Objective: Symptom clustering research provides a unique opportunity for understanding complex medical conditions. The objective of this study was to apply a variable-centered analytic approach to understand how symptoms may cluster together, within and across domains of functioning in mild cognitive impairment (MCI) and dementia, to better understand these conditions and potential etiological, prevention, and intervention considerations. Method: Cognitive, motor, sensory, emotional, and social measures from the NIH Toolbox were analyzed using exploratory factor analysis (EFA) from a dataset of 165 individuals with a research diagnosis of either amnestic MCI or dementia of the Alzheimer’s type. Results: The six-factor EFA solution described here primarily replicated the intended structure of the NIH Toolbox with a few deviations, notably sensory and motor scores loading onto factors with measures of cognition, emotional, and social health. These findings suggest the presence of cross-domain symptom clusters in these populations. In particular, negative affect, stress, loneliness, and pain formed one unique symptom cluster that bridged the NIH Toolbox domains of physical, social, and emotional health. Olfaction and dexterity formed a second unique cluster with measures of executive functioning, working memory, episodic memory, and processing speed. A third novel cluster was detected for mobility, strength, and vision, which was considered to reflect a physical functioning factor. Somewhat unexpectedly, the hearing test included did not load strongly onto any factor. Conclusion: This research presents a preliminary effort to detect symptom clusters in amnestic MCI and dementia using an existing dataset of outcome measures from the NIH Toolbox.

中文翻译：

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使用 NIH 工具箱探索轻度认知障碍和痴呆症的症状群

目的：症状聚类研究为了解复杂的医疗状况提供了独特的机会。本研究的目的是应用以变量为中心的分析方法来了解轻度认知障碍 (MCI) 和痴呆的功能领域内和之间的症状如何聚集在一起，从而更好地了解这些病症以及潜在的病因、预防和治疗方法。干预考虑。方法：使用探索性因子分析 (EFA) 对 165 名被研究诊断为遗忘性 MCI 或阿尔茨海默型痴呆的个体数据集进行探索性因子分析 (EFA)，对 NIH 工具箱中的认知、运动、感觉、情绪和社会测量进行分析。结果：此处描述的六因素 EFA 解决方案主要复制了 NIH 工具箱的预期结构，但存在一些偏差，特别是加载到认知、情绪和社会健康测量因素上的感觉和运动分数。这些发现表明这些人群中存在跨域症状群。特别是，负面情绪、压力、孤独和疼痛形成了一个独特的症状群，连接了 NIH 工具箱的身体、社会和情感健康领域。嗅觉和敏捷性形成了第二个独特的集群，包括执行功能、工作记忆、情景记忆和处理速度。检测到第三个新的集群是针对活动性、力量和视力，这被认为反映了身体功能因素。有点出乎意料的是，听力测试并没有对任何因素产生强烈影响。结论：本研究提出了利用 NIH 工具箱中现有结果测量数据集检测遗忘性 MCI 和痴呆症症状群的初步努力。