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Natural progression model of cognition and physical functioning among people with mild cognitive impairment and alzheimer's disease.

Abstract

BACKGROUND

Empirical models of the natural history of Alzheimer's disease (AD) may help to evaluate new interventions for AD.

OBJECTIVE

We aimed to estimate AD-free survival time in people with mild cognitive impairment (MCI) and decline of cognitive and physical function in AD cases.

METHODS

Within the Kungsholmen project, 153 incident MCI and 323 incident AD cases (international criteria) were identified during 9 years of follow-up in a cognitively healthy cohort of elderly people aged ≥75 at baseline (n = 1,082). Global cognitive function was assessed with the Mini-Mental State Examination (MMSE), and daily life function was evaluated with the Katz index of activities of daily living (ADL) at each follow-up examination. Data were analyzed using parametric survival analysis and mixed effect models.

RESULTS

Median AD-free survival time of 153 participants with incident MCI was 3.5 years. Among 323 incident AD cases, the cognitive decline was 1.84 MMSE points per year, which was significantly associated with age. Physical functioning declined by 0.38 ADL points per year and was significantly associated with age, education, and MMSE, but not with gender.

CONCLUSION

Elderly people with MCI may develop AD in approximately 3.5 years. Both cognitive and physical function may decline gradually after AD onset. The empirical models can be used to evaluate long-term disease progression of new interventions for AD.

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  • Authors+Show Affiliations

    ,

    Alzheimer Centre Limburg, School for Mental Health and Neuroscience (MHeNS), University Medical Centre, Maastricht, The Netherlands.

    , , , , , , , , ,

    Source

    MeSH

    Aged
    Aged, 80 and over
    Alzheimer Disease
    Cognitive Dysfunction
    Cohort Studies
    Community Health Planning
    Disease Progression
    Female
    Humans
    Male
    Mental Status Schedule
    Motor Activity
    Neuropsychological Tests
    Survival Analysis
    Sweden
    Time Factors

    Pub Type(s)

    Journal Article
    Research Support, Non-U.S. Gov't

    Language

    eng

    PubMed ID

    23948894

    Citation

    Handels, Ron L H., et al. "Natural Progression Model of Cognition and Physical Functioning Among People With Mild Cognitive Impairment and Alzheimer's Disease." Journal of Alzheimer's Disease : JAD, vol. 37, no. 2, 2013, pp. 357-65.
    Handels RL, Xu W, Rizzuto D, et al. Natural progression model of cognition and physical functioning among people with mild cognitive impairment and alzheimer's disease. J Alzheimers Dis. 2013;37(2):357-65.
    Handels, R. L., Xu, W., Rizzuto, D., Caracciolo, B., Wang, R., Winblad, B., ... Wimo, A. (2013). Natural progression model of cognition and physical functioning among people with mild cognitive impairment and alzheimer's disease. Journal of Alzheimer's Disease : JAD, 37(2), pp. 357-65. doi:10.3233/JAD-130296.
    Handels RL, et al. Natural Progression Model of Cognition and Physical Functioning Among People With Mild Cognitive Impairment and Alzheimer's Disease. J Alzheimers Dis. 2013;37(2):357-65. PubMed PMID: 23948894.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Natural progression model of cognition and physical functioning among people with mild cognitive impairment and alzheimer's disease. AU - Handels,Ron L H, AU - Xu,Weili, AU - Rizzuto,Debora, AU - Caracciolo,Barbara, AU - Wang,Rui, AU - Winblad,Bengt, AU - Verhey,Frans R J, AU - Severens,Johan L, AU - Fratiglioni,Laura, AU - Joore,Manuela A, AU - Wimo,Anders, PY - 2013/8/17/entrez PY - 2013/8/21/pubmed PY - 2014/4/16/medline SP - 357 EP - 65 JF - Journal of Alzheimer's disease : JAD JO - J. Alzheimers Dis. VL - 37 IS - 2 N2 - BACKGROUND: Empirical models of the natural history of Alzheimer's disease (AD) may help to evaluate new interventions for AD. OBJECTIVE: We aimed to estimate AD-free survival time in people with mild cognitive impairment (MCI) and decline of cognitive and physical function in AD cases. METHODS: Within the Kungsholmen project, 153 incident MCI and 323 incident AD cases (international criteria) were identified during 9 years of follow-up in a cognitively healthy cohort of elderly people aged ≥75 at baseline (n = 1,082). Global cognitive function was assessed with the Mini-Mental State Examination (MMSE), and daily life function was evaluated with the Katz index of activities of daily living (ADL) at each follow-up examination. Data were analyzed using parametric survival analysis and mixed effect models. RESULTS: Median AD-free survival time of 153 participants with incident MCI was 3.5 years. Among 323 incident AD cases, the cognitive decline was 1.84 MMSE points per year, which was significantly associated with age. Physical functioning declined by 0.38 ADL points per year and was significantly associated with age, education, and MMSE, but not with gender. CONCLUSION: Elderly people with MCI may develop AD in approximately 3.5 years. Both cognitive and physical function may decline gradually after AD onset. The empirical models can be used to evaluate long-term disease progression of new interventions for AD. SN - 1875-8908 UR - https://www.unboundmedicine.com/medline/citation/23948894/Natural_progression_model_of_cognition_and_physical_functioning_among_people_with_mild_cognitive_impairment_and_alzheimer's_disease_ L2 - https://content.iospress.com/openurl?genre=article&id=doi:10.3233/JAD-130296 DB - PRIME DP - Unbound Medicine ER -