Predicting conversion to dementia in a memory clinic: A standard clinical approach compared with an empirically defined clustering method (latent profile analysis) for mild cognitive impairment subtyping

Bernadette McGuinness, Suzanne L. Barrett, John McIlvenna, Anthony Peter Passmore, Gillian Shorter

Research output: Contribution to journalArticlepeer-review

20 Citations (Scopus)
314 Downloads (Pure)

Abstract

Introduction
Mild cognitive impairment (MCI) has clinical value in its ability to predict later dementia. A better understanding of cognitive profiles can further help delineate who is most at risk of conversion to dementia. We aimed to (1) examine to what extent the usual MCI subtyping using core criteria corresponds to empirically defined clusters of patients (latent profile analysis [LPA] of continuous neuropsychological data) and (2) compare the two methods of subtyping memory clinic participants in their prediction of conversion to dementia.

Methods
Memory clinic participants (MCI, n = 139) and age-matched controls (n = 98) were recruited. Participants had a full cognitive assessment, and results were grouped (1) according to traditional MCI subtypes and (2) using LPA. MCI participants were followed over approximately 2 years after their initial assessment to monitor for conversion to dementia.

Results
Groups were well matched for age and education. Controls performed significantly better than MCI participants on all cognitive measures. With the traditional analysis, most MCI participants were in the amnestic multidomain subgroup (46.8%) and this group was most at risk of conversion to dementia (63%). From the LPA, a three-profile solution fit the data best. Profile 3 was the largest group (40.3%), the most cognitively impaired, and most at risk of conversion to dementia (68% of the group).

Discussion
LPA provides a useful adjunct in delineating MCI participants most at risk of conversion to dementia and adds confidence to standard categories of clinical inference.
Original languageEnglish
Pages (from-to)447-454
JournalAlzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring
Volume1
Issue number4
DOIs
Publication statusPublished - Dec 2015

Bibliographical note

This article has been cited 18 times. I was responsible for ethical approval, phenotyping of participants with mild cognitive impairment, carrying out neuropsychological tests, follow up of participants to ascertain if they had converted to Alzheimer's disease, statistical analysis and writing the manuscript.

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