Item Details

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)

2025-05-22T08:30:08Z (available)

2024 (issued)

degree

Neuroscience (discipline)

embargo

2025-05-22 (terms)

identifier

http://hdl.handle.net/10339/109443 (uri)

language

en (iso)

publisher

Wake Forest University

type

Dissertation