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Alzheimer's Disease (AD) is a continually advancing neurodegenerative disorder, distinguished by escalating memory loss, cognitive dysfunction, and dementia. The disease unfolds in three stages: preclinical, mild cognitive impairment (MCI), and dementia. Its onset is insidious, and the progression gradual, with the cause not well explained by other disorders.
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Application of Granger Causality Analysis of the Directed Functional Connection in Alzheimer's Disease and Mild Cognitive Impairment
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Global cognitive trajectory patterns in Alzheimer's disease.

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Summary

Researchers identified five distinct cognitive trajectories in Alzheimer's disease (AD) patients, revealing patterns in decline and stability. Understanding these Alzheimer's disease (AD) cognitive trajectories can inform future clinical research and patient care.

Keywords:
Alzheimer’s diseasecognitive trajectoriescoursedementiaoutcome

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Area of Science:

  • Neuroscience
  • Gerontology
  • Clinical Neurology

Background:

  • Limited data exists on long-term cognitive trajectories in Alzheimer's disease (AD).
  • Understanding cognitive progression is crucial for clinical research and patient care in AD.

Purpose of the Study:

  • To identify distinct global cognitive outcome trajectories in individuals with Alzheimer's disease (AD).
  • To determine predictor variables associated with these cognitive trajectories.

Main Methods:

  • Utilized data from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set.
  • Analyzed cognitive trajectories of 414 participants with probable or possible AD over 5 years using a hybrid approach.
  • Employed qualitative analysis of Mini-Mental State Examination (MMSE) trajectories and binary logistic regression for 19 predictor variables.

Main Results:

  • Identified five cognitive trajectories: fast decliners (32.6%), slow decliners (30.7%), zigzag stable (15.9%), stable (15.9%), and improvers (4.8%).
  • Fast decliners associated with female gender, lower baseline MMSE, shorter illness duration, or cognitive enhancers.
  • Predictors of favorable outcomes included higher traumatic brain injury rates, absence of ApoE ε4 allele, and male gender.

Conclusions:

  • A hybrid approach revealed five distinct cognitive trajectories in Alzheimer's disease (AD), reflecting real-world clinical observations.
  • The identified trajectories and their subtypes offer a more nuanced understanding of AD progression than previous statistical models.
  • Further research is needed to validate these findings across different clinical settings.