Clinical and psychological characteristics of the initial cohort of the Dominantly Inherited Alzheimer Network (DIAN).

Objective: The purpose was to describe clinical, cognitive, and personality characteristics at baseline assessment of 249 participants, 19 to 60 years of age, in a multinational longitudinal study of autosomal dominant Alzheimer's disease (ADAD).

Method: Participants (74% cognitively normal) were from ADAD families with mutations in 1 of 3 genes (APP, PSEN1, or PSEN2). Mixed model analyses, including family as a random variable and controlling for years from expected time of symptomatic onset of ADAD based on parental age at onset, compared 3 groups (cognitively normal mutation noncarriers, cognitively normal mutation carriers, very mildly impaired mutation carriers).

Progression of Alzheimer's disease as measured by Clinical Dementia Rating Sum of Boxes scores.

Background: This study examined rates of dementia progression as ascertained by the Clinical Dementia Rating Sum of Boxes (CDR-SB) for symptomatic Alzheimer's disease (sAD), and assessed participant characteristics as predictors of CDR-SB progression.

Methods: Participants (n = 792) were enrolled in longitudinal studies at an Alzheimer's Disease Research Center, received a diagnosis of sAD with a global CDR of 0.5 (n = 466) or 1 (n = 326), and had at least one follow-up assessment.

Toward a multifactorial model of Alzheimer disease.

Relations among antecedent biomarkers of Alzheimer disease (AD) were evaluated using causal modeling; although correlation cannot be equated to causation, causation does require correlation. Individuals aged 43 to 89 years (N = 220) enrolled as cognitively normal controls in longitudinal studies had clinical and psychometric assessment, structural magnetic resonance imaging (MRI), cerebrospinal fluid (CSF) biomarkers, and brain amyloid imaging via positron emission tomography with Pittsburgh Compound B (PIB) obtained within 1 year. CSF levels of Aβ(42) and tau were minimally correlated, indicating they represent independent processes.

Role of family history for Alzheimer biomarker abnormalities in the adult children study.

Objective: To assess whether family history (FH) of Alzheimer disease (AD) alone influences AD biomarker abnormalities.

Design: Adult Children Study.

Setting: Washington University's Charles F.

Ascertainment bias in the clinical diagnosis of Alzheimer disease.

Background: The clinical diagnosis of Alzheimer disease (AD) is often based, at least in part, on poor cognitive test performance compared with normative values.

Objective: To examine the presence and extent of an ascertainment bias (omission of affected individuals) produced by such criteria when applied as early as possible in the course of the disease.

Design: Longitudinal study (1979-2008).

Absence of Pittsburgh compound B detection of cerebral amyloid beta in a patient with clinical, cognitive, and cerebrospinal fluid markers of Alzheimer disease: a case report.

Background: To date, there have been no reports of individuals who have been characterized longitudinally using clinical and cognitive measures and who transitioned from cognitive normality to early symptomatic Alzheimer disease (AD) during a period when both cerebrospinal fluid (CSF) markers and Pittsburgh Compound B (PiB) amyloid imaging were obtained.

Objective: To determine the temporal relationships of clinical, cognitive, CSF, and PiB amyloid imaging markers of AD.

Design: Case report.

Cognitive decline and brain volume loss as signatures of cerebral amyloid-beta peptide deposition identified with Pittsburgh compound B: cognitive decline associated with Abeta deposition.

Objective: To examine the relation of amyloid-beta peptide (Abeta) levels in the cerebral cortex with structural brain integrity and cognitive performance in cognitively healthy older people.

Design: Longitudinal study from May 22, 1985, through October 15, 2008.

Setting: Washington University Alzheimer Disease Research Center.

Pittsburgh compound B imaging and prediction of progression from cognitive normality to symptomatic Alzheimer disease.

Objective: To determine whether preclinical Alzheimer disease (AD), as detected by the amyloid-imaging agent Pittsburgh Compound B (PiB) in cognitively normal older adults, is associated with risk of symptomatic AD.

