title: Neuropsychological changes in asymptomatic persons with Alzheimer disease neuropathology.
abstract: OBJECTIVE
  To determine whether asymptomatic persons with Alzheimer disease (AD) neuropathologic change differ in the trajectory of their cognitive performance compared to asymptomatic persons without AD neuropathologic change.
  
  
  METHODS
  Longitudinal performance on standard neuropsychological tests was examined in participants who died within 2 years of their last cognitive assessment and who were never diagnosed with mild cognitive impairment or dementia (Clinical Dementia Rating global score of 0 at all assessments). Using cognitive and neuropathologic data collected between 2005 and 2013 from the 34 National Institute on Aging-sponsored Alzheimer's Disease Centers, cognitive trajectories were compared for persons with and without evidence of AD neuropathologic change. We evaluated rates of decline in 4 domains (episodic memory, language, attention/working memory, executive function). The significance of the differences (β) in rates of decline was tested using linear regression, adjusting for age, education, sex, and other neuropathologic lesions.
  
  
  RESULTS
  Participants who had low to high levels of AD neuropathologic change (n = 131) showed a greater rate of decline on the attention/working memory domain score (β = -0.11; 95% confidence interval = -0.19, -0.02; p = 0.02) when compared to 80 participants who died without evidence of AD neuropathologic change.
  
  
  CONCLUSIONS
  Clinically normal individuals who come to autopsy with AD neuropathologic change exhibit subtle evidence of declining cognitive trajectories for attention/working memory.
authors.affiliation: From the National Alzheimer's Coordinating Center (S.E.M., C.M., W.K.), University of Washington, Seattle; and Knight Alzheimer's Disease Research Center (J.H., C.M.R., N.J.C., J.C.M.), Department of Neurology, Washington University School of Medicine, St. Louis, MO. smonsell@u.washington.edu.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Monsell
authors.affiliation: From the National Alzheimer's Coordinating Center (S.E.M., C.M., W.K.), University of Washington, Seattle; and Knight Alzheimer's Disease Research Center (J.H., C.M.R., N.J.C., J.C.M.), Department of Neurology, Washington University School of Medicine, St. Louis, MO.
authors.forename: Charles
authors.initials: C
authors.lastname: Mock
authors.affiliation: From the National Alzheimer's Coordinating Center (S.E.M., C.M., W.K.), University of Washington, Seattle; and Knight Alzheimer's Disease Research Center (J.H., C.M.R., N.J.C., J.C.M.), Department of Neurology, Washington University School of Medicine, St. Louis, MO.
authors.forename: Jason
authors.initials: J
authors.lastname: Hassenstab
authors.affiliation: From the National Alzheimer's Coordinating Center (S.E.M., C.M., W.K.), University of Washington, Seattle; and Knight Alzheimer's Disease Research Center (J.H., C.M.R., N.J.C., J.C.M.), Department of Neurology, Washington University School of Medicine, St. Louis, MO.
authors.forename: Catherine M
authors.initials: CM
authors.lastname: Roe
authors.affiliation: From the National Alzheimer's Coordinating Center (S.E.M., C.M., W.K.), University of Washington, Seattle; and Knight Alzheimer's Disease Research Center (J.H., C.M.R., N.J.C., J.C.M.), Department of Neurology, Washington University School of Medicine, St. Louis, MO.
authors.forename: Nigel J
authors.initials: NJ
authors.lastname: Cairns
authors.affiliation: From the National Alzheimer's Coordinating Center (S.E.M., C.M., W.K.), University of Washington, Seattle; and Knight Alzheimer's Disease Research Center (J.H., C.M.R., N.J.C., J.C.M.), Department of Neurology, Washington University School of Medicine, St. Louis, MO.
authors.forename: John C
authors.initials: JC
authors.lastname: Morris
authors.affiliation: From the National Alzheimer's Coordinating Center (S.E.M., C.M., W.K.), University of Washington, Seattle; and Knight Alzheimer's Disease Research Center (J.H., C.M.R., N.J.C., J.C.M.), Department of Neurology, Washington University School of Medicine, St. Louis, MO.
authors.forename: Walter
authors.initials: W
authors.lastname: Kukull
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000473:pathology* / Q000523:psychology*; D058070:Asymptomatic Diseases / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests