 |
|
Change in Cognitive Function in Older Persons From a Community Population
Relation to Age and Alzheimer Disease
Robert S. Wilson, PhD;
Laurel A. Beckett, PhD;
David A. Bennett, MD;
Marilyn S. Albert, PhD;
Denis A. Evans, MD
Arch Neurol. 1999;56:1274-1279.
Objective To examine change in cognitive function in older persons sampled from a community population, and its relation to age and Alzheimer disease.
Design Prospective cohort study with an average of 3.5 years of follow-up.
Setting East Boston, Mass—a geographically defined, urban, working-class community.
Participants A stratified, random sample of persons 65 years and older underwent uniform, structured clinical evaluation for Alzheimer disease. The 388 persons (89.2% of those eligible) who completed at least 1 annual follow-up evaluation were studied: 97 had Alzheimer disease at baseline; 95 developed Alzheimer disease during the study; and 196 were unaffected.
Outcome Measures Eight cognitive performance tests were administered, then converted to population-weighted z scores and averaged to create a composite summary measure of cognitive function. Initial level of and change in this score were the outcome measures.
Results In the population as a whole, many persons experienced a decline in cognitive performance, and age was related to both initial level and rate of decline. Analyses were conducted in 3 subgroups: persons with Alzheimer disease at baseline, those who developed Alzheimer disease during the study, and those who remained unaffected. In both Alzheimer disease subgroups, substantial cognitive decline was observed, but neither initial level nor rate of decline was related to age. In unaffected persons, little cognitive decline was evident, and there was a small, inverse association of age with initial level of cognitive function.
Conclusion In a general population sample, there was little evidence of cognitive decline during a 3.5-year period among persons who remained free of Alzheimer disease.
From the Rush Alzheimer's Disease Center and Rush Institute for Healthy Aging (Drs Wilson, Beckett, Bennett, and Evans) and Departments of Neurological Science (Drs Wilson, Bennett, and Evans), Medicine (Drs Beckett and Evans), and Psychology (Dr Wilson), Rush University and Rush-Presbyterian-Saint Luke's Medical Center, Chicago, Ill; and the Departments of Psychiatry and Neurology (Dr Albert), Massachusetts General Hospital and Harvard Medical School, Boston.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
RELATED ARTICLE
Archives of Neurology Reader's Choice: Continuing Medical Education
Arch Neurol. 1999;56(10):1302-1303.
FULL TEXT
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Education and trajectories of cognitive decline over 9 years in very old people: methods and risk analysis
Muniz-Terrera et al.
Age Ageing 2009;38:277-282.
ABSTRACT
| FULL TEXT
Patient Age Influences Recognition of Alzheimer's Disease
McCarten et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2008;63:625-628.
ABSTRACT
| FULL TEXT
Neuroprotective effect of mild hypothermia in patients undergoing coronary artery surgery with cardiopulmonary bypass: Five-year follow-up of a randomized trial
Nathan et al.
J. Thorac. Cardiovasc. Surg. 2007;133:1206-1211.
ABSTRACT
| FULL TEXT
Urban Neighborhood Context, Educational Attainment, and Cognitive Function among Older Adults
Wight et al.
Am J Epidemiol 2006;163:1071-1078.
ABSTRACT
| FULL TEXT
Mild cognitive impairment in different functional domains and incident Alzheimer's disease
Aggarwal et al.
J. Neurol. Neurosurg. Psychiatry 2005;76:1479-1484.
ABSTRACT
| FULL TEXT
Predictors of Preclinical Alzheimer Disease and Dementia: A Clinicopathologic Study
Galvin et al.
Arch Neurol 2005;62:758-765.
ABSTRACT
| FULL TEXT
Education and the course of cognitive decline in Alzheimer disease
Wilson et al.
Neurology 2004;63:1198-1202.
ABSTRACT
| FULL TEXT
Postmenopausal hormone therapy and risk of cognitive decline in community-dwelling aging women
Kang et al.
Neurology 2004;63:101-107.
ABSTRACT
| FULL TEXT
Diabetes Mellitus and Risk of Alzheimer Disease and Decline in Cognitive Function
Arvanitakis et al.
Arch Neurol 2004;61:661-666.
ABSTRACT
| FULL TEXT
Essentials of the Proper Diagnoses of Mild Cognitive Impairment, Dementia, and Major Subtypes of Dementia
Knopman et al.
Mayo Clin Proc. 2003;78:1290-1308.
ABSTRACT
Rate of Cognitive Decline in Preclinical Alzheimer's Disease: The Role of Comorbidity
Backman et al.
Journals of Gerontology Series B: Psychological Sciences and Social Science 2003;58:P228-236.
ABSTRACT
| FULL TEXT
Terminal decline in cognitive function
Wilson et al.
Neurology 2003;60:1782-1787.
ABSTRACT
| FULL TEXT
Relation of cerebral infarctions to dementia and cognitive function in older persons
Schneider et al.
Neurology 2003;60:1082-1088.
ABSTRACT
| FULL TEXT
Apolipoprotein E {epsilon}4 allele, AD pathology, and the clinical expression of Alzheimer's disease
Bennett et al.
Neurology 2003;60:246-252.
ABSTRACT
| FULL TEXT
Natural history of mild cognitive impairment in older persons
Bennett et al.
Neurology 2002;59:198-205.
ABSTRACT
| FULL TEXT
Evaluating an Educational Intervention With Relatives of Persons in the Early Stages of Alzheimer's Disease
Kuhn and de Leon
Research on Social Work Practice 2001;11:531-548.
ABSTRACT
Cognitive Changes 5 Years After Coronary Artery Bypass Grafting: Is There Evidence of Late Decline?
Selnes et al.
Arch Neurol 2001;58:598-604.
ABSTRACT
| FULL TEXT
Coronary-Artery Bypass Surgery and the Brain
Selnes and McKhann
NEJM 2001;344:451-452.
FULL TEXT
Diabetes and Change in Cognitive Function
Bennett
Arch Intern Med 2000;160:141-143.
FULL TEXT
|
