Latent Classes of Cognitive Functioning among Depressed Older Adults Without Dementia

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Latent Classes of Cognitive Functioning among Depressed Older Adults Without Dementia. / Morin, Ruth T.; Insel, Philip; Nelson, Craig; Butters, Meryl; Bickford, David; Landau, Susan; Saykin, Andrew; Weiner, Michael; Mackin, R. Scott.

I: Journal of the International Neuropsychological Society, 24.06.2019.

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Morin, Ruth T. ; Insel, Philip ; Nelson, Craig ; Butters, Meryl ; Bickford, David ; Landau, Susan ; Saykin, Andrew ; Weiner, Michael ; Mackin, R. Scott. / Latent Classes of Cognitive Functioning among Depressed Older Adults Without Dementia. I: Journal of the International Neuropsychological Society. 2019.

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TY - JOUR

T1 - Latent Classes of Cognitive Functioning among Depressed Older Adults Without Dementia

AU - Morin, Ruth T.

AU - Insel, Philip

AU - Nelson, Craig

AU - Butters, Meryl

AU - Bickford, David

AU - Landau, Susan

AU - Saykin, Andrew

AU - Weiner, Michael

AU - Mackin, R. Scott

PY - 2019/6/24

Y1 - 2019/6/24

N2 - Objective:Use latent class analysis (LCA) to identify patterns of cognitive functioning in a sample of older adults with clinical depression and without dementia and assess demographic, psychiatric, and neurobiological predictors of class membership.Method:Neuropsychological assessment data from 121 participants in the Alzheimer's Disease Neuroimaging Initiative-Depression project (ADNI-D) were analyzed, including measures of executive functioning, verbal and visual memory, visuospatial and language functioning, and processing speed. These data were analyzed using LCA, with predictors of class membership such as depression severity, depression and treatment history, amyloid burden, and APOE e4 allele also assessed.Results:A two-class model of cognitive functioning best fit the data, with the Lower Cognitive Class (46.1% of the sample) performing approximately one standard deviation below the Higher Cognitive Class (53.9%) on most tests. When predictors of class membership were assessed, carrying an APOE e4 allele was significantly associated with membership in the Lower Cognitive Class. Demographic characteristics, age of depression onset, depression severity, history of psychopharmacological treatment for depression, and amyloid positivity did not predict class membership.Conclusion:LCA allows for identification of subgroups of cognitive functioning in a mostly cognitively intact late life depression (LLD) population. One subgroup, the Lower Cognitive Class, more likely to carry an APOE e4 allele, may be at a greater risk for subsequent cognitive decline, even though current performance on neuropsychological testing is within normal limits. These findings have implications for early identification of those at greatest risk, risk factors, and avenues for preventive intervention.

AB - Objective:Use latent class analysis (LCA) to identify patterns of cognitive functioning in a sample of older adults with clinical depression and without dementia and assess demographic, psychiatric, and neurobiological predictors of class membership.Method:Neuropsychological assessment data from 121 participants in the Alzheimer's Disease Neuroimaging Initiative-Depression project (ADNI-D) were analyzed, including measures of executive functioning, verbal and visual memory, visuospatial and language functioning, and processing speed. These data were analyzed using LCA, with predictors of class membership such as depression severity, depression and treatment history, amyloid burden, and APOE e4 allele also assessed.Results:A two-class model of cognitive functioning best fit the data, with the Lower Cognitive Class (46.1% of the sample) performing approximately one standard deviation below the Higher Cognitive Class (53.9%) on most tests. When predictors of class membership were assessed, carrying an APOE e4 allele was significantly associated with membership in the Lower Cognitive Class. Demographic characteristics, age of depression onset, depression severity, history of psychopharmacological treatment for depression, and amyloid positivity did not predict class membership.Conclusion:LCA allows for identification of subgroups of cognitive functioning in a mostly cognitively intact late life depression (LLD) population. One subgroup, the Lower Cognitive Class, more likely to carry an APOE e4 allele, may be at a greater risk for subsequent cognitive decline, even though current performance on neuropsychological testing is within normal limits. These findings have implications for early identification of those at greatest risk, risk factors, and avenues for preventive intervention.

KW - Aging

KW - Cognitive functioning

KW - Late life depression

KW - Latent class analysis

KW - Major depression

KW - Neuropsychology

U2 - 10.1017/S1355617719000596

DO - 10.1017/S1355617719000596

M3 - Article

JO - Journal of the International Neuropsychological Society

T2 - Journal of the International Neuropsychological Society

JF - Journal of the International Neuropsychological Society

SN - 1355-6177

ER -