ArticleJournal of Alzheimer's disease : JAD2021
Four Common Late-Life Cognitive Trajectories Patterns Associate with Replicable Underlying Neuropathologies.
Article in Journal of Alzheimer's disease : JAD, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 20 citations in OpenAlex.
- Frailty and Health Outcomes in People 65 Years or Older Living With Dementia: A Systematic Review of the Literature.Journal of the American Geriatrics Society · 2026Pooled it
- Data-driven thresholds for standardized classification of severe Alzheimer's disease neuropathology using digital neuropathology.Brain pathology (Zurich, Switzerland) · 2026Article
- Alzheimer neuropathological change, α-synuclein and transactive response DNA-binding protein of 43 kDa expression in children and young adult brains from forensic autopsies: Value for early measurement of abnormal protein expression prevalence in neurodegenerative diseases.Journal of neuropathology and experimental neurology · 2026Article
- Understanding Multilevel Correlates of Long-Term Physical Activity Trajectories Among Middle-Aged and Older Adults: A Machine-Learning Analysis.Behavioral sciences (Basel, Switzerland) · 2026Article
- The role of comorbidities in the associations between air pollution and Alzheimer's disease: A national cohort study in the American Medicare population.PLoS medicine · 2026Article
- Neuropathologic Profiles and Associated Cognitive Trajectories in Community-Living Older Adults.JAMA network open · 2026Article
- Supraspan memory performance is impaired in subjective cognitive impairment compared to cognitively unimpaired individuals.Scientific reports · 2025Article
- Review
- Comprehensive assessment of TDP-43 neuropathology data in the National Alzheimer's Coordinating Center database.Acta neuropathologica · 2024Article
- Limbic-predominant age-related TDP-43 encephalopathy (LATE-NC): Co-pathologies and genetic risk factors provide clues about pathogenesis.Journal of neuropathology and experimental neurology · 2024Review
- Polypathologic Associations with Gray Matter Atrophy in Neurodegenerative Disease.The Journal of neuroscience : the official journal of the Society for Neuroscience · 2024Article
- Associations between resting heart rate and cognitive decline in Chinese oldest old individuals: a longitudinal cohort study.BMC geriatrics · 2024Article
- 2024 United States Elections: Air Pollution, Neurodegeneration, Neuropsychiatric, and Neurodevelopmental Disorders. Who Cares?Journal of Alzheimer's disease : JAD · 2024Article
- Neurodegenerative pathologies associated with behavioral and psychological symptoms of dementia in a community-based autopsy cohort.Acta neuropathologica communications · 2023Article
- Pathological combinations in neurodegenerative disease are heterogeneous and disease-associated.Brain : a journal of neurology · 2023Article
- Symptomatic Profile and Cognitive Performance in Autopsy-Confirmed Limbic-Predominant Age-Related TDP-43 Encephalopathy With Comorbid Alzheimer Disease.Journal of neuropathology and experimental neurology · 2022Article
- Multiple gene variants linked to Alzheimer's-type clinical dementia via GWAS are also associated with non-Alzheimer's neuropathologic entities.Neurobiology of disease · 2022Article
- A Perspective: Challenges in Dementia Research.Medicina (Kaunas, Lithuania) · 2022Article
- Cancer diagnosis is associated with a lower burden of dementia and less Alzheimer's-type neuropathology.Brain : a journal of neurology · 2022Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundLate-life cognitive function is heterogeneous, ranging from no decline to severe dementia. Prior studies of cognitive trajectories have tended to focus on a single measure of global cognition or individual tests scores, rather than considering longitudinal performance on multiple tests simultaneously.
objectiveThe current study aimed to examine cognitive trajectories from two independent datasets to assess whether similar patterns might describe longitudinal cognition in the decade preceding death, as well as what participant characteristics were associated with trajectory membership.
methodsData were drawn from autopsied longitudinally followed participants of two cohorts (total N = 1,346), community-based cohort at the University of Kentucky Alzheimer's Disease Research Center (n = 365) and National Alzheimer's Coordinating Center (n = 981). We used group-based multi-trajectory models (GBMTM) to identify cognitive trajectories over the decade before death using Mini-Mental State Exam, Logical Memory-Immediate, and Animal Naming performance. Multinomial logistic and Random Forest analyses assessed characteristics associated with trajectory groups.
resultsGBMTM identified four similar cognitive trajectories in each dataset. In multinomial models, death age, Braak neurofibrillary tangles (NFT) stage, TDP-43, and α-synuclein were associated with declining trajectories. Random Forest results suggested the most important trajectory predictors were Braak NFT stage, cerebral atrophy, death age, and brain weight. Multiple pathologies were most common in trajectories with moderate or accelerated decline.
conclusionCognitive trajectories associated strongly with neuropathology, particularly Braak NFT stage. High frequency of multiple pathologies in trajectories with cognitive decline suggests dementia treatment and prevention efforts must consider multiple diseases simultaneously.
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