Trajectory of mobility decline by type of dementia

Research output: Contribution to journalArticlepeer-review

33 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)60-66
Number of pages7
JournalAlzheimer disease and associated disorders
Volume30
Issue number1
DOIs
StatePublished - 2016
Externally publishedYes

Keywords

  • Alzheimer disease
  • Dementia with Lewy bodies
  • Frontotemporal dementia
  • Mobility
  • Physical functional decline
  • Vascular dementia

ASJC Scopus subject areas

  • Clinical Psychology
  • Gerontology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health

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