Abstract：
OBJECTIVES:Previous studies have identified several subgroups (ie, latent trajectories) with distinct disease progression among people with dementia. However, the methods and results were not always consistent. This study aims to perform a coordinated analysis of latent trajectories of cognitive and functional progression in dementia across two datasets. METHODS:Included and analyzed using the same statistical approach were 1628 participants with dementia from the US National Alzheimer's Coordinating Center (NACC) and 331 participants with dementia from the Dutch Clinical Course of Cognition and Comorbidity study (4C-Study). Trajectories of cognition and instrumental activities of daily living (IADL) were modeled jointly in a parallel-process growth mixture model. RESULTS:Cognition and IADL tended to decline in unison across the two samples. Slow decline in both domains was observed in 26% of the US sample and 74% of the Dutch sample. Rapid decline in cognition and IADL was observed in 7% of the US sample and 26% of the Dutch sample. The majority (67%) of the US sample showed moderate cognitive decline and rapid IADL decline. CONCLUSIONS:Trajectories of slow and rapid dementia progression were identified in both samples. Despite using the same statistical methods, the number of latent trajectories was not replicated and the relative class sizes differed considerably across datasets. These results call for careful consideration when comparing progression estimates in the literature. In addition, the observed discrepancy between cognitive and functional decline stresses the need to monitor dementia progression across multiple domains.
journal_name
Int J Geriatr Psychiatryjournal_title
International journal of geriatric psychiatryauthors
Wang Y,Haaksma ML,Ramakers IHGB,Verhey FRJ,van de Flier WM,Scheltens P,van Maurik I,Olde Rikkert MGM,Leoutsakos JS,Melis RJFdoi
10.1002/gps.5175subject
Has Abstractpub_date
2019-11-01 00:00:00pages
1623-1632issue
11eissn
0885-6230issn
1099-1166journal_volume
34pub_type
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