AD pathology and cerebral infarctions are associated with memory and executive functioning one and five years before death

Abstract

We provide rigorous psychometric evidence for distinct patterns of cognitive impairment for Alzheimer's disease (AD) and cerebral infarctions using 440 participants from the Religious Order Study. Latent variable models were used to decompose the effects of AD pathology and cerebral infarctions assessed at autopsy on overall cognition and specific neuropsychological tests at one and five years prior to death. Results support clinical and univariate psychometric analyses that memory impairment is more pronounced in AD, and executive impairment is more pronounced in the presence of cerebral infarctions. These specific effects are subtle relative to the stronger associations of both AD neuropathology and cerebral infarctions with overall levels of cognitive impairment.

Keywords:

• Neuropathology
• Alzheimer's disease
• Cerebrovascular disease
• Neuropsychological measures
• Latent variable models

Acknowledgments

This work was supported in part by Grants R13 AG030995–01A1, R01 AG025308, R01 AG029672, P30AG10161, and R01 AG15819 from the National Institute on Aging, National Institutes of Health, as well as the NARSAD Young Investigator Award. The authors report no disclosures.