Cognitive decline and survival in Alzheimer's disease
- 21 March 2006
- journal article
- research article
- Published by Wiley in International Journal of Geriatric Psychiatry
- Vol. 21 (4) , 356-362
- https://doi.org/10.1002/gps.1472
Abstract
Objective To test the association of rate of cognitive decline, an indicator of the severity of the underlying disease process, with risk of death in Alzheimer's disease (AD). Methods A total of 472 persons with clinically diagnosed AD were recruited from a memory disorders clinic and day care centers in the Chicago area. They completed a uniform clinical evaluation at baseline and a battery of nine cognitive tests at six‐month intervals for a mean of about three years. A previously established measure of global cognition was derived from the nine tests. Results During follow‐up, 168 persons (36%) died. In a proportional hazards model that controlled for age, sex, race, education, and baseline level of cognition, individual rate of global cognitive decline, estimated with least squares regression, was linearly related to mortality risk. Thus, a person declining minimally (increase of 0.04 unit per year, 90th percentile) was 2.7 times less likely to die during the study period than a person declining rapidly (decrease of 0.76 unit per year, 10th percentile). Controlling for baseline disability did not substantially affect results. The association of cognitive decline with mortality was substantially stronger for white persons compared to African Americans and in those with less compared to more education. Conclusion The results indicate that the rate at which cognition declines in AD is robustly related to survival. Copyright © 2006 John Wiley & Sons, Ltd.Keywords
This publication has 32 references indexed in Scilit:
- Mortality in Alzheimer’s DiseaseDementia and Geriatric Cognitive Disorders, 2003
- Predictors of nursing home admission and/or death in incident Alzheimer's disease and other dementia cases compared to controlsJournal of Clinical Epidemiology, 2002
- Individual differences in rates of change in cognitive abilities of older persons.Psychology and Aging, 2002
- Person-specific paths of cognitive decline in Alzheimer's disease and their relation to age.Psychology and Aging, 2000
- Predictors of survival with Alzheimer's disease: a community-based studyPsychological Medicine, 1995
- The Consortium to Establish a Registry for Alzheimer's Disease (CERAD). Part V. A normative study of the neuropsychological batteryNeurology, 1994
- Factors affecting survival in Alzheimer's diseasePsychological Medicine, 1991
- Reliability of estimates of changes in mental status test performance in senile dementia of the alzheimer typeJournal of Clinical Epidemiology, 1990
- Clinical diagnosis of Alzheimer's diseaseNeurology, 1984
- “Mini-mental state”Journal of Psychiatric Research, 1975