Latent class analysis identifies functional decline with Amsterdam IADL in preclinical Alzheimer's disease

Sarah-Christine Villeneuve (1, 2) , Marion Houot (1) , Federica Cacciamani (3, 4) , Merike Verrijp (5) , Bruno Dubois (1, 3) , Sietske Sikkes (5, 6) , Stéphane Epelbaum (1, 3, 4)

1 CHU Pitié-Salpêtrière [AP-HP]
2 Hôpital Maisonneuve-Rosemont
3 ICM - Institut du Cerveau = Paris Brain Institute
4 ARAMIS - Algorithms, models and methods for images and signals of the human brain = Algorithmes, modèles et méthodes pour les images et les signaux du cerveau humain [ICM Paris]
5 VUMC - Vrije Universiteit Medical Centre
6 HMS - Harvard Medical School [Boston]

Introduction: Trials in Alzheimer's disease (AD) now include participants at the earliest stages to prevent further decline. However, the lack of tools sensitive to subtle functional changes in early-stage AD hinders the development of new therapies as it is difficult to prove their clinical relevance. Methods: We assessed functional changes over three years in 289 elderly memory complainers from the Investigation of Alzheimer's Predictors in subjective memory complainers cohort using the Am-sterdam Instrumental-Activities-of-Daily-Living questionnaire (A-IADL-Q). Results: No overall functional decline related to AD imaging markers was evidenced. However, five distinct classes of A-IADL-Q trajectories were identified. The largest class (212 [73.4%]) had stable A-IADL-Q scores over 3 years. A second group (23 [8.0%]) showed a persistent functional decline, higher amyloid load (P 5 .0005), and lower education (P 5 .0392). Discussion: The A-IADL-Q identified a subtle functional decline in asymptomatic at-risk AD individuals. This could have important implications in the field of early intervention in AD.

Mots clés: Latent class analysis; Alzheimer's disease AD; Autonomy; Amsterdam-IADL; Linear mixed model; Latent class analysis

Domaines: Neurosciences; Sciences cognitives; Gériatrie et gérontologie; Méthodologie [stat.ME]

Sarah-Christine Villeneuve, Marion Houot, Federica Cacciamani, Merike Verrijp, Bruno Dubois, et al.. Latent class analysis identifies functional decline with Amsterdam IADL in preclinical Alzheimer's disease. Alzheimer's & Dementia : the Journal of the Alzheimer's Association, 2019, 5, pp.553-562. ⟨10.1016/j.trci.2019.08.009⟩. ⟨hal-02333456⟩