Dataset Information

A trichotomy method for defining homogeneous subgroups in a dementia population.

ABSTRACT:

Introduction

Diagnosis of dementia in the aging brain is confounded by the presence of multiple pathologies. Mixed dementia (MX), a combination of Alzheimer's disease (AD) proteins with vascular disease (VD), is frequently found at autopsy, and has been difficult to diagnose during life. This report develops a method for separating the MX group and defining preclinical AD (presence of AD factors with normal cognition) and preclinical VD subgroups (presence of white matter damage with normal cognition).

Methods

Clustering was based on three diagnostic axes: (1) AD factor (ADF) derived from cerebrospinal fluid proteins (Aβ42 and pTau), (2) VD factor (VDF) calculated from mean free water and peak width of skeletonized mean diffusivity in the white matter, and (3) Cognition (Cog) based on memory and executive function. The trichotomy method was applied to an Alzheimer's Disease Neuroimaging Initiative cohort (N = 538).

Results

Eight biologically defined subgroups were identified which included the MX group with both high ADF and VDF (9.3%) and a preclinical VD group (3.9%), and a preclinical AD group (13.6%). Cog is significantly associated with both ADF and VDF, and the partial-correlation remains significant even when the effect of the other variable is removed (r(Cog, ADF/VDF removed) = 0.46, p < 10^-28 and r(Cog, VDF/ADF removed) = 0.24, p < 10^-7 ).

Discussion

The trichotomy method creates eight biologically characterized patient groups, which includes MX, preclinical AD, and preclinical VD subgroups. Further longitudinal studies are needed to determine the utility of the 3-way clustering method with multimodal biological biomarkers.

SUBMITTER: Caprihan A

PROVIDER: S-EPMC10578887 | biostudies-literature | 2023 Oct

REPOSITORIES: biostudies-literature

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Publications

A trichotomy method for defining homogeneous subgroups in a dementia population.

Caprihan Arvind A Hillmer Laura L Erhardt Erik Barry EB Adair John C JC Knoefel Janice E JE Prestopnik Jillian J Rosenberg Gary A GA

Annals of clinical and translational neurology 20230821 10

<h4>Introduction</h4>Diagnosis of dementia in the aging brain is confounded by the presence of multiple pathologies. Mixed dementia (MX), a combination of Alzheimer's disease (AD) proteins with vascular disease (VD), is frequently found at autopsy, and has been difficult to diagnose during life. This report develops a method for separating the MX group and defining preclinical AD (presence of AD factors with normal cognition) and preclinical VD subgroups (presence of white matter damage with nor ...[more]

PMID: 37602520

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Project description:According to the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5), a sexual fantasy (SF) is paraphilic if it concerns activities outside the realm of "genital stimulation or preparatory fondling with phenotypically normal, physically mature, consenting human partners" (normophilic). Intensity of the paraphilic SF is also "greater than or equal to normophilic interests." Surprisingly, however, very few data are available to corroborate that definition of a paraphilic SF. Although the relatively high prevalence of paraphilic SF in the general population is well known, the magnitude of difference between intensity of "normophilic" and "paraphilic" SF remains to be assessed.The main goal of this study was to analyze the SF of adults recruited in the general population to obtain person profiles based on the nature and intensity of their SF.Multiple correspondence analysis (MCA) were used with data collected from 1,501 adults recruited in the general population to generate subgroups of participants based on the nature and intensity of their SF.The main outcome measures used was a revised version of the Wilson Sex Fantasy Questionnaire.When all participants are considered as a unique group, the mean intensity of the most intense "normophilic" SF (oral sex) is significantly higher than the mean intensity of the most intense "paraphilic" SF (being sexually dominated for women and watching two women having sex for men), as expected from the DSM-5. When clusters of participants are considered separately, however, conclusions are nuanced. Four significant clusters of participants (two predominantly female and two predominantly male) reported at least one paraphilic SF with intensity as high as that of their most intense "normophilic" SF. In fact, 57% of this sample met the criteria of paraphilia.These results suggest that the current criteria for paraphilia are too inclusive. Suggestions are given to improve the definition of pathological sexual interests, and the crucial difference between SF and sexual interest is underlined. Joyal CC. Defining "normophilic" and "paraphilic" sexual fantasies in a population-based sample: On the importance of considering subgroups. Sex Med 2015;3:321-330.

Dataset Information

A trichotomy method for defining homogeneous subgroups in a dementia population.

Introduction

Methods

Results

Discussion

Publications

A trichotomy method for defining homogeneous subgroups in a dementia population.

Similar Datasets

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