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COGNITIVE MIGRATION: EXAMINATIONS OF MULTISTATE TRANSITIONS IN OLDER ADULTS WITH NEUROIMAGING AND CLINICAL BIOMARKERS

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title
COGNITIVE MIGRATION: EXAMINATIONS OF MULTISTATE TRANSITIONS IN OLDER ADULTS WITH NEUROIMAGING AND CLINICAL BIOMARKERS
author
Duran, Tugce
abstract
In 2023, Alzheimer’s disease (AD) dementia affected more than 6 million older adults in the United States. As individuals age, they are more susceptible to cognitive migration, a concept developed in this dissertation to better understand the progression to mild cognitive impairment (MCI) and reversion to normal cognitive function (NC) from MCI. In the field of AD and related dementias (ADRD), this concept can address the gap between healthy brain aging and preclinical disease. The dissertation project consists of a research study examining the roles of imaging and clinical/metabolic risk factors on cognitive migration (CM) over one year. The first analysis presented in this dissertation explored structural imaging biomarkers and impaired glucose tolerance as key contributors to varying CM outcomes. The second study introduced a harmonized cognitive composite measure for heterogeneous cognitive data (in-person and remotely administered assessments) to differentiate those with or without cognitive impairment and inform neuroimaging outcomes in older individuals. The final analysis provides evidence that specific white matter (association) pathways contribute differently to CM. In summary, this dissertation contributes significantly to the field of AD/ADRD research by providing novel insights into the biomarkers and clinical features associated with CM. The studies presented here underscore the complexity of cognitive decline and the challenges in predicting trajectory of cognitive impairment, paving the way for future research and potential early health interventions in dementia.
subject
Alzheimer's Disease
Cognitive Migration
Dementia
Mild Cognitive Impairment
Neuroimaging
contributor
Lockhart, Samuel N. (advisor)
Espeland, Mark A. (committee member)
Orr, Miranda E. (committee member)
Bateman, James R. (committee member)
date
2024-05-23T08:36:21Z (accessioned)
2024 (issued)
degree
Neuroscience (discipline)
embargo
2025-05-22 (terms)
2025-05-22 (liftdate)
identifier
http://hdl.handle.net/10339/109443 (uri)
language
en (iso)
publisher
Wake Forest University
type
Dissertation

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