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The cognitive and neuroimaging for neurodegenerative disorders study (CogNID) : design and initial findings from real-world clinical practice
Hosseini, Akram A. Shao, Beili Lee, Abigail Rebecca Dhillon, Permesh Junaid, Kehinde Gran, Bruno Sellars, Peter Sargisson, Hannah Jung, JeYoung Mukaetova-Ladinska, Elizabeta B.
Hosseini, Akram A.
Shao, Beili
Lee, Abigail Rebecca
Dhillon, Permesh
Junaid, Kehinde
Gran, Bruno
Sellars, Peter
Sargisson, Hannah
Jung, JeYoung
Mukaetova-Ladinska, Elizabeta B.
Abstract
Introduction: Dementia presents with significant heterogeneity across age groups, particularly in early-onset cognitive decline (EOCD), which poses diagnostic and management challenges. The Cognitive and Neuroimaging for Neurodegenerative Disorders (CogNID) study aims to characterise clinical, cognitive, neuroimaging, and biomarker features across a diverse cohort of individuals with cognitive impairment, with a focus on diagnostic complexity, biomarker utility, and mortality.MethodsOut of 680 study participants within this prospective cohort enrolled from the real-world clinics within the National Health Service, who consented to take part in the study, we analysed data from 429. Individuals were recruited between December 2018 and November 2024 from the Memory Clinics, including the early-onset dementia service and associated services. Participants underwent structured cognitive assessments, neuroimaging (MRI/CT), and Cerebrospinal fluid (CSF) biomarker evaluation, where available. Diagnoses were made by multidisciplinary consensus. Group comparisons were conducted between early-onset (EOCD, <65 years) and late-onset cognitive decline (LOCD, ≥65 years).ResultsOf the 429 participants, 349 (81.4%) had EOCD and 80 (18.6%) had LOCD. The mean age was 60.05 years, with no significant difference in sex or ethnicity across groups. Depression and anxiety were common (29.6%), as were cardiovascular risk factors. Lumbar punctures were more frequently performed in EOCD (p = 0.03), with 36.4% of tested participants demonstrating biomarker profiles consistent with Alzheimer’s disease (A+T+). Functional cognitive disorder (FCD) was more common in EOCD (22.3% vs. 5.0%, p < 0.001). Subgroup analysis revealed significantly lower ACE-III scores and higher pathological CSF findings in Alzheimer’s disease versus FCD. Mortality was higher in the LOCD group (11.3% vs. 4.6%, p = 0.03).ConclusionThe CogNID study highlights the clinical and diagnostic heterogeneity of individuals with cognitive impairment, particularly in younger adults. Incorporating neuroimaging and CSF biomarkers into routine clinical pathways enhances diagnostic precision and reveals distinct phenotypic profiles between EOCD and LOCD. These findings underscore the need for harmonised diagnostic protocols, broader biomarker accessibility, and inclusive recruitment strategies in dementia research and clinical services.
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2025
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Hosseini, A. A., Shao, B., Lee, A. R., Dhillon, P., Junaid, K., Gran, B., Sellars, P., Sargisson, H., Jung, J. & Mukaetova-Ladinska, E. B. (2025). The cognitive and neuroimaging for neurodegenerative disorders study (CogNID) : design and initial findings from real-world clinical practice. Frontiers in Psychiatry, 16.
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© 2025 Hosseini, Shao, Lee, Dhillon, Junaid, Gran, Sellars, Sargisson, Jung and Mukaetova-Ladinska. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.