Identification of Successful Cognitive Aging in the Alzheimer’s Disease Neuroimaging Initiative Study

Article type: Research Article

Authors: Lin, Feng V.^{a; b; c; d; *} | Wang, Xixi^{c; e} | Wu, Rachel^f | Rebok, George W.^g | Chapman, Benjamin P.^{b; h} | the Alzheimer’s Disease Neuroimaging Initiative¹

Affiliations: [a] School of Nursing, University of Rochester Medical Center, Rochester, NY, USA | [b] Department of Psychiatry, University of Rochester Medical Center, Rochester, NY, USA | [c] Department of Brain and Cognitive Science, University of Rochester, Rochester, NY, USA | [d] Department of Neuroscience, University of Rochester Medical Center, Rochester, NY, USA | [e] Department of Biomedical Engineering, University of Rochester, Rochester, NY, USA | [f] Department of Psychology, University of California, Riverside, Riverside, CA, USA | [g] Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA | [h] Department of Public Health Science, University of Rochester Medical Center, Rochester, NY, USA

Correspondence: [*] Correspondence to: Feng Vankee Lin, PhD, University of Rochester Medical Center, 601 Elmwood Ave, Rochester, NY 14618, USA. Tel.: +1 585 276 6002; Fax: +1 585 273 1258; E-mail: vankee_lin@urmc.rochester.edu.

Note: [1] Data used in preparation of this article were obtained from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) database (http://adni.loni.usc.edu). As such, the investigators within the ADNI contributed to the design and implementation of ADNI and/or provided data but did not participate in analysis or writing of this report. A complete listing of ADNI investigators can be found at: http://adni.loni.usc.edu/wp-content/uploads/how_to_apply/ADNI_Acknowledgement_List.pdf

Abstract: The present prospective observational study aimed to identify the existence of successful cognitive agers among a group of well-defined cognitively healthy older adults (n = 354, mean age = 75 years), and to examine baseline individual-level predictors and associated health outcomes over time. Episodic memory (EM) and executive function (EF) composite scores and multiple health outcomes were obtained annually over 5 years. Potential individual-level predictors that were related to Alzheimer’s disease pathology or genetic risk, neurodegeneration, and vascular risks were collected at baseline. Three latent classes with matched age and education were identified using growth mixture modeling: a group of participants who exhibited high, stable EM and EF (40.7% of the sample, “successful agers”); a group who had initial high cognitive performance that declined over time (21.2%, “declining agers”); and a group who had normal (EM) or poor (EF) but stable cognitive performance over time (38.1%, “low stable agers”). The group classification predicted significant differences in the incidence of global cognitive impairment, the development of at least one depressive symptom, and everyday functional impairment. Sex, apolipoprotein E allele 4, amyloid-β1-42, and t-tau significantly contributed to the difference in cognitive trajectories between the successful agers and the other two groups. Characterizing successful cognitive agers who are relatively resistant to both tau and amyloid pathology provides potential pathways for promoting successful cognitive aging and preventing cognitive decline.

Keywords: Amyloid-β, episodic memory, executive function, successful cognitive aging, tau

DOI: 10.3233/JAD-161278

Journal: Journal of Alzheimer's Disease, vol. 59, no. 1, pp. 101-111, 2017