ArticleJournal of Alzheimer's disease : JAD2016
The Role of Alzheimer's and Cerebrovascular Pathology in Mediating the Effects of Age, Race, and Apolipoprotein E Genotype on Dementia Severity in Pathologically-Confirmed Alzheimer's Disease.
Article in Journal of Alzheimer's disease : JAD, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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Who cites it
24 citing papers in PubMed, 31 citations in OpenAlex.
- A randomized controlled trial to test the efficacy of a diabetes behavioral intervention to prevent memory decline in older blacks/African Americans with diabetes and mild cognitive impairment.Contemporary clinical trials · 2022Trial
- Preventing Cognitive Decline in Black Individuals With Mild Cognitive Impairment: A Randomized Clinical Trial.JAMA neurology · 2018Trial
- Biomarker affliction classes contribute additively to observed dementia severity and prospective conversion risk.Journal of Alzheimer's disease : JAD · 2026Article
- Affliction class moderates the dementing impact of amyloidopathy.Neuropsychology · 2025Article
- Mediation of the Association BetweenNeurology · 2025Article
- Statin use moderates APOE's and CRP's associations with dementia and is associated with lesser dementia severity in ε4 carriers.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2024Article
- Association between APOE-ε4 allele and cognitive function is mediated by Alzheimer's disease pathology: a population-based autopsy study in an admixed sample.Acta neuropathologica communications · 2023Review
- AD and non-AD mediators of the pathway between the APOE genotype and cognition.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2023Article
- APOE effects on regional tau in preclinical Alzheimer's disease.Molecular neurodegeneration · 2023Article
- The effects of CNS atrophy and ICVD on tests of executive function and functional status are mediated by intelligence.Cerebral circulation - cognition and behavior · 2023Article
- Blood-based protein mediators of senility with replications across biofluids and cohorts.Brain communications · 2020Article
- Blood-based protein predictors of dementia severity as measured by δ: Replication across biofluids and cohorts.Alzheimer's & dementia (Amsterdam, Netherlands) · 2019Article
- Memory improvement in African Americans with amnestic mild cognitive impairment.International journal of geriatric psychiatry · 2019Article
- TREM2 brain transcript-specific studies in AD and TREM2 mutation carriers.Molecular neurodegeneration · 2019Article
- APOE genotypes as a risk factor for age-dependent accumulation of cerebrovascular disease in older adults.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2019Article
- Article
- Analysis of apolipoprotein E genetic variation in patients with Alzheimer disease referred to Imam Reza Clinic, Rasht, Iran, in 2015.Iranian journal of neurology · 2017Article
- Article
- Risk Factors and Pathological Substrates Associated with Agitation/Aggression in Alzheimer's Disease: A Preliminary Study using NACC Data.Journal of Alzheimer's disease : JAD · 2017Article
- δ scores predict mild cognitive impairment and Alzheimer's disease conversions from nondemented states.Alzheimer's & dementia (Amsterdam, Netherlands) · 2017Article
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundDementia severity can be modeled as the construct δ, representing the "cognitive correlates of functional status."
objectiveWe recently validated a model for estimating δ in the National Alzheimer's Coordinating Center's Uniform Data Set; however, the association of δ with neuropathology remains untested.
methodsWe used data from 727 decedents evaluated at Alzheimer's Disease (AD) Centers nationwide. Participants spoke English, had no genetic abnormalities, and were pathologically diagnosed with AD as a primary or contributing etiology. Clinical data from participants' last visit prior to death were used to estimate dementia severity (δ).
resultsA structural equation model using age, education, race, and apolipoprotein E (APOE) genotype (number of ɛ2 and ɛ4 alleles) as predictors and latent AD pathology and cerebrovascular disease (CVD) pathology as mediators fit the data well (RMSEA = 0.031; CFI = 0.957). AD pathology mediated the effects of age and APOE genotype on dementia severity. An older age at death and more ɛ2 alleles were associated with less AD pathology and, in turn, with less severe dementia. In contrast, more ɛ4 alleles were associated with more pathology and more severe dementia. Although age and race contributed to differences in CVD pathology, CVD pathology was not related to dementia severity in this sample of decedents with pathologically-confirmed AD.
conclusionsUsing δ as an estimate of dementia severity fits well within a structural model in which AD pathology directly affects dementia severity and mediates the relationship between age and APOE genotype on dementia severity.
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