Cognitive subtypes of probable Alzheimer's disease robustly identified in four cohorts

Nienke M.E. Scheltens*, Betty M. Tijms, Teddy Koene, Frederik Barkhof, Charlotte E. Teunissen, Steffen Wolfsgruber, Michael Wagner, Johannes Kornhuber, Oliver Peters, Brendan I. Cohn-Sheehy, Gil D. Rabinovici, Bruce L. Miller, Joel H. Kramer, Philip Scheltens, Wiesje M. van der Flier, Alzheimer's Disease Neuroimaging Initiative, German Dementia Competence Network, University of California San Francisco Memory and Aging Center, Amsterdam Dementia Cohort

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Introduction Patients with Alzheimer's disease (AD) show heterogeneity in profile of cognitive impairment. We aimed to identify cognitive subtypes in four large AD cohorts using a data-driven clustering approach. Methods We included probable AD dementia patients from the Amsterdam Dementia Cohort (n = 496), Alzheimer's Disease Neuroimaging Initiative (n = 376), German Dementia Competence Network (n = 521), and University of California, San Francisco (n = 589). Neuropsychological data were clustered using nonnegative matrix factorization. We explored clinical and neurobiological characteristics of identified clusters. Results In each cohort, a two-clusters solution best fitted the data (cophenetic correlation >0.9): one cluster was memory-impaired and the other relatively memory spared. Pooled analyses showed that the memory-spared clusters (29%–52% of patients) were younger, more often apolipoprotein E (APOE) ɛ4 negative, and had more severe posterior atrophy compared with the memory-impaired clusters (all P <.05). Conclusions We could identify two robust cognitive clusters in four independent large cohorts with distinct clinical characteristics.

Original languageEnglish
Pages (from-to)1226-1236
Number of pages11
JournalAlzheimer's and Dementia
Volume13
Issue number11
DOIs
Publication statusPublished - 1 Nov 2017

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