Abstract
Introduction: In an attempt to capture clinically meaningful cognitive decline in early dementia, we developed the Cognitive-Functional Composite (CFC). We investigated the CFC's sensitivity to decline in comparison to traditional clinical endpoints. Methods: This longitudinal construct validation study included 148 participants with subjective cognitive decline, mild cognitive impairment, or mild dementia. The CFC and traditional tests were administered at baseline, 3, 6, and 12 months. Sensitivity to change was investigated using linear mixed models and r2 effect sizes. Results: CFC scores declined over time (β = −.16, P <.001), with steepest decline observed in mild Alzheimer's dementia (β = −.25, P <.001). The CFC showed medium-to-large effect sizes at succeeding follow-up points (r2=.08-.42), exhibiting greater change than the Clinical Dementia Rating scale (r2=.02-.12). Moreover, change on the CFC was significantly associated with informant reports of cognitive decline (β =.38, P <.001). Discussion: By showing sensitivity to decline, the CFC could enhance the monitoring of disease progression in dementia research and clinical practice.
Original language | English |
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Article number | e12020 |
Pages (from-to) | 1-11 |
Number of pages | 11 |
Journal | Alzheimer's and Dementia: Translational Research and Clinical Interventions |
Volume | 6 |
Issue number | 1 |
Early online date | 17 Apr 2020 |
DOIs | |
Publication status | Published - 2020 |
Funding
The authors would like to thank Philippe Lee Meeuw Kjoe, Mandy Ter Haar, Larissa Masselink, Judith Meurs, Mieke Geertsma, Nina Schimmel, Ilya de Groot, Judy van Hemmen, Kate Forsyth, Sarah Gregory, Neil Fullerton, Clare Dolan, and Matthew Hunter for their help with the data collection. Additionally, we would like to acknowledge Stichting Buytentwist for their support. Research of the Alzheimer Center Amsterdam is part of the neurodegeneration research program of Amsterdam Neuroscience. The Alzheimer Center Amsterdam is supported by Alzheimer Nederland and Stichting VUmc Fonds. The present study is supported by a grant from Memorabel (grant no. 733050205), which is the research program of the Dutch Deltaplan for2 Dementia. R.J.J., A.B., R.V., R.A.J.D, F.J.J, C.W.R., E.O.M., and A.A. report no relevant disclosures. In the past 2 years, J.H. has received honoraria and paid consultancy from 23andMe, Abbvie, A2Q, AlzCure, Amgen, Anavex, Aptinyx, Astellas, AstraZeneca, Avraham, Axon, Axovant, Biogen, Boehringer Ingelheim, Bracket, Catenion, Cognition Therapeutics, CRF Health, Curasen, DeNDRoN, Enzymotec, Eisai, Eli Lilly, GfHEu, Heptares, Johnson & Johnson, Kaasa Health, Lysosome Therapeutics, Lundbeck, Merck, MyCognition, Mind Agilis, Neurocog, Neurim, Neuroscios, Neurotrack, Novartis, Nutricia, Pfizer, PriceSpective, Probiodrug, Regeneron, Rodin Therapeutics, Roche, Sanofi, Servier, Shire, Takeda, and vTv Therapeutics. P.S. has acquired grant support (for the institution) from GE Healthcare and Piramal. In the past 2 years, he has received consultancy/speaker fees (paid to the institution) from Novartis, Probiodrug, Biogen, Roche, and EIP Pharma, LLC. S.A.M.S. is supported by grants from JPND and Zon‐MW, and has provided consultancy services in the past 2 years for Nutricia and Takeda. All funds were paid to her institution.
Funders | Funder number |
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Dutch Deltaplan for2 Dementia | |
Nutricia and Takeda | |
Stichting Buytentwist | 733050205 |
EU Joint Programme – Neurodegenerative Disease Research |
Keywords
- Alzheimer's disease
- cognition
- dementia
- instrumental activities of daily living
- mild cognitive impairment
- outcome measures