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Liampas I, Dimitriou N, Siokas V, Messinis L, Nasios G, Dardiotis E. Cognitive trajectories preluding the onset of different dementia entities: a descriptive longitudinal study using the NACC database. Aging Clin Exp Res 2024; 36:119. [PMID: 38780681 PMCID: PMC11116253 DOI: 10.1007/s40520-024-02769-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2024] [Accepted: 05/02/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE To describe the 10-year preclinical cognitive trajectories of older, non-demented individuals towards the onset of the four most prevalent types of dementia, i.e., Alzheimer's disease(AD), Lewy body(LBD), vascular(VD) and frontotemporal dementia(FTD). METHODS Our analysis focused on data from older (≥ 60years) NACC (National Alzheimer's Coordinating Center) participants. Four distinct presymptomatic dementia groups (AD-LBD-VD-FTD) and a comparison group of cognitively unimpaired(CU) participants were formed. Comprehensive cognitive assessments involving verbal episodic memory, semantic verbal fluency, confrontation naming, mental processing speed - attention and executive function - cognitive flexibility were conducted at baseline and on an approximately yearly basis. Descriptive analyses (adjusted general linear models) were performed to determine and compare the yearly cognitive scores of each group throughout the follow-up. Exploratory analyses were conducted to estimate the rates of cognitive decline. RESULTS There were 3343 participants who developed AD, 247 LBD, 108 FTD, 155 VD and 3398 composed the CU group. Participants with AD performed worse on episodic memory than those with VD and LBD for about 3 to 4 years prior to dementia onset (the FTD group documented an intermediate course). Presymptomatic verbal fluency and confrontation naming trajectories differentiated quite well between the FTD group and the remaining dementia entities. Participants with incident LBD and VD performed worse than those with AD on executive functions and mental processing speed-attention since about 5 years prior to the onset of dementia, and worse than those with FTD more proximally to the diagnosis of the disorder. CONCLUSIONS Heterogeneous cognitive trajectories characterize the presymptomatic courses of the most prevalent dementia entities.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, School of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo Hill, Larissa, 41100, Greece.
| | - Nefeli Dimitriou
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, 45500, Greece
| | - Vasileios Siokas
- Department of Neurology, School of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo Hill, Larissa, 41100, Greece
| | - Lambros Messinis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, 54124, Greece
| | - Grigorios Nasios
- Department of Speech and Language Therapy, School of Health Sciences, University of Ioannina, Ioannina, 45500, Greece
| | - Efthimios Dardiotis
- Department of Neurology, School of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo Hill, Larissa, 41100, Greece
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Botezatu MR, Miller E, Kiselica AM. Limited connectedness of spontaneous speech may be a marker of dementia due to Alzheimer's disease. Front Aging Neurosci 2023; 15:1252614. [PMID: 37794978 PMCID: PMC10546011 DOI: 10.3389/fnagi.2023.1252614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 09/07/2023] [Indexed: 10/06/2023] Open
Abstract
The study evaluated the connectedness of spontaneous speech production in individuals with dementia as a potential predictor of dementia severity. Data were derived from the baseline sample of 143 individuals with dementia in the English Pitt corpus. Dementia severity was assessed via the Mini Mental Status Exam, the Mattis Dementia Rating Scale, and the Blessed Dementia Scale. Language abilities were evaluated using verbal fluency and picture description tasks. Graph analysis was carried out for the picture description task using the computational tool SpeechGraphs to calculate connectedness. Results demonstrated that higher educational attainment, higher verbal fluency and strongly-connected spontaneous speech were associated with better cognitive function. Results suggest that automated language processing approaches, such as graph structure analysis, may provide a faster and ecologically valid method of detecting dementia symptoms.
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Affiliation(s)
- Mona Roxana Botezatu
- Department of Speech, Language and Hearing Sciences, University of Missouri, Columbia, MO, United States
| | - Erika Miller
- Department of Speech, Language and Hearing Sciences, University of Missouri, Columbia, MO, United States
| | - Andrew M. Kiselica
- Department of Health Psychology, University of Missouri, Columbia, MO, United States
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Wright LM, De Marco M, Venneri A. Current Understanding of Verbal Fluency in Alzheimer's Disease: Evidence to Date. Psychol Res Behav Manag 2023; 16:1691-1705. [PMID: 37179686 PMCID: PMC10167999 DOI: 10.2147/prbm.s284645] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 04/05/2023] [Indexed: 05/15/2023] Open
Abstract
Since their development, verbal fluency tests (VFTs) have been used extensively throughout research and in clinical settings to assess a variety of cognitive functions in diverse populations. In Alzheimer's disease (AD), these tasks have proven particularly valuable in identifying the earliest forms of cognitive decline in semantic processing and have been shown to relate specifically to brain regions associated with the initial stages of pathological change. In recent years, researchers have developed more nuanced techniques to evaluate verbal fluency performance, extracting a wide range of cognitive metrics from these simple neuropsychological tests. Such novel techniques allow for a more detailed exploration of the cognitive processes underlying successful task performance beyond the raw test score. The versatility of VFTs and the richness of data they may provide, in light of their low cost and speed of administration, therefore, highlight their potential value both in future research as outcome measures for clinical trials and in a clinical setting as a screening measure for early detection of neurodegenerative diseases.
