medRxiv · Nov 2, 2024

Executive Functioning and Processing Speed as Predictors of Global Cognitive Decline in Alzheimer Disease

By Haran JP, Barrett AM, Lai Y et al.

INTRODUCTION: There is a lack of cognitive tools to predict disease progression in mild cognitive impairment (MCI) and Alzheimer's disease (AD). METHODS: We assessed patients with MCI, AD, and cognitively healthy controls (cHC) using NIH toolbox assessments for attention/concentration and executive functioning and overall cognitive decline by the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog). RESULTS: Among 183 participants over a median follow-up of 540 days, both between- and within-subjects variance in NIH toolbox and ADAS-Cog assessments increased from cHC to MCI to AD patients. Among patients with AD, pattern comparison processing speed (PCPS) and dimensional change card sort tests (DCCS) declined at 3 and 6 months prior to global cognitive decline (p=0.008 & 0.0012). A 5-point decrease in either PCPS or DCCS increased risk of global cognitive decline (HR 1.32 (1.08-1.60) and 1.62 (1.16-2.26)). DISCUSSION: Testing for cognitive domains of attention/concentration and executive functioning may predict subsequent global cognitive, and functional decline.

doi.org/10.1101/2024.10.31.24316508 Open access PubMed 39574871 Biomarkers