This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (137)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Alzheimer Disease  • Behavioral Neurology  • Dementias  • Alert me on articles by topic

Three- and 6-Year Follow-up of a Population-Based Sample

Brent J. Small, PhD; Laura Fratiglioni, MD, PhD; Matti Viitanen, MD, PhD; Bengt Winblad, MD, PhD; Lars Bäckman, PhD

Arch Neurol. 2000;57:839-844.

Objectives  To examine the ability of the total score and individual items from the Mini-Mental State Examination in predicting the development of Alzheimer disease (AD) across a 3- and 6-year period in a population-based sample, and to describe the longitudinal changes in these measures across the same follow-up periods.

Design  Prospective follow-up of a community-based cohort, with 3 times of testing across a 6-year period. At each time of measurement, participants were clinically examined by physicians to identify demented and nondemented participants according to Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition, criteria.

Participants  The study population consisted of all participants who were nondemented at the first follow-up and participated in the second follow-up examination. Among those, 459 remained nondemented and 73 developed AD during the second follow-up period.

Results  Baseline differences in the total Mini-Mental State Examination score and the delayed memory item were seen 6 years before eventual dementia diagnosis (P<.01). Analysis of the longitudinal changes showed no differences in the rate of decline for the incident AD or nondemented group between time 1 and time 2 (P>.10). However, the incident AD group exhibited precipitous declines in 8 of the 10 subscales between time 2 and time 3, the point at which they were clinically diagnosed (P<.01). Logistic regression analyses showed that only the delayed memory item was a significant predictor of who would develop AD, independent of age, sex, and years of education, at both of the first 2 times of measurement (P<.001).

Conclusions  The diagnosis of AD is preceded by a long preclinical phase in which deficits in memory performance are most common. These deficits remain relatively stable up until the time that a dementia diagnosis can be rendered.

From the Department of Gerontology, University of South Florida, Tampa (Dr Small); Division of Geriatric Medicine, NEUROTEC, Karolinska Institute, Stockholm, Sweden (Drs Small, Fratiglioni, Viitanen, Winblad, and Bäckman); and Department of Psychology, Uppsala University, Uppsala, Sweden (Dr Bäckman).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Tea consumption and cognitive impairment and decline in older Chinese adults
Ng et al.
Am. J. Clin. Nutr. 2008;88:224-231.
ABSTRACT | FULL TEXT  

A Randomized Trial of Beta Carotene Supplementation and Cognitive Function in Men: The Physicians' Health Study II
Grodstein et al.
Arch Intern Med 2007;167:2184-2190.
ABSTRACT | FULL TEXT  

Amnestic syndrome of the medial temporal type identifies prodromal AD: A longitudinal study
Sarazin et al.
Neurology 2007;69:1859-1867.
ABSTRACT | FULL TEXT  

Disease-modifying therapies for Alzheimer disease: Challenges to early intervention
Cummings et al.
Neurology 2007;69:1622-1634.
ABSTRACT | FULL TEXT  

Cognitive Errors, Symptom Severity, and Response to Cognitive Behavior Therapy in Older Adults With Generalized Anxiety Disorder
Caudle et al.
AJGP 2007;15:680-689.
ABSTRACT | FULL TEXT  

Low dose aspirin and cognitive function in the women's health study cognitive cohort
Kang et al.
BMJ 2007;334:987-987.
ABSTRACT | FULL TEXT  

Brain structural alterations before mild cognitive impairment
Smith et al.
Neurology 2007;68:1268-1273.
ABSTRACT | FULL TEXT  

A Randomized Trial of Vitamin E Supplementation and Cognitive Function in Women
Kang et al.
Arch Intern Med 2006;166:2462-2468.
ABSTRACT | FULL TEXT  

Plasma C-Peptide and Cognitive Performance in Older Men Without Diabetes
Okereke et al.
AJGP 2006;14:1041-1050.
ABSTRACT | FULL TEXT  

Midlife Plasma Insulin-Like Growth Factor I and Cognitive Function in Older Men
Okereke et al.
J. Clin. Endocrinol. Metab. 2006;91:4306-4312.
ABSTRACT | FULL TEXT  

Green tea consumption and cognitive function: a cross-sectional study from the Tsurugaya Project 1
Kuriyama et al.
Am. J. Clin. Nutr. 2006;83:355-361.
ABSTRACT | FULL TEXT  

Depressive Symptoms and Cognitive Decline in Late Life: A Prospective Epidemiological Study
Ganguli et al.
Arch Gen Psychiatry 2006;63:153-160.
ABSTRACT | FULL TEXT  

Prodromal cognitive signs of dementia in 85-year-olds using four sources of information
Sacuiu et al.
Neurology 2005;65:1894-1900.
ABSTRACT | FULL TEXT  

Middle-Aged Children of Alzheimer Parents, A Pilot Study: Stable Neurocognitive Performance at 20-Year Follow-up
Jarvik et al.
J Geriatr Psychiatry Neurol 2005;18:187-191.
ABSTRACT  

