Cognitive and physical aspects of functionality are closely related. However, whether physical decline differs by dementia type and progression rate is debatable. To address these issues, we conducted a longitudinal study of 766 older adults whose physical performance and cognitive
status were assessed annually with standard assessment tools [eg, Physical Performance Test, Clinical Dementia Rate (CDR)] for 8 years. Compared with participants who remained cognitively normal, those progressing to later-stage dementia (CDR=1) declined in their mobility by a factor of 2.82
(P<0.001), followed by those who maintained a later-stage diagnosis (slope=−1.84, P<0.001), those progressing from early-stage to later-stage (CDR=0.5 to CDR=1) dementia (slope=−1.20, P<0.001), and those who progressed to early-stage dementia (slope=−0.39,
P=0.038) suggesting a steeper physical decline with dementia progression, particularly in those with the fastest disease progression. Although all types of dementia experienced mobility decline, those progressing to non-Alzheimer disease (AD) dementias, especially vascular dementia
declined faster than those who remained normal (slope=−2.70, P<0.001) or progressed to AD (slope=−2.18, P<0.001). These associations were better captured by the gait/balance component of physical functionality. Our findings suggest that rapidly progressing dementia
patients particularly those with non-AD subtypes should be targeted for interventions to maintain or improve gait/balance and prevent functional decline and disability although AD patients may also benefit.
No Reference information available - sign in for access.
No Citation information available - sign in for access.
No Supplementary Data.
No Article Media
dementia with Lewy bodies;
physical functional decline;
Document Type: Research Article
Departments of Neurology, Psychiatry, and Population Health, Alzheimer’s Disease Center, Center for Cognitive Neurology, New York University School of Medicine, New York, NY
Charles F. and Joanne Knight Alzheimer’s Disease Research Center, Washington University, St Louis, MO
Publication date: January 1, 2016