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Modeling the Cognitive Trajectory in CADASIL.

Sandrine Brice1, Aude Jabouley2, Sonia Reyes2

  • 1Sorbonne Université, INSERM, Institut Pierre Louis d'Épidémiologie et de Santé Publique, Paris, France.

Journal of Alzheimer'S Disease : JAD
|August 18, 2020
PubMed
Summary
This summary is machine-generated.

Cognitive decline in Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) accelerates after age 50. Standard cognitive tests like MMSE and MDRS have limitations for tracking this decline over time.

Keywords:
AgingAlzheimer’s diseaseCADASILbehaviorcognitive declinelatent variable modelinglongitudinal studiesneuropsychological testspatient outcome assessment

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Area of Science:

  • Neurology
  • Neuroscience
  • Clinical Research

Background:

  • Cerebral Autosomal Dominant Arteriopathy with Subcortical Infarcts and Leukoencephalopathy (CADASIL) is a genetic condition affecting the brain.
  • Understanding long-term cognitive changes is vital for future clinical trial development in CADASIL.

Purpose of the Study:

  • To investigate the global cognitive trajectory in CADASIL patients.
  • To evaluate the performance of the Mini-Mental State Examination (MMSE) and the Mattis Dementia Rating Scale (MDRS) in longitudinal studies of CADASIL.

Main Methods:

  • Analysis of follow-up data from 185 CADASIL patients.
  • Utilized a multivariate latent process mixed model to delineate cognitive trajectory.
  • Adjusted for sex and education, comparing MMSE and MDRS sensitivities.

Main Results:

  • Cognitive performance declines with age, particularly after 50 years.
  • Higher education correlated with a higher baseline cognitive level, but did not alter decline rate.
  • MMSE and MDRS showed similar sensitivities but were limited by ceiling effects and non-linearity.

Conclusions:

  • Cognitive decline in CADASIL is non-linear and predominantly occurs after age 50.
  • MMSE and MDRS exhibit significant limitations for long-term cognitive monitoring in CADASIL patients.
  • Further research is needed to identify more sensitive cognitive assessment tools for CADASIL clinical trials.