{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:31:24Z","timestamp":1777393884883,"version":"3.51.4"},"reference-count":42,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2016,1,12]],"date-time":"2016-01-12T00:00:00Z","timestamp":1452556800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAD"],"published-print":{"date-parts":[[2016,1,12]]},"abstract":"<jats:p>Background: Alzheimer\u2019s disease (AD) is associated with variable cognitive and functional decline, and it is difficult to predict who will develop the disease and how they will progress. Objective: This exploratory study aimed to define latent classes from participants in the Alzheimer\u2019s Disease Neuroimaging Initiative (ADNI) database who had similar growth patterns of both cognitive and functional change using Growth Mixture Modeling (GMM), identify characteristics associated with those trajectories, and develop a decision tree using clinical predictors to determine which trajectory, as determined by GMM, individuals will most likely follow. Methods: We used ADNI early mild cognitive impairment (EMCI), late MCI (LMCI), AD dementia, and healthy control (HC) participants with known amyloid-\u03b2 status and follow-up assessments on the Alzheimer\u2019s Disease Assessment Scale - Cognitive Subscale or the Functional Activities Questionnaire (FAQ) up to 24 months postbaseline. GMM defined trajectories. Classification and Regression Tree (CART) used certain baseline variables to predict likely trajectory path. Results: GMM identified three trajectory classes (C): C1 (n\u200a=\u200a162, 13.6%) highest baseline impairment and steepest pattern of cognitive\/functional decline; C3 (n\u200a=\u200a819, 68.7%) lowest baseline impairment and minimal change on both; C2 (n\u200a=\u200a211, 17.7%) intermediate pattern, worsening on both, but less steep than C1. C3 had fewer amyloid- or apolipoprotein-E \u025b4 (APOE4) positive and more healthy controls (HC) or EMCI cases. CART analysis identified two decision nodes using the FAQ to predict likely class with 82.3% estimated accuracy. Conclusions: Cognitive\/functional change followed three trajectories with greater baseline impairment and amyloid and APOE4 positivity associated with greater progression. FAQ may predict trajectory class.<\/jats:p>","DOI":"10.3233\/jad-150563","type":"journal-article","created":{"date-parts":[[2016,1,8]],"date-time":"2016-01-08T10:10:18Z","timestamp":1452247818000},"page":"271-282","source":"Crossref","is-referenced-by-count":15,"title":["Empirically Defining Trajectories of Late-Life Cognitive and Functional Decline"],"prefix":"10.1177","volume":"50","author":[{"given":"Helen","family":"Hochstetler","sequence":"first","affiliation":[{"name":"Eli Lilly and Company or a Wholly Owned subsidiary, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the Alzheimer\u2019s Disease Neuroimaging Initiative","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paula T.","family":"Trzepacz","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shufang","family":"Wang","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company or a Wholly Owned subsidiary, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peng","family":"Yu","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company or a Wholly Owned subsidiary, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael","family":"Case","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company or a Wholly Owned subsidiary, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David B.","family":"Henley","sequence":"additional","affiliation":[{"name":"Eli Lilly and Company or a Wholly Owned subsidiary, Indianapolis, IN, USA"},{"name":"Indiana University School of Medicine, Indianapolis, IN, USA"},{"name":"Indiana University Physician Group, Indiana University Health, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Degenhardt","sequence":"additional","affiliation":[{"name":"Indiana University Physician Group, Indiana University Health, Indianapolis, IN, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeannie-Marie","family":"Leoutsakos","sequence":"additional","affiliation":[{"name":"Johns Hopkins University and Johns Hopkins Bayview, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Constantine G.","family":"Lyketsos","sequence":"additional","affiliation":[{"name":"Johns Hopkins University and Johns Hopkins Bayview, Baltimore, MD, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","reference":[{"key":"10.3233\/JAD-150563_ref1","doi-asserted-by":"crossref","first-page":"181","DOI":"10.1002\/ana.22248","article-title":"Longitudinal assessment of A\u03b2 and cognition in aging and Alzheimer disease","volume":"69","author":"Villemagne","year":"2011","journal-title":"Ann Neurol"},{"key":"10.3233\/JAD-150563_ref2","doi-asserted-by":"crossref","first-page":"268","DOI":"10.1097\/WAD.0b013e318194a324","article-title":"Rate of decline in Alzheimer disease measured by a Dementia Severity Rating Scale","volume":"23","author":"Xie","year":"2009","journal-title":"Alzheimer Dis Assoc Disord"},{"key":"10.3233\/JAD-150563_ref3","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/j.jalz.2010.03.018","article-title":"Disease progression model for cognitive deterioration from Alzheimer\u2019s Disease Neuroimaging Initiative database","volume":"7","author":"Ito","year":"2011","journal-title":"Alzheimers Dement"},{"key":"10.3233\/JAD-150563_ref4","doi-asserted-by":"crossref","first-page":"650","DOI":"10.3109\/09540261.2013.859128","article-title":"Rapid cognitive decline in Alzheimer\u2019s disease: A literature review","volume":"25","author":"Sona","year":"2013","journal-title":"Int Rev Psychiatry"},{"key":"10.3233\/JAD-150563_ref5","doi-asserted-by":"crossref","unstructured":"Muthen B (2004) Latent variable analysis: Growth mixture modeling and related techniques for longitudinal data. 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