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Published on: February 14, 2014
Executive Functioning and Processing Speed as Predictors of Global Cognitive Decline in Alzheimer Disease
Introduction:
There is a lack of cognitive tools to predict disease progression in mild cognitive impairment (MCI) and Alzheimer's disease (AD).
Methods:
We assessed patients with MCI, AD, and cognitively healthy controls (cHC) using NIH toolbox assessments for attention/concentration and executive functioning and overall cognitive decline by the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog).
Results:
Among 183 participants over a median follow-up of 540 days, both between- and within-subjects variance in NIH toolbox and ADAS-Cog assessments increased from cHC to MCI to AD patients. Among patients with AD, pattern comparison processing speed (PCPS) and dimensional change card sort tests (DCCS) declined at 3 and 6 months prior to global cognitive decline (p=0.008 & 0.0012). A 5-point decrease in either PCPS or DCCS increased risk of global cognitive decline (HR 1.32 (1.08-1.60) and 1.62 (1.16-2.26)).
Discussion:
Testing for cognitive domains of attention/concentration and executive functioning may predict subsequent global cognitive, and functional decline.
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