A Latent Transition Analysis Model to Assess Change in Cognitive States over Three Occasions: Results from the Rush Memory and Aging Project

Andrea R. Zammit, David A. Bennett, Charles B. Hall, Richard B. Lipton, Mindy J. Katz, Graciela Muniz-Terrera

Research output: Contribution to journalArticle


BACKGROUND: Conceptualizing cognitive aging as a step-sequential process is useful in identifying particular stages of cognitive function and impairment. OBJECTIVE: We applied latent transition analysis (LTA) to determine 1) whether the underlying structure of cognitive profiles found at every measurement occasion are uniform across three waves of assessment, 2) whether class-instability is predictive of distal outcomes, and 3) whether class-reversions from impaired to non-impaired using latent modelling is lower than when using clinical criteria of mild cognitive impairment (MCI). METHODS: A mover-stayer LTA model with dementia as a distal outcome was specified to model transitions of ten neuropsychological measures over three annual waves in the Rush Memory and Aging Project (n = 1,661). The predictive validity of the mover-stayer status for incident Alzheimer's disease (AD) was then assessed. RESULTS: We identified a five-class model across the three time-points: Mixed-Domain Impairment, Memory-Specific Impairment, Frontal Impairment, Average, and Superior Cognition. None of the individuals in the Impairment classes reverted to the Average or Superior classes. Conventional MCI classification identified 26.4% and 14.1% at Times 1 and 2 as false-positive cases. "Movers" had 87% increased risk of developing dementia compared to those classified as "Stayers". CONCLUSION: Our findings support the use of latent variable modelling that incorporates comprehensive neuropsychological assessment to identify and classify cognitive impairment.

Original languageEnglish (US)
Pages (from-to)1063-1073
Number of pages11
JournalJournal of Alzheimer's disease : JAD
Issue number3
StatePublished - Jan 1 2020



  • Alzheimer’s disease
  • cognitive heterogeneity
  • cognitive profiles
  • cognitive status
  • dementia
  • individual differences
  • latent transition analysis
  • neuropsychological profiles

ASJC Scopus subject areas

  • Neuroscience(all)
  • Clinical Psychology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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