Longitudinal Models of Growth and Survival Applied to the Early Detection of Alzheimer's Disease
McArdle et al.
J Geriatr Psychiatry Neurol 2005;18:234-241.
ABSTRACT  

Serum C-Reactive Protein and Cognitive Function in Healthy Elderly Italian Community Dwellers
Ravaglia et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2005;60:1017-1021.
ABSTRACT | FULL TEXT  

Plasma C Peptide Level and Cognitive Function Among Older Women Without Diabetes Mellitus
Okereke et al.
Arch Intern Med 2005;165:1651-1656.
ABSTRACT | FULL TEXT  

The 9 year cognitive decline before dementia of the Alzheimer type: a prospective population-based study
Amieva et al.
Brain 2005;128:1093-1101.
ABSTRACT | FULL TEXT  

Neuropsychological predictors of dependency in patients with Alzheimer disease
Sarazin et al.
Neurology 2005;64:1027-1031.
ABSTRACT | FULL TEXT  

Apolipoprotein {varepsilon}4 Allele and Problems With Orientation Are Associated With a Persistent Decline in Cognition in Community-Dwelling Elderly Persons
Wayne et al.
J. Gerontol. A Biol. Sci. Med. Sci. 2005;60:375-379.
ABSTRACT | FULL TEXT  

Effects of Moderate Alcohol Consumption on Cognitive Function in Women
Stampfer et al.
NEJM 2005;352:245-253.
ABSTRACT | FULL TEXT  

Preclinical Alzheimer disease: Neuropsychological test performance 1.5 to 8 years prior to onset
Saxton et al.
Neurology 2004;63:2341-2347.
ABSTRACT | FULL TEXT  

Physical Activity, Including Walking, and Cognitive Function in Older Women
Weuve et al.
JAMA 2004;292:1454-1461.
ABSTRACT | FULL TEXT  

APOE and cognitive decline in preclinical Alzheimer disease and non-demented aging
Bunce et al.
Neurology 2004;63:816-821.
ABSTRACT | FULL TEXT  

Cognitive Functioning in Preclinical Vascular Dementia: A 6-Year Follow-Up
Laukka et al.
Stroke 2004;35:1805-1809.
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  

Search Strategies Used by APP Transgenic Mice During Navigation in the Morris Water Maze
Janus
Learn. Mem. 2004;11:337-346.
ABSTRACT | FULL TEXT  

Rate of Cognitive Decline in Preclinical Alzheimer's Disease: The Role of Comorbidity
Backman et al.
J. Gerontol. B Psychol. Sci. Soc. Sci. 2003;58:P228-236.
ABSTRACT | FULL TEXT  

Leisure Activities and the Risk of Dementia in the Elderly
Verghese et al.
NEJM 2003;348:2508-2516.
ABSTRACT | FULL TEXT  

MMSE Items Predict Cognitive Decline in Persons with Genetic Risk for Alzheimer's Disease
Ercoli et al.
J Geriatr Psychiatry Neurol 2003;16:67-73.
ABSTRACT  

Visual memory predicts Alzheimer's disease more than a decade before diagnosis
Kawas et al.
Neurology 2003;60:1089-1093.
ABSTRACT | FULL TEXT  

Neuropsychological prediction of conversion to dementia from questionable dementia: statistically significant but not yet clinically useful
Tian et al.
J. Neurol. Neurosurg. Psychiatry 2003;74:433-438.
ABSTRACT | FULL TEXT  

Detection of Alzheimer's disease and dementia in the preclinical phase: population based cohort study
Palmer et al.
BMJ 2003;326:245-245.
ABSTRACT | FULL TEXT  

Rates of progression in mild cognitive impairment and early Alzheimer's disease
Storandt et al.
Neurology 2002;59:1034-1041.
ABSTRACT | FULL TEXT  

Late-Life Engagement in Social and Leisure Activities Is Associated with a Decreased Risk of Dementia: A Longitudinal Study from the Kungsholmen Project
Wang et al.
Am J Epidemiol 2002;155:1081-1087.
ABSTRACT | FULL TEXT  

A 5-Year Retrospective Examination of Cognitive Screening Test Stages in Normal Older Adults and Patients With Alzheimer's Disease: The Tajiri Project
Meguro et al.
J. Gerontol. B Psychol. Sci. Soc. Sci. 2001;56:P314-318.
ABSTRACT | FULL TEXT  

Patterns of Cognitive Decline in Presymptomatic Alzheimer Disease: A Prospective Community Study
Chen et al.
Arch Gen Psychiatry 2001;58:853-858.
ABSTRACT | FULL TEXT  

Canaries in a Coal Mine: Cognitive Markers of Preclinical Alzheimer Disease
Small et al.
Arch Gen Psychiatry 2001;58:859-860.
FULL TEXT  

Neuron Number in the Entorhinal Cortex and CA1 in Preclinical Alzheimer Disease
Price et al.
Arch Neurol 2001;58:1395-1402.
ABSTRACT | FULL TEXT  

Absence of cognitive impairment or decline in preclinical Alzheimer's disease
Goldman et al.
Neurology 2001;56:361-367.
ABSTRACT | FULL TEXT