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 (75)  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in this journal  Topic Collections  • Aging/ Geriatrics  • Alzheimer Disease  • Cognitive Disorders  • Dementias  • Alert me on articles by topic  Social Bookmarking   What's this?

Scott Marquis, BS; M. Milar Moore, BS; Diane B. Howieson, PhD; Gary Sexton, PhD; Haydeh Payami, PhD; Jeffrey A. Kaye, MD; Richard Camicioli, MD

Arch Neurol. 2002;59:601-606.

Background  Several studies have shown that individually memory, hippocampal volume, and motor measures presage the onset of dementia. It is unclear if these independently contribute to the prediction of mild cognitive impairment.

Objective  To determine the ability of memory, hippocampal volume, and a gait speed to independently predict cognitive decline in healthy elderly persons.

Design  A prospective, longitudinal, observational cohort study with a mean follow-up of 6 years.

Participants  One hundred eight optimally healthy elderly cognitively intact subjects.

Main Outcome Measures  Any cognitive impairment noted on the Clinical Dementia Rating Scale (score = 0.5) or persistent or progressive cognitive impairment. Cox modeling determined if time to onset of cognitive impairment was associated with baseline logical memory II test score (a measure of delayed recall), hippocampal volume (magnetic resonance imaging), or gait speed (time to walk 30 ft [9 m]) independent of age, sex, depression, or the allele producing the 4 type of apolipoprotein E (APOE 4).

Results  Questionable dementia occurred in 48 participants in a mean (SD) of 3.7 (2.4) years. This progressed to persistent cognitive impairment in 38 of these participants in a mean (SD) of 4.4 (2.4) years. Logical memory II test performance and hippocampal volume each predicted onset of questionable dementia, independent of age and sex. Time to walk 30 ft additionally contributed independently to the prediction of time to onset of persistent cognitive impairment. Possessing the APOE 4 allele and depression did not enter either model significantly.

Conclusions  Models combining multiple risk factors should refine the prediction of questionable dementia and persistent cognitive impairment, harbingers of dementia. Individuals at risk for cognitive impairment may represent a high-risk group for intervention.

From the Department of Neurology, Oregon Health Sciences University (Drs Howieson, Sexton, Payami, and Kaye, Mr Marquis, and Ms Moore), and the Portland Veterans Affairs Medical Center (Dr Kaye), Portland, Ore; and the Department of Medicine, University of Alberta, Edmonton (Dr Camicioli).

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati     What's this?

RELATED ARTICLE

Archives of Neurology Reader's Choice: Continuing Medical Education
Arch Neurol. 2002;59(4):655-656.
FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Gait speed under varied challenges and cognitive decline in older persons: a prospective study
Deshpande et al.
Age Ageing 2009;0:afp093v1-afp093.
ABSTRACT | FULL TEXT  

Making Physical Activity Accessible to Older Adults With Memory Loss: A Feasibility Study
Logsdon et al.
The Gerontologist 2009;49:S94-S99.
ABSTRACT | FULL TEXT  

Guest Editorial: Linking Thinking, Walking, and Falling
Alexander and Hausdorff
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2008;63:1325-1328.
FULL TEXT  

Healthy Cognitive Aging and Leisure Activities Among the Oldest Old in Japan: Takashima Study
Dodge et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2008;63:1193-1200.
ABSTRACT | FULL TEXT  

Atrophy rates accelerate in amnestic mild cognitive impairment
Jack et al.
Neurology 2008;70:1740-1752.
ABSTRACT | FULL TEXT  

Quantitative gait dysfunction and risk of cognitive decline and dementia
Verghese et al.
J. Neurol. Neurosurg. Psychiatry 2007;78:929-935.
ABSTRACT | FULL TEXT  

Impaired Attention Predicts Motor Performance Decline in Older Community-Dwellers With Normal Baseline Mobility: Results From the Italian Longitudinal Study on Aging (ILSA)
Inzitari et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2007;62:837-843.
ABSTRACT | FULL TEXT  

Frailty: An Emerging Research and Clinical Paradigm Issues and Controversies
Bergman et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2007;62:731-737.
ABSTRACT | FULL TEXT  

Improvements in Speed-Based Gait Classifications Are Meaningful
Schmid et al.
Stroke 2007;38:2096-2100.
ABSTRACT | FULL TEXT  

Performance-based physical function and future dementia in older people.
Wang et al.
Arch Intern Med 2006;166:1115-1120.
ABSTRACT | FULL TEXT  

Neuropsychological Markers of Progression From Mild Cognitive Impairment to Alzheimer's Disease
Marcos et al.
AM J ALZHEIMERS DIS OTHER DEMEN 2006;21:189-196.
ABSTRACT  

Familial risk for Alzheimer's disease alters fMRI activation patterns
Bassett et al.
Brain 2006;129:1229-1239.
ABSTRACT | FULL TEXT  

Relationship Between Duration of Untreated Psychosis and Outcome in First-Episode Schizophrenia: A Critical Review and Meta-Analysis
Perkins et al.
Am. J. Psychiatry 2005;162:1785-1804.
ABSTRACT | FULL TEXT  

Implicit memory and Alzheimer's disease neuropathology
Fleischman et al.
Brain 2005;128:2006-2015.
ABSTRACT | FULL TEXT  

Early Event-Related Potential Changes During Working Memory Activation Predict Rapid Decline in Mild Cognitive Impairment
Missonnier et al.
Journals of Gerontology Series A: Biological Sciences and Medical Sciences 2005;60:660-666.
ABSTRACT | FULL TEXT  

Apolipoprotein E {varepsilon}4 Allele and Lorazepam Effects on Memory in High-Functioning Older Adults
Pomara et al.
Arch Gen Psychiatry 2005;62:209-216.
ABSTRACT | FULL TEXT  

Memory impairment, but not cerebrovascular disease, predicts progression of MCI to dementia
DeCarli et al.
Neurology 2004;63:220-227.
ABSTRACT | FULL TEXT  

Predicting the rate of cognitive decline in aging and early Alzheimer disease
Adak et al.
Neurology 2004;63:108-114.
ABSTRACT | FULL TEXT  

Mild cognitive impairment: Directions for future research
Luis et al.
Neurology 2003;61:438-444.
ABSTRACT | FULL TEXT  

Natural history of cognitive decline in the old old
Howieson et al.
Neurology 2003;60:1489-1494.
ABSTRACT | FULL TEXT