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Late-life memory trajectories in relation to incident dementia and regional brain atrophy

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Abstract

The trajectory, or slope, of cognitive decline may provide differentiation of older adults with and without incipient neurodegenerative disease. Cognitive aging phenotypes based on memory trajectories could be used as outcome measures for clinical trials or observational studies of risk and protective factors for dementia. This study used growth mixture modeling (GMM) to identify trajectory groups based on age- and education-corrected composite memory scores derived from immediate, delayed and recognition trials of the Selective Reminding Test. Participants included 2593 participants initially without dementia (mean age at entry = 76) in a community-based study of aging and dementia in northern Manhattan. Trajectory groups were compared on consensus diagnoses of dementia and structural MRI measures of hippocampal volume and entorhinal cortical thickness. Heterogeneity in memory trajectories allowed us to identify four groups: Stable-High (43.5 %), Stable-Low (17.1 %), Decliner (26.8 %), and Rapid Decliner (12.5 %). Decliners had more brain atrophy and higher rates of conversion to dementia. This study highlights the heterogeneity in cognitive aging and provides evidence that most elderly maintain memory function as they age. Associations with dementia and imaging measures validate subgroups of older adults identified with GMM based on their memory trajectories. Future research should use these memory trajectory phenotypes to determine whether dementia risk and protective factors differ for individuals following different memory trajectories.

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Acknowledgments

This study was funded with support from the National Institute on Aging (grant numbers AG047963, AG037212, AG034189, AG007232). The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; or decision to submit the manuscript for publication. On behalf of all authors, the corresponding author states that there is no conflict of interest.

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Authors and Affiliations

  1. The Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, 630 West 168th Street, P&S Box 16, New York, NY, 10032, USA

    Laura B. Zahodne, Nicole Schupf, Richard Mayeux, Jennifer J. Manly, Yaakov Stern & Adam M. Brickman

  2. The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Laura B. Zahodne, Richard Mayeux, Jennifer J. Manly, Yaakov Stern & Adam M. Brickman

  3. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Laura B. Zahodne, Richard Mayeux, Jennifer J. Manly, Yaakov Stern & Adam M. Brickman

  4. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA

    Melanie M. Wall, Nicole Schupf & Richard Mayeux

  5. Department of Biostatistics, School of Public Health, Columbia University, New York, NY, USA

    Melanie M. Wall

  6. Department of Epidemiology, School of Public Health, Columbia University, New York, NY, USA

    Nicole Schupf & Richard Mayeux

Authors
  1. Laura B. Zahodne
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  2. Melanie M. Wall
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  3. Nicole Schupf
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  4. Richard Mayeux
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  5. Jennifer J. Manly
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  6. Yaakov Stern
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  7. Adam M. Brickman
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Corresponding author

Correspondence to Adam M. Brickman.

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All authors declare no conflict of interest.

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All participants gave informed consent before entering the study. The study was approved by the Institutional Review Boards at Columbia University.

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Zahodne, L.B., Wall, M.M., Schupf, N. et al. Late-life memory trajectories in relation to incident dementia and regional brain atrophy. J Neurol 262, 2484–2490 (2015). https://doi.org/10.1007/s00415-015-7871-8

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  • DOI: https://doi.org/10.1007/s00415-015-7871-8

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