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

Sarah-Christine Villeneuve; Marion Houot; Federica Cacciamani; Merike Verrijp; Bruno Dubois; Sietske Sikkes; Stéphane Epelbaum; MEMENTO study group and the INSIGHT-preAD study group

doi:10.1016/j.trci.2019.08.009

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

Alzheimers Dement (N Y). 2019 Oct 8:5:553-562. doi: 10.1016/j.trci.2019.08.009. eCollection 2019.

Authors

Sarah-Christine Villeneuve^{1

2}, Marion Houot¹, Federica Cacciamani^{3

4

5

6

7}, Merike Verrijp⁸, Bruno Dubois^{1

3

4

5

6}, Sietske Sikkes^{8

9}, Stéphane Epelbaum^{1

3

4

5

6

7}; MEMENTO study group and the INSIGHT-preAD study group

Collaborators

Affiliations

¹ Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Center of excellence of neurodegenerative disease (CoEN) and National Reference Center for Rare or Early Dementias Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l'hôpital, Paris, France.
² Department of Geriatry, Hôpital Maisonneuve-Rosemont, Montréal, QC, Canada.
³ Institut du Cerveau et de la Moelle épinière, ICM, Paris, France.
⁴ Inserm, U 1127, Paris, France.
⁵ CNRS, UMR 7225, Paris, France.
⁶ Sorbonne Université, Paris, France.
⁷ Inria, Aramis project-team, Paris, France.
⁸ Department of Neurology, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands.
⁹ Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.

Abstract

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 Amsterdam 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 = .0005), and lower education (P = .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.

Keywords: Alzheimer's disease; Amsterdam-IADL; Autonomy; Latent class analysis; Linear mixed model.