Design: A longitudinal cohort study of cognitively normal older adults assessed with positron emission tomography (PET) to determine the mean cortical binding potential for PiB and followed up with annual clinical and cognitive assessments for progression to very mild dementia of the Alzheimer type (DAT).

Setting: The Alzheimer's Disease Research Center, Washington University, St Louis, Missouri.

Longitudinal study of the transition from healthy aging to Alzheimer disease.

Background: Detection of the earliest cognitive changes signifying Alzheimer disease is difficult.

Objective: To model the cognitive decline in preclinical Alzheimer disease.

Design: Longitudinal archival study comparing individuals who became demented during follow-up and people who remained nondemented on each of 4 cognitive factors: global, verbal memory, visuospatial, and working memory.

Long-term cognitive decline in older subjects was not attributable to noncardiac surgery or major illness.

Background: Persistent postoperative cognitive decline is thought to be a public health problem, but its severity may have been overestimated because of limitations in statistical methodology. This study assessed whether long-term cognitive decline occurred after surgery or illness by using an innovative approach and including participants with early Alzheimer disease to overcome some limitations.

Methods: In this retrospective cohort study, three groups were identified from participants tested annually at the Washington University Alzheimer's Disease Research Center in St.

Older adults' responses to emotional stimuli: a cautionary note.

Thirty younger (mean age = 21 years) and 30 older (mean age = 73 years) adults were compared to determine if they had similar affective experiences to eight emotion films previously validated with young adults (Gross & Levenson, 1995). Participants rated their emotions, and heart rate was collected during two films of each emotion: amusement, anger, sadness, and fear. Older and younger adults were generally similar in their physiological and subjective responses to films, but with a few exceptions.

The power of personality in discriminating between healthy aging and early-stage Alzheimer's disease.

This study examined differences in personality in the earliest stages of dementia of the Alzheimer type (DAT) relative to healthy aging, and the power of personality in discriminating healthy aging from early-stage DAT. Four groups of participants (middle-aged controls, older controls, persons with very mild DAT, and persons with mild DAT) and their families were administered Costa and McCrae's NEO Five-Factor Inventory. On the basis of both self-report and informant report, there was an increase in neuroticism and a decrease in conscientiousness in persons with very mild DAT relative to healthy individuals without it, and in persons with mild DAT relative to those with very mild DAT.

Model stability of the 15-item Geriatric Depression Scale across cognitive impairment and severe depression.

The 15-item Geriatric Depression Scale (GDS) is used in a wide variety of clinical and research settings. The study's purpose was to further establish the validity of the 15-item GDS by exploring the underlying factor structure in a healthy, nondemented sample of older adults and then analyzing whether this factor structure remained stable across a sample of demented individuals and a sample of individuals with a history of depression 6 months after discharge from an inpatient psychiatric setting. A 2-factor model fit the data best in the exploratory analyses.

Clinical and psychometric distinction of frontotemporal and Alzheimer dementias.

Background: A proportion of patients who meet the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Associations criteria for Alzheimer disease (AD) have frontotemporal lobar degeneration (FTLD) confirmed at autopsy, with or without concomitant AD. Thus, the clinical phenotypes of the 2 disorders may overlap.

Objective: To identify clinical and psychometric indicators that distinguish AD from FTLD at initial presentation.

Visual search for change in older adults.

Previous research has demonstrated that younger adults are surprisingly poor at detecting substantial changes to visual scenes. Little is known, however, about age differences in this phenomenon. In the 2 experiments reported here, older adults were slower than younger adults in detecting changes to simple visual stimuli.

Effects of environmental support and strategy training on older adults' use of context.

Age-related cognitive differences may be due, in part, to difficulties using task-relevant context in a proactive manner. Two studies evaluated different methods for increasing older adults' use of context in the AX-Continuous Performance Task (H. E.