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Affiliation(s)
- Laura M Wright
- Translational and Clinical Research Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - Matteo De Marco
- Department of Life Sciences, Brunel University London, London, UK
| | - Annalena Venneri
- Department of Life Sciences, Brunel University London, London, UK
- Department of Medicine and Surgery, University of Parma, Parma, Italy
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Liampas I, Siokas V, Lyketsos CG, Dardiotis E. Associations between neuropsychiatric symptoms and incident Alzheimer's dementia in men versus women. J Neurol 2023; 270:2069-2083. [PMID: 36572715 PMCID: PMC10025238 DOI: 10.1007/s00415-022-11541-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To examine whether associations between individual neuropsychiatric symptoms (NPS) and incident Alzheimer's dementia (AD) differ in men versus women. METHODS Data were acquired from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set. Two sets of older (≥ 60 years) participants were formed: one of cognitively unimpaired (CU) individuals, and one of participants with mild cognitive impairment (MCI). NPS were assessed using the Neuropsychiatric Inventory Questionnaire. Cox proportional hazards models examined associations between individual NPS and AD incidence separately for each participant set. These models featured individual NPS, sex, NPS by sex interactions as well as a number of covariates. RESULTS The analysis involved 9,854 CU individuals followed for 5.5 ± 3.8 years and 6,369 participants with MCI followed for 3.8 ± 3.0 years. NPS were comparably associated with future AD in men and women with MCI. Regarding CU participants, the following significant sex by NPS interactions were noted: female sex moderated the risk conferred by moderate/severe apathy (HR = 7.36, 3.25-16.64) by 74%, mitigated the risk conferred by moderate/severe depression (HR = 3.61, 2.08-6.28) by 52%, and augmented the risks conferred by mild depression (HR = 1.00, 0.60-1.68) and agitation (HR = 0.81, 0.40-1.64) by 83% and 243%, respectively. CONCLUSIONS Apathy, depression and agitation were differentially associated with incident AD in CU men and women. No individual NPS was associated with different risks of future AD in men versus women with MCI.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, Faculty of Medicine, School of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo Hill, 41100, Larissa, Greece.
| | - Vasileios Siokas
- Department of Neurology, Faculty of Medicine, School of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo Hill, 41100, Larissa, Greece
| | - Constantine G Lyketsos
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, School of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo Hill, 41100, Larissa, Greece
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
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Liampas I, Folia V, Zoupa E, Siokas V, Yannakoulia M, Sakka P, Hadjigeorgiou G, Scarmeas N, Dardiotis E, Kosmidis MH. Qualitative Verbal Fluency Components as Prognostic Factors for Developing Alzheimer's Dementia and Mild Cognitive Impairment: Results from the Population-Based HELIAD Cohort. Medicina (B Aires) 2022; 58:medicina58121814. [PMID: 36557016 PMCID: PMC9786933 DOI: 10.3390/medicina58121814] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Background and Objectives: The aim of the present study was to investigate the prognostic value of the qualitative components of verbal fluency (clustering, switching, intrusions, and perseverations) on the development of mild cognitive impairment (MCI) and dementia. Materials and Methods: Participants were drawn from the multidisciplinary, population-based, prospective HELIAD (Hellenic Longitudinal Investigation of Aging and Diet) cohort. Two participant sets were separately analysed: those with normal cognition and MCI at baseline. Verbal fluency was assessed via one category and one letter fluency task. Separate Cox proportional hazards regressions adjusted for important sociodemographic parameters were performed for each qualitative semantic and phonemic verbal fluency component. Results: There were 955 cognitively normal (CN), older (72.9 years ±4.9), predominantly female (~60%) individuals with available follow-up assessments after a mean of 3.09 years (±0.83). Among them, 34 developed dementia at follow-up (29 of whom progressed to Alzheimer's dementia (AD)), 160 developed MCI, and 761 remained CN. Each additional perseveration on the semantic condition increased the risk of developing all-cause dementia and AD by 52% and 55%, respectively. Of note, participants with two or more perseverations on the semantic task presented a much more prominent risk for incident dementia compared to those with one or no perseverations. Among the remaining qualitative indices, none were associated with the hazard of developing all-cause dementia, AD, and MCI at follow-up. Conclusions: Perseverations on the semantic fluency condition were related to an increased risk of incident all-cause dementia or AD in older, CN individuals.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
| | - Vasiliki Folia
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
- Correspondence:
| | - Elli Zoupa
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou, 17671 Athens, Greece
| | - Paraskevi Sakka
- Athens Alzheimer’s Association, 89 M. Mousourou & 33 Stilponos St, 11636 Athens, Greece
| | - Georgios Hadjigeorgiou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
- School of Medicine, University of Cyprus, 93 Agiou Nikolaou St, Engomi, Nicosia 2408, Cyprus
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, 72-74 Vassilissis Sofias Ave, 11528 Athens, Greece
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, 710 West 168th St, New York, NY 10032, USA
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
| | - Mary H. Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
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