2024/11/28 by Clayton Mansel, Diego R. Mazzotti, Ryan Townley +4 · 1 voice
Medicine · #Alzheimer's disease research and treatments #Cancer-related cognitive impairment studies #Dementia and Cognitive Impairment Research
paper · pdf · doi:10.1101/2024.11.26.24317918
openalex publication_date 2024/11/28 · openalex created_date 2025/10/10 · openalex updated_date 2026/08/01
INTRODUCTION: Phenotype clustering reduces patient heterogeneity and could be useful when designing precision clinical trials. We hypothesized that the onset of early cognitive decline in patients would exhibit variance predicated on the clinical history documented prior to an Alzheimer's Disease (AD) diagnosis. METHODS: Self-reported medical and substance use history (i.e., problem history) was used to cluster participants from the National Alzheimer's Coordinating Centers (NACC) into distinct subtypes. Linear mixed effects modeling was used to determine the effect of problem history subtype on cognitive decline over two years. RESULTS: 2754 individuals were partitioned into three subtypes: minimal (n = 1380), substance use (n = 1038), and cardiovascular (n = 336) subtypes. The cardiovascular problem history subtype had significantly worse cognitive decline over a two-year follow-up period (p = 0.013). DISCUSSION: Our study highlights the need to account for problem history to reduce heterogeneity of outcomes in AD clinical trials.