Longitudinal course and neuropathologic outcomes in original vs revised MCI and in pre-MCI.

Objectives: To compare the natural history of individuals classified with mild cognitive impairment (MCI) in accordance with original criteria to the natural history of individuals classified with revised MCI criteria.

Methods: The authors compared the rates of progression in 32 individuals with amnestic MCI and in 90 people with MCI according to revised criteria that allow nonamnestic deficits with progression in 276 individuals who were too minimally impaired (pre-MCI) to meet either MCI criteria. All individuals in this study were determined clinically to be very mildly cognitively impaired with a Clinical Dementia Rating (CDR) of 0.

Driving cessation in older adults with dementia of the Alzheimer's type.

The psychometric profile of 143 drivers with dementia who stopped driving did not differ from that of 58 individuals with dementia of similar severity who still drove. The reasons given for driving cessation by drivers with dementia as reported by a collateral source are reported.

A comparison of narratives told by younger and older adults.

The few studies that have examined verbal discourse in both young and older adults have yielded inconsistent results with respect to talkativeness and story quality. The disparity may arise from methodological differences. In this study the authors examined word count, irrelevant utterances, and ratings of quality of stories told by 24 young (mean age = 19.

Predictors of preclinical Alzheimer disease and dementia: a clinicopathologic study.

Background: To understand the earliest signs of cognitive decline caused by Alzheimer disease (AD) and other illnesses causing dementia, information is needed from well-characterized individuals without dementia studied longitudinally until autopsy.

Objective: To determine clinical and cognitive features associated with the development of AD or other dementias in older adults.

Design: Longitudinal study of memory and aging.

Self-discipline and self-consciousness predict subjective memory in older adults.

Research has shown the personality variables of conscientiousness and neuroticism to be related to subjective memory in older adults. This study was designed to determine the specific facets of these traits involved in the relation between personality and memory complaints. Subjective memory evaluations were examined in 85 community-dwelling people aged 56 to 94 years.

Personality change precedes clinical diagnosis of dementia of the Alzheimer type.

We examined personality changes reported by a collateral source on the Blessed Dementia Scale in people who were nondemented when they entered a longitudinal study. Of the 108 participants examined here, 68 received a clinical diagnosis of dementia at some point after entry into the study. The other 40 participants died and came to autopsy with a clinical diagnosis of no dementia; however, 14 received a neuropathological diagnosis of Alzheimer's disease.

Dementia does not explain correlation between age and scores on Boston Naming Test.

The major purpose of this study was to determine if the correlation between age and performance on the Boston Naming Test that has been reported by some investigators results from inclusion of people in the early stages of dementia in those samples. The correlation between age and naming score was -.36 in 125 carefully evaluated nondemented individuals aged 60-88 years who were enrolled in the control group at an Alzheimer's Disease Research Center between 1985 and 1998.

Absence of effect of depression on cognitive performance in early-stage Alzheimer disease.

Background: Depression can interfere with the normal expression of cognitive abilities in adults of all ages, but it is unclear if depression in demented people, which is common, is associated with reduced cognitive performance beyond the effect of the dementia itself.

Objective: To determine if depression adds to the cognitive deficit in dementia.

Design: Performance on psychometric tests of memory and other cognitive function was correlated with the number of depressive features reported by the individual and by a knowledgeable collateral source, as well as the judgment of a research clinician as to whether the person was depressed.

Predictors of subjective memory in older adults.

Memory complaints by healthy older people usually show little relation to objective memory performance. If subjective memory evaluations are not driven by actual memory problems, what is the cause of these complaints? Correlations of an objective measure of memory as well as measures of personality, emotional distress, and health with subjective memory evaluations were examined in 283 community-dwelling people aged 45 to 94 years. Stepwise regression analysis revealed that a combination of personality measures (Conscientiousness, self-esteem, Neuroticism) explained about a third of the variance in memory complaints compared with only 4% unique variance associated with the objective memory measure.