| Heterogeneity of cognitive trajectories in diverse older persons. | |
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MedLine Citation:
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PMID: 20677882 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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This study examined trajectories of cognitive change in psychometrically matched measures of episodic memory, semantic memory, and executive function in an ethnically, demographically, and cognitively diverse sample of older persons. Individual rates of change showed considerable heterogeneity in each domain. Baseline clinical diagnosis predicted differential change in semantic memory and executive function, dementia > mild cognitive impairment (MCI) > normal, but average decline in verbal episodic memory was similar across all 3 diagnostic groups. There was substantial overlap of distributions of cognitive change across baseline diagnostic groups for all 3 measures. Cognitive change was strongly related to change in clinical diagnosis. Rapid and similar change was present for all 3 cognitive measures in patients with dementia and in those with normal cognition and those with MCI who progressed clinically. In cognitively normal patients, verbal episodic memory change was greater than change in the other two domains. Global status, measured by the Clinical Dementia Rating scale (Morris, 1993), predicted change in semantic memory and executive function, whereas APOE genotype predicted change in verbal episodic memory, and age had no effect on rates of change in any domain independent of global status and APOE. Results show important limitations in using cross-sectional diagnosis to predict prognosis and suggest that research to identify robust predictors of cognitive change across the full spectrum from normal to dementia is needed for better early identification of diseases that cause progressive decline. |
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Authors:
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Dan Mungas; Laurel Beckett; Danielle Harvey; Sarah Tomaszewski Farias; Bruce Reed; Owen Carmichael; John Olichney; Joshua Miller; Charles DeCarli |
Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: Psychology and aging Volume: 25 ISSN: 1939-1498 ISO Abbreviation: Psychol Aging Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-09-22 Completed Date: 2011-05-09 Revised Date: 2013-05-29 |
Medline Journal Info:
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Nlm Unique ID: 8904079 Medline TA: Psychol Aging Country: United States |
Other Details:
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Languages: eng Pagination: 606-19 Citation Subset: IM |
Copyright Information:
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(c) 2010 APA, all rights reserved. |
Affiliation:
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Department of Neurology, School of Medicine, University of California, Sacramento, CA 95817, USA. dmmungas@ucdavis.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Aged, 80 and over Aging / physiology, psychology* Apolipoproteins E / genetics Cognition* Cognition Disorders / diagnosis, etiology, physiopathology* Dementia / complications, diagnosis, physiopathology* Educational Status Executive Function* Female Genotype Humans Longitudinal Studies Male Memory* Middle Aged Neuropsychological Tests Psychometrics Severity of Illness Index |
| Grant Support | |
ID/Acronym/Agency:
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AG021028/AG/NIA NIH HHS; AG10129/AG/NIA NIH HHS; AG10220/AG/NIA NIH HHS; P30 AG010129-129001/AG/NIA NIH HHS; P30 AG010129-18/AG/NIA NIH HHS; P30 AG010129-19/AG/NIA NIH HHS; R01 AG010220-12/AG/NIA NIH HHS; R01 AG010220-17/AG/NIA NIH HHS; R01 AG021028/AG/NIA NIH HHS; R01 AG021028-05/AG/NIA NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Apolipoproteins E |
| Comments/Corrections | |
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