The Cognitive-Functional Composite is sensitive to clinical progression in early dementia: Longitudinal findings from the Catch-Cog study cohort

Roos J. Jutten*, John E. Harrison, A. J. Brunner, R. Vreeswijk, R. A.J. van Deelen, Frank Jan de Jong, Esther M. Opmeer, Craig W. Ritchie, André Aleman, Philip Scheltens, Sietske A.M. Sikkes

*Corresponding author for this work

Research output: Contribution to JournalArticleAcademicpeer-review

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 languageEnglish
Article numbere12020
Pages (from-to)1-11
Number of pages11
JournalAlzheimer's and Dementia: Translational Research and Clinical Interventions
Volume6
Issue number1
Early online date17 Apr 2020
DOIs
Publication statusPublished - 2020

Keywords

  • Alzheimer's disease
  • cognition
  • dementia
  • instrumental activities of daily living
  • mild cognitive impairment
  • outcome measures

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