Exploring symptom clusters in mild cognitive impairment and dementia with the NIH Toolbox

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Author(s)Tyner, Callie E.
Author(s)Boulton, Aaron J.
Author(s)Slotkin, Jerry
Author(s)Cohen, Matthew L.
Author(s)Weintraub, Sandra
Author(s)Gershon, Richard C.
Author(s)Tulsky, David S.
Date Accessioned2024-02-19T17:58:08Z
Date Available2024-02-19T17:58:08Z
Publication Date2024-02-16
DescriptionThis article was originally published in Journal of the International Neuropsychological Society. The version of record is available at: https://doi.org/10.1017/S1355617724000055. © The Author(s), 2024. Published by Cambridge University Press on behalf of International Neuropsychological Society
AbstractObjective: Symptom clustering research provides a unique opportunity for understanding complex medical conditions. The objective of this study was to apply a variable-centered analytic approach to understand how symptoms may cluster together, within and across domains of functioning in mild cognitive impairment (MCI) and dementia, to better understand these conditions and potential etiological, prevention, and intervention considerations. Method: Cognitive, motor, sensory, emotional, and social measures from the NIH Toolbox were analyzed using exploratory factor analysis (EFA) from a dataset of 165 individuals with a research diagnosis of either amnestic MCI or dementia of the Alzheimer’s type. Results: The six-factor EFA solution described here primarily replicated the intended structure of the NIH Toolbox with a few deviations, notably sensory and motor scores loading onto factors with measures of cognition, emotional, and social health. These findings suggest the presence of cross-domain symptom clusters in these populations. In particular, negative affect, stress, loneliness, and pain formed one unique symptom cluster that bridged the NIH Toolbox domains of physical, social, and emotional health. Olfaction and dexterity formed a second unique cluster with measures of executive functioning, working memory, episodic memory, and processing speed. A third novel cluster was detected for mobility, strength, and vision, which was considered to reflect a physical functioning factor. Somewhat unexpectedly, the hearing test included did not load strongly onto any factor. Conclusion: This research presents a preliminary effort to detect symptom clusters in amnestic MCI and dementia using an existing dataset of outcome measures from the NIH Toolbox.
SponsorThis work was supported by the National Institute of Nursing Research (D.T., C.T., A.B., J.S., & M.C., grant number R01NR018684), and National Institute on Aging (R.G., S.W, & J.S., grant number U2C AG057441).
CitationTyner CE, Boulton AJ, Slotkin J, et al. Exploring symptom clusters in mild cognitive impairment and dementia with the NIH Toolbox. Journal of the International Neuropsychological Society. Published online 2024:1-12. doi:10.1017/S1355617724000055
ISSN1469-7661
URLhttps://udspace.udel.edu/handle/19716/34000
Languageen_US
PublisherJournal of the International Neuropsychological Society
dc.rightsAttribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/
Keywordsadults
Keywordsaged
Keywordscognition
Keywordsemotion
Keywordssensory function
Keywordspain assessment
Keywordssocial support
Keywordspsychomotor performances
Keywordsstatistical factor analyses
TitleExploring symptom clusters in mild cognitive impairment and dementia with the NIH Toolbox
TypeArticle
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