Investigating the Factor Structure of the Preclinical Alzheimer Cognitive Composite and Cognitive Function Index across Racial/Ethnic, Sex, and Aβ Status Groups in the A4 Study - 21/11/24

Doi : 10.14283/jpad.2023.98 
M. Ruthirakuhan 1, M. Wood Alexander 1, 2, H. Cogo-Moreira 3, T. Robinson 4, R. Amariglio 4, 5, R.F. Buckley 4, 5, 6, R.A. Sperling 4, 5, 7, W. Swardfager 1, S.E. Black 1, 2, 8, J.S. Rabin 1, 2, 8, 9, 10,
1 LC Campbell Cognitive Neurology Research Unit, Hurvitz Brain Sciences Research Program, Sunnybrook Research Institute, University of Toronto, Toronto, ON, Canada 
2 Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada 
3 Department of Education, ICT and Learning, Ostfold University College, Halden, Norway 
4 Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA 
5 Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA 
6 Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia 
7 Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA 
8 Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Canada 
9 Harquail Centre for Neuromodulation, Sunnybrook Research Institute, Toronto, Ontario, Canada 
10 Sunnybrook Health Sciences Centre, Room M6-178, 2075 Bayview Avenue, M4N 3M5, Toronto, ON, Canada 

k jennifer.rabin@sri.utoronto.ca jennifer.rabin@sri.utoronto.ca

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Abstract

Background

Disparities in Alzheimer’s disease (AD) are well-documented among different racial/ethnic groups and between sex/genders. Neuropsychological assessment provides important information about cognitive changes and can offer valuable insights into disparities. However, neuropsychological measures must be comparable across racial/ethnic and sex/gender groups to accurately interpret disparities.

Objectives

To evaluate measurement invariance (equivalence) of the Preclinical Alzheimer Cognitive Composite (PACC) and the Cognitive Function Index across racial/ethnic, sex/gender, and β-amyloid (Aβ) status groups.

Design, Setting, Participants

Cross-sectional analysis of screening data from the Anti-Amyloid in Asymptomatic AD (A4) Study. The study enrolled participants aged 65–85 from sites across the United States, Canada, Australia, and Japan.

Measurements

Participants completed the PACC and the Cognitive Function Index. Participants classified as cognitively normal also underwent a Positron Emission Tomography (PET) scan to determine Aβ status.

Results

Participants self-identified as non-Hispanic White (n=5241), non-Hispanic Black (n=267), Asian (n=228), or Hispanic White (n=225) as well as male (n=2885) or female (n=3076). Among those who underwent a PET scan, 3115 were classified as Aβ− and 1309 were classified as Aβ+. We found support for a one-factor model for both the PACC and Cognitive Function Index across the full sample and in samples stratified by race/ethnicity, sex/gender, and Aβ status. The one-factor model of the PACC and Cognitive Function Index demonstrated scalar measurement invariance across racial/ethnic, sex/gender, and Aβ status groups.

Conclusions

Our findings suggest that performance on the PACC and Cognitive Function Index can be compared across the racial/ethnic, sex/gender, and Aβ status groups examined in this study.

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Key words : Measurement invariance, confirmatory factor analysis, preclinical Alzheimer cognitive composite, cognitive function index, race/ethnicity, sex/gender, β-amyloid, neuropsychology


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Vol 11 - N° 1

P. 48-55 - janvier 2024 Retour au numéro
Article précédent Article précédent
  • Consistency between Treatment Effects on Clinical and Brain Atrophy Outcomes in Alzheimer’s Disease Trials
  • M. ten Kate, F. Barkhof, Adam J. Schwarz
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  • Neuropsychiatric Symptoms in AD: Clinical Trials Targeting Mild Behavioral Impairment: A Report from the International CTAD Task Force
  • Maria Soto, P. Rosenberg, C. Ballard, B. Vellas, D. Miller, S. Gauthier, M.C. Carrillo, C. Lyketsos, Z. Ismail, Susan Abushakra, Mohammad Afshar, Sam Agus, Paul Aiden, John Alam, Alicia Algeciras-Schimnich, Sandrine Andrieu, Amos Baruch, Randall Bateman, Richard Batrla, Monika Baudler, Joanne Bell, Tobias Bittner, Sasha Bozeat, Joel Braunstein, Dawn Brooks, Tricia Brooks, Szofia Bullain, Jan Burmeister, Maria Carrillo, Min Cho, Emily Collins, Gavin Cook, Chris Dague, Susan De Santi, Rachelle Doody, Billy Dunn, Michael Egan, Sven Eriksson, Rianne Esquivel, Tom Fagan, Phyllis Ferrell, Howard Fillit, Michela Gallagher, Anna-Kaija Grönblad, Avis Hains, Harald Hampel, Oskar Hansson, Nanco Hefting, Suzanne Hendrix, Carole Ho, Helen Hu, Daryl Jones, Gene Kinney, Paul Kinnon, Ricky Kurzman, Lars Lannfelt, John Lawson, Nathalie LeBastard, Valérie Legrand, Nicole Lewandowski, Carine Lim, Donna Masterman, Colin Masters, Ming Lu, Mark Mintun, José Luis Molinuevo, Cecilia Monteiro, Bradford Navia, Tomas Odergren, Gunilla Osswald, Lewis Penny, Michael Pontecorvo, Anton Porsteinsson, Christine Rabe, Rema Raman, Gesine Respondek, Larisa Reyderman, Sharon Rogers, Paul Rosenberg, Sharon Rosenzweig-Lipson, Mark Roskey, Rubel Carrie, Ziad Saad, Stephen Salloway, Rachel Schindler, Dennis Selkoe, Melanie Shulman, John Sims, Kaycee Sink, Lisa Sipe, Daniel Skovronsky, Elizabeth Somers, Johannes Streffer, Pedro Such, Joyce Suhy, Masoud Toloue, Jacques Touchon, Manu Vandijck, Michael Weiner, Anne White, David Wilson, Wagner Zago, Jin Zhou, International CTAD Task Force members, EU/US CTAD Task force

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