socioeconomic, vascular, and genetic factors on the cognitive decline. DESIGN, SETTING, AND PARTICIPANTS: We performed a retrospective cohort study from January 1, 1995, through June 31, 2012, of individuals from Antioquia, Colombia, who tested positive for the ADAD-associated PSEN1 E280A mutation. Data analysis was performed from August 20, 2014, through November 30, 2015. A mixed-effects model was used to estimate annual rates of change in cognitive test scores and to mark the onset of cognitive decline. MAIN OUTCOMES AND MEASURES: Memory, language, praxis, and total scores from the Consortium to Establish a Registry for Alzheimer Disease test battery. Chronologic age was used as a time scale in the models. We explore the effects of sex; educational level; socioeconomic status; residence area; occupation type; marital status; history of hypertension, diabetes mellitus, and dyslipidemia; tobacco and alcohol use; and APOE ε4 on the rates of cognitive decline. RESULTS: A total of 493 carriers met the inclusion criteria and were analyzed. A total of 256 carriers had 2 or more assessments. At the time of the initial assessment, participants had a mean (SD) age of 33.4 (11.7) years and a mean (SD) educational level of 7.2 (4.2) years. They were predominantly female (270 [54.8%]), married (293 [59.4%]), and of low socioeconomic status (322 [65.3%]). Word list recall scores provided the earliest indicator of preclinical cognitive decline at 32 years of age, 12 and 17 years before the kindred's respective median ages at mild cognitive impairment and dementia onset. After the change point, carriers had a statistically significant cognitive decline with a loss of 0.24 (95% CI, -0.26 to -0.22) points per year for the word list recall test and 2.13 (95% CI, -2.29 to -1.96) points per year for total scores. Carriers with high educational levels had an increase of approximately 36% in the rate of cognitive decline after the change point when compared with those with low educational levels (-2.89 vs -2.13 points per year, respectively). Onset of cognitive decline was delayed by 3 years in individuals with higher educational levels compared with those with lower educational levels. Those with higher educational level, middle/high socioeconomic status, history of diabetes and hypertension, and tobacco and alcohol use had a steeper cognitive decline after onset. CONCLUSIONS AND RELEVANCE: Preclinical cognitive decline was evident in PSEN1 E280A mutation carriers 12 years before the onset of clinical impairment. Educational level may be a protective factor against the onset of cognitive impairment.

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Crossref · 10.1001/jamaneurol.2015.4851

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  • The neuropsychological battery had been adapted and validated to detect Alzheimer's disease-related cognitive impairment in this kindred.

    “Neuropsychological assessments were conducted in Spanish with the use of a battery that has been adapted and validated for the detection of Alzheimer’s disease–related cognitive impairment in this kindred”

    From <i>APOE3</i> Christchurch Heterozygosity and Autosomal Dominant Alzheimer’s Disease (2024) · cites this paper as [10]

    Methods > Procedures (page unavailable) says the CERAD battery and MMSE were validated in the study population, and the Discussion says CERAD is sensitive to early changes associated with mild cognitive impairment. The copy does not state that the battery was adapted or specifically validated to detect Alzheimer’s-related impairment in this kindred. (LLM, conf=0.82)

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  • The intervals between tests were homogeneous for APOE3Ch carriers and noncarriers.

    “The intervals between testing have been analyzed previously and were homogeneous across APOE3Ch carriers and noncarriers.1,10”

    From <i>APOE3</i> Christchurch Heterozygosity and Autosomal Dominant Alzheimer’s Disease (2024) · cites this paper as [10]

    The Discussion reports a median of 2 years between assessments for participants with repeated testing, but does not compare testing intervals by APOE3Ch status. The Genetic Analyses and Exploratory Analysis sections examine APOE ε4, not APOE3Ch. Searches for homogeneous testing intervals and APOE3Ch carriers found no passage addressing the claimed comparison. (LLM, conf=0.76)

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Research works printed but not linked: 1

  1. [10]Tirado V Motta M Aguirre-Acevedo DC Pineda DA Lopera F Analysis of intrusive errors in a memory test as possible pre-clinical marker of familial Alzheimer disease, in E280A presenilin-1 mutation carrier [in Spanish] Rev Neurol 2008 47 6 290 294 18803154

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Authors
Aguirre-Acevedo, D. C., Lopera, F., Henao, E., Tirado, V., Muñoz, C., Giraldo, M., Bangdiwala, S. I., Reiman, E. M., Tariot, P. N., Langbaum, J. B., Quiroz, Y. T., & Jaimes, F.
Affiliations
  • Neuroscience Group of Antioquia, University of Antioquia, Medellín, Colombia2Academic Group of Clinical Epidemiology, University of Antioquia, Medellín, Colombia
  • Universidad de Antioquia (CO)
  • University of North Carolina at Chapel Hill (US)
  • Banner Alzheimer’s Institute (US)
ORCID
Venue
JAMA Neurology
Publisher
American Medical Association (AMA)
Published
2016-04-01
Volume
73
Issue
4
Pages
431
ISSN
2168-6149 (ISSN-L)
DOI
10.1001/jamaneurol.2015.4851
PMC
PMC5505685
OpenAlex
W2275920323
Cited by
90
References
36
Citations by year
2026: 5 · 2025: 5 · 2024: 8 · 2023: 10 · 2022: 2 · 2021: 18 · 2020: 15 · 2019: 11 · 2018: 8 · 2017: 6 · 2016: 2
FWCI
8.00
Type
journal article
Language
en
Open access
Locations
  • JAMA Neurology (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Institutional Repository University of Antioquia (University of Antioquia) (submittedVersion, cc-by-nc-nd)
Funders
  • Departamento Administrativo de Ciencia, Tecnología e Innovación (COLCIENCIAS)
  • National Institutes of Health (DP5OD019833)
  • National Institute on Aging (AG019610, R01AG055444, AG031581, R01AG031581, P30AG019610)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Neurology › Amyotrophic Lateral Sclerosis Research
Keywords
autosomal dominant Alzheimer's disease, PSEN1 E280A mutation, word list recall, mild cognitive impairment, dementia onset, APOE ε4, socioeconomic status, vascular risk factors, hypertension, diabetes mellitus, dyslipidemia, alcohol and tobacco use, educational attainment, sex differences, genetic risk factors, longitudinal cognitive trajectories
MeSH terms
Adult, Alzheimer Disease, Cognition Disorders, Colombia, Female, Heterozygote, Humans, Longitudinal Studies, Male, Middle Aged, Retrospective Studies, Cohort Studies, Presenilin-1

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