Mixed Membership Trajectory Model of Cognitive Impairment in the Cardiovascular Health Study - Cognition Study (S36.007)

OBJECTIVE: To describe individual trajectories to Mild Cognitive Impairment (MCI) and dementia among elderly individuals participating in the Cardiovascular Health Study - Cognition Study (CHS-CS). BACKGROUND: Alzheimer9s disease (AD) is the most common form of dementia in the elderly, and the complex relationships among risk factors, produces highly variable natural histories from normal cognition through the prodromal stage of Mild Cognitive Impairment (MCI) to clinical dementia. METHODS: We used a novel statistical approach, Mixed Membership Trajectory Models (MMTMs), to capture the variety of such pathways 652 participants in the CHS-CS over 20 years of follow-up. RESULTS: We identified three trajectories - a “healthy profile with a peak probability of MCI between 95 and 100 years of age and only a 50[percnt] probability of dementia by age 100; an “intermediate” profile with a peak probability of MCI between 85 and 90 years of age and to dementia between 90 and 95 years, and an “unhealthy” profile with a peak probability of progressing to MCI between age 75 and 80, and to dementia between the ages of 80 and 85. Hypertension, education, race and APOE*4 all affected the closeness of an individual to one or more of the canonical trajectories. CONCLUSIONS: These results provide new insights into the natural history of AD, and provide evidence for a potential difference in the pathophysiology of the development of dementia as a function of age. Study Supported by: This work was supported in part by funds from the NIH/NIA to the University of Pittsburgh Alzheimer’s Disease Research Center (AGO5133; OLL Scientific Director), and in part by funds from the NIH/NIA to support the CHS-CS (AG020098; OLL Principal Investigator). Disclosure: Dr. Lecci has nothing to disclose. Dr. Junker has nothing to disclose. Dr. Kuller has nothing to disclose. Dr. Lopez has received personal compensation for activities with Merz Pharma as a consultant. Dr. Becker has nothing to disclose.