A Neuropsychological Perspective on Defining Cognitive Impairment in the Clinical Study of Alzheimer's Disease: Towards a More Continuous Approach

Roos J. Jutten; Louisa Thompson; Sietske A.M. Sikkes; Paul Maruff; José Luis Molinuevo; Henrik Zetterberg; Jessica Alber; David Faust; Serge Gauthier; Michael Gold; John Harrison; Athene K.W. Lee; Peter J. Snyder

doi:10.3233/JAD-215098

A Neuropsychological Perspective on Defining Cognitive Impairment in the Clinical Study of Alzheimer's Disease: Towards a More Continuous Approach

Roos J. Jutten, Louisa Thompson^*, Sietske A.M. Sikkes, Paul Maruff, José Luis Molinuevo, Henrik Zetterberg, Jessica Alber, David Faust, Serge Gauthier, Michael Gold, John Harrison, Athene K.W. Lee, Peter J. Snyder

^*Corresponding author for this work

Research output: Contribution to Journal › Review article › Academic › peer-review

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Abstract

The global fight against Alzheimer's disease (AD) poses unique challenges for the field of neuropsychology. Along with the increased focus on early detection of AD pathophysiology, characterizing the earliest clinical stage of the disease has become a priority. We believe this is an important time for neuropsychology to consider how our approach to the characterization of cognitive impairment can be improved to detect subtle cognitive changes during early-stage AD. The present article aims to provide a critical examination of how we define and measure cognitive status in the context of aging and AD. First, we discuss pitfalls of current methods for defining cognitive impairment within the context of research shifting to earlier (pre)symptomatic disease stages. Next, we introduce a shift towards a more continuous approach for identifying early markers of cognitive decline and characterizing progression and discuss how this may be facilitated by novel assessment approaches. Finally, we summarize potential implications and challenges of characterizing cognitive status using a continuous approach.

Original language	English
Pages (from-to)	511-524
Number of pages	14
Journal	Journal of Alzheimer's Disease
Volume	86
Issue number	2
Early online date	22 Mar 2022
DOIs	https://doi.org/10.3233/JAD-215098
Publication status	Published - 2022

Bibliographical note

Funding Information:
HZ is a Wallenberg Scholar supported by grants from the Swedish Research Council (#2018-02532), the European Research Council (#681712), Swedish State Support for Clinical Research (#ALFGBG-720931), the Alzheimer Drug Discovery Foundation (ADDF), USA (#201809-2016862), and the UK Dementia Research Institute at UCL. AL and JA are partially supported by Institutional Development Award Number U54GM115677 from the National Institute of General Medical Sciences of the National Institutes of Health, which funds Advance Clinical and Translational Research (Advance-CTR). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Publisher Copyright:
© 2022 - IOS Press. All rights reserved.

Funding

HZ is a Wallenberg Scholar supported by grants from the Swedish Research Council (#2018-02532), the European Research Council (#681712), Swedish State Support for Clinical Research (#ALFGBG-720931), the Alzheimer Drug Discovery Foundation (ADDF), USA (#201809-2016862), and the UK Dementia Research Institute at UCL. AL and JA are partially supported by Institutional Development Award Number U54GM115677 from the National Institute of General Medical Sciences of the National Institutes of Health, which funds Advance Clinical and Translational Research (Advance-CTR). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Funders	Funder number
Advance Clinical and Translational Research
Swedish State Support for Clinical Research	-720931
National Institutes of Health
National Institute of General Medical Sciences	U54GM115677
Alzheimer's Drug Discovery Foundation	201809-2016862
European Research Council	681712
Vetenskapsrådet	2018-02532
UK Dementia Research Institute

Keywords

Cognitive assessment
early diagnosis
neuropsychology
preclinical Alzheimer's disease
progression

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10.3233/JAD-215098

A Neuropsychological Perspective on Defining Cognitive Impairment in the Clinical Study of Alzheimer’s DiseaseFinal published version, 115 KBLicence: Article 25fa Dutch Copyright Act

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Jutten, R. J., Thompson, L., Sikkes, S. A. M., Maruff, P., Molinuevo, J. L., Zetterberg, H., Alber, J., Faust, D., Gauthier, S., Gold, M., Harrison, J., Lee, A. K. W., & Snyder, P. J. (2022). A Neuropsychological Perspective on Defining Cognitive Impairment in the Clinical Study of Alzheimer's Disease: Towards a More Continuous Approach. Journal of Alzheimer's Disease, 86(2), 511-524. https://doi.org/10.3233/JAD-215098

