Description:
<jats:title>Abstract</jats:title><jats:sec><jats:title>INTRODUCTION</jats:title><jats:p>Reversion, or change in cognitive status from impaired to normal, is common in aging and dementia studies, but it remains unclear what factors predict reversion.</jats:p></jats:sec><jats:sec><jats:title>METHODS</jats:title><jats:p>We investigated whether reverters, defined as those who revert from a Clinical Dementia Rating® (CDR®) scale score of 0.5 to CDR 0) differed on cognition and biomarkers from unimpaired participants (always CDR 0) and impaired participants (converted to CDR > 0 and had no reversion events). Models evaluated relationships between biomarker status, <jats:italic>apolipoprotein E (APOE)</jats:italic> ε4 status, and cognition. Additional models described predictors of reversion and predictors of eventual progression to CDR > 0.</jats:p></jats:sec><jats:sec><jats:title>RESULTS</jats:title><jats:p>CDR reversion was associated with younger age, better cognition, and negative amyloid biomarker status. Reverters that eventually progressed to CDR > 0 had more visits, were older, and were more likely to have an <jats:italic>APOE ε</jats:italic>4 allele.</jats:p></jats:sec><jats:sec><jats:title>DISCUSSION</jats:title><jats:p>CDR reversion occupies a transitional phase in disease progression between cognitive normality and overt dementia. Reverters may be ideal candidates for secondary prevention Alzheimer's disease (AD) trials.</jats:p></jats:sec><jats:sec><jats:title>Highlights</jats:title><jats:p><jats:list list-type="bullet">
<jats:list-item><jats:p>Reverters had more longitudinal cognitive decline than those who remained cognitively normal.</jats:p></jats:list-item>
<jats:list-item><jats:p>Predictors of reversion: younger age, better cognition, and negative amyloid biomarker status.</jats:p></jats:list-item>
<jats:list-item><jats:p>Reverting from CDR 0.5 to 0 is a risk factor for future conversion to CDR > 0.</jats:p></jats:list-item>
<jats:list-item><jats:p>CDR reversion may be a transitional phase in Alzheimer's Disease progression.</jats:p></jats:list-item>
<jats:list-item><jats:p>CDR reverters may be ideal for Alzheimer's disease secondary prevention trials.</jats:p></jats:list-item>
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