Disease progression modeling of Alzheimer’s disease according to education level
Abstract To develop a disease progression model of Alzheimer’s disease (AD) that shows cognitive decline from subjective cognitive impairments (SCI) to the end stage of AD dementia (ADD) and to investigate the effect of education level on the whole disease spectrum, we enrolled 565 patients who were...
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doaj-23908a28c5ed4cfebfb3d7ecb177188a2021-10-10T11:20:41ZengNature Publishing GroupScientific Reports2045-23222020-10-011011910.1038/s41598-020-73911-6Disease progression modeling of Alzheimer’s disease according to education levelKo Woon Kim0Sook Young Woo1Seonwoo Kim2Hyemin Jang3Yeshin Kim4Soo Hyun Cho5Si Eun Kim6Seung Joo Kim7Byoung-Soo Shin8Hee Jin Kim9Duk L. Na10Sang Won Seo11Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of MedicineStatistics and Data Center, Samsung Medical CenterStatistics and Data Center, Samsung Medical CenterDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Neurology, School of Medicine, Jeonbuk National University HospitalDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of MedicineDepartment of Neurology, Samsung Medical Center, Sungkyunkwan University School of MedicineAbstract To develop a disease progression model of Alzheimer’s disease (AD) that shows cognitive decline from subjective cognitive impairments (SCI) to the end stage of AD dementia (ADD) and to investigate the effect of education level on the whole disease spectrum, we enrolled 565 patients who were followed up more than three times and had a clinical dementia rating sum of boxes (CDR-SB). Three cohorts, SCI (n = 85), amnestic mild cognitive impairment (AMCI, n = 240), and ADD (n = 240), were overlapped in two consecutive cohorts (SCI and AMCI, AMCI and ADD) to construct a model of disease course, and a model with multiple single-cohorts was estimated using a mixed-effect model. To examine the effect of education level on disease progression, the disease progression model was developed with data from lower (≤ 12) and higher (> 12) education groups. Disease progression takes 274.3 months (22.9 years) to advance from 0 to 18 points using the CDR-SB. Based on our predictive equation, it takes 116.5 months to progress from SCI to AMCI and 56.2 months to progress from AMCI to ADD. The rate of CDR-SB progression was different according to education level. The lower-education group showed faster CDR-SB progression from SCI to AMCI compared to the higher-education group, and this trend disappeared from AMCI to ADD. In the present study, we developed a disease progression model of AD spectrum from SCI to the end stage of ADD. Our disease modeling provides us with more understanding of the effect of education on cognitive trajectories.https://doi.org/10.1038/s41598-020-73911-6 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ko Woon Kim Sook Young Woo Seonwoo Kim Hyemin Jang Yeshin Kim Soo Hyun Cho Si Eun Kim Seung Joo Kim Byoung-Soo Shin Hee Jin Kim Duk L. Na Sang Won Seo |
spellingShingle |
Ko Woon Kim Sook Young Woo Seonwoo Kim Hyemin Jang Yeshin Kim Soo Hyun Cho Si Eun Kim Seung Joo Kim Byoung-Soo Shin Hee Jin Kim Duk L. Na Sang Won Seo Disease progression modeling of Alzheimer’s disease according to education level Scientific Reports |
author_facet |
Ko Woon Kim Sook Young Woo Seonwoo Kim Hyemin Jang Yeshin Kim Soo Hyun Cho Si Eun Kim Seung Joo Kim Byoung-Soo Shin Hee Jin Kim Duk L. Na Sang Won Seo |
author_sort |
Ko Woon Kim |
title |
Disease progression modeling of Alzheimer’s disease according to education level |
title_short |
Disease progression modeling of Alzheimer’s disease according to education level |
title_full |
Disease progression modeling of Alzheimer’s disease according to education level |
title_fullStr |
Disease progression modeling of Alzheimer’s disease according to education level |
title_full_unstemmed |
Disease progression modeling of Alzheimer’s disease according to education level |
title_sort |
disease progression modeling of alzheimer’s disease according to education level |
publisher |
Nature Publishing Group |
series |
Scientific Reports |
issn |
2045-2322 |
publishDate |
2020-10-01 |
description |
Abstract To develop a disease progression model of Alzheimer’s disease (AD) that shows cognitive decline from subjective cognitive impairments (SCI) to the end stage of AD dementia (ADD) and to investigate the effect of education level on the whole disease spectrum, we enrolled 565 patients who were followed up more than three times and had a clinical dementia rating sum of boxes (CDR-SB). Three cohorts, SCI (n = 85), amnestic mild cognitive impairment (AMCI, n = 240), and ADD (n = 240), were overlapped in two consecutive cohorts (SCI and AMCI, AMCI and ADD) to construct a model of disease course, and a model with multiple single-cohorts was estimated using a mixed-effect model. To examine the effect of education level on disease progression, the disease progression model was developed with data from lower (≤ 12) and higher (> 12) education groups. Disease progression takes 274.3 months (22.9 years) to advance from 0 to 18 points using the CDR-SB. Based on our predictive equation, it takes 116.5 months to progress from SCI to AMCI and 56.2 months to progress from AMCI to ADD. The rate of CDR-SB progression was different according to education level. The lower-education group showed faster CDR-SB progression from SCI to AMCI compared to the higher-education group, and this trend disappeared from AMCI to ADD. In the present study, we developed a disease progression model of AD spectrum from SCI to the end stage of ADD. Our disease modeling provides us with more understanding of the effect of education on cognitive trajectories. |
url |
https://doi.org/10.1038/s41598-020-73911-6 |
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