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title = "A Neuropsychological Perspective on Defining Cognitive Impairment in the Clinical Study of Alzheimer's Disease: Towards a More Continuous Approach",

abstract = "The global fight against Alzheimer's disease (AD) poses unique challenges for the field of neuropsychology. Along with the increased focus on early detection of AD pathophysiology, characterizing the earliest clinical stage of the disease has become a priority. We believe this is an important time for neuropsychology to consider how our approach to the characterization of cognitive impairment can be improved to detect subtle cognitive changes during early-stage AD. The present article aims to provide a critical examination of how we define and measure cognitive status in the context of aging and AD. First, we discuss pitfalls of current methods for defining cognitive impairment within the context of research shifting to earlier (pre)symptomatic disease stages. Next, we introduce a shift towards a more continuous approach for identifying early markers of cognitive decline and characterizing progression and discuss how this may be facilitated by novel assessment approaches. Finally, we summarize potential implications and challenges of characterizing cognitive status using a continuous approach.",

keywords = "Cognitive assessment, early diagnosis, neuropsychology, preclinical Alzheimer's disease, progression",

author = "Jutten, {Roos J.} and Louisa Thompson and Sikkes, {Sietske A.M.} and Paul Maruff and Molinuevo, {Jos{\'e} Luis} and Henrik Zetterberg and Jessica Alber and David Faust and Serge Gauthier and Michael Gold and John Harrison and Lee, {Athene K.W.} and Snyder, {Peter J.}",

note = "Funding Information: HZ is a Wallenberg Scholar supported by grants from the Swedish Research Council (#2018-02532), the European Research Council (#681712), Swedish State Support for Clinical Research (#ALFGBG-720931), the Alzheimer Drug Discovery Foundation (ADDF), USA (#201809-2016862), and the UK Dementia Research Institute at UCL. AL and JA are partially supported by Institutional Development Award Number U54GM115677 from the National Institute of General Medical Sciences of the National Institutes of Health, which funds Advance Clinical and Translational Research (Advance-CTR). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Publisher Copyright: {\textcopyright} 2022 - IOS Press. All rights reserved.",

year = "2022",

doi = "10.3233/JAD-215098",

language = "English",

volume = "86",

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journal = "Journal of Alzheimer's Disease",

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Jutten, RJ, Thompson, L, Sikkes, SAM, Maruff, P, Molinuevo, JL, Zetterberg, H, Alber, J, Faust, D, Gauthier, S, Gold, M, Harrison, J, Lee, AKW & Snyder, PJ 2022, 'A Neuropsychological Perspective on Defining Cognitive Impairment in the Clinical Study of Alzheimer's Disease: Towards a More Continuous Approach', Journal of Alzheimer's Disease, vol. 86, no. 2, pp. 511-524. https://doi.org/10.3233/JAD-215098

A Neuropsychological Perspective on Defining Cognitive Impairment in the Clinical Study of Alzheimer's Disease: Towards a More Continuous Approach. / Jutten, Roos J.; Thompson, Louisa; Sikkes, Sietske A.M. et al.
In: Journal of Alzheimer's Disease, Vol. 86, No. 2, 2022, p. 511-524.

Research output: Contribution to Journal › Review article › Academic › peer-review

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AU - Jutten, Roos J.

AU - Thompson, Louisa

AU - Sikkes, Sietske A.M.

AU - Maruff, Paul

AU - Molinuevo, José Luis

AU - Zetterberg, Henrik

AU - Alber, Jessica

AU - Faust, David

AU - Gauthier, Serge

AU - Gold, Michael

AU - Harrison, John

AU - Lee, Athene K.W.

AU - Snyder, Peter J.

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PY - 2022

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N2 - The global fight against Alzheimer's disease (AD) poses unique challenges for the field of neuropsychology. Along with the increased focus on early detection of AD pathophysiology, characterizing the earliest clinical stage of the disease has become a priority. We believe this is an important time for neuropsychology to consider how our approach to the characterization of cognitive impairment can be improved to detect subtle cognitive changes during early-stage AD. The present article aims to provide a critical examination of how we define and measure cognitive status in the context of aging and AD. First, we discuss pitfalls of current methods for defining cognitive impairment within the context of research shifting to earlier (pre)symptomatic disease stages. Next, we introduce a shift towards a more continuous approach for identifying early markers of cognitive decline and characterizing progression and discuss how this may be facilitated by novel assessment approaches. Finally, we summarize potential implications and challenges of characterizing cognitive status using a continuous approach.

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KW - neuropsychology

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KW - progression

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A Neuropsychological Perspective on Defining Cognitive Impairment in the Clinical Study of Alzheimer's Disease: Towards a More Continuous Approach

Abstract

Bibliographical note

Funding

Keywords

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