Cognitive decline in prodromal Alzheimer disease and mild cognitive impairment
Open accessAbstract
OBJECTIVE: To characterize the course of cognitive decline during the prodromal phase of Alzheimer disease. DESIGN: Longitudinal cohort study with up to 16 years of observation. PARTICIPANTS: Older persons from 2 studies underwent annual clinical evaluations that included cognitive function testing and clinical classification of mild cognitive impairment, dementia, and Alzheimer disease. At baseline, there were 2071 individuals without dementia and 1511 without cognitive impairment. RESULTS: During follow-up, 462 persons developed Alzheimer disease (20 with dementia solely due to another condition were excluded). Five to six years before diagnosis, the rate of global cognitive decline accelerated more than 15-fold. The acceleration in cognitive decline occurred slightly earlier for semantic memory (76 months before diagnosis) and working memory (75 months) than other cognitive functions. Mild cognitive impairment was also preceded by years of cognitive decline that began earlier (80 months before diagnosis) and proceeded more rapidly (annual loss of 0.102 unit) in the amnestic than in the nonamnestic (62 months, 0.072 unit) subtype. CONCLUSION: Dementia due to Alzheimer disease is preceded by about 5 to 6 years of accelerated decline in multiple cognitive functions. By contrast, little decline is evident in persons who do not develop Alzheimer disease.
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Various studies suggest the pre-dementia period of cognitive decline lasts at least a decade and perhaps many decades.
“Various studies suggest this pre-dementia period of cognitive decline lasts at least a decade and perhaps even many decades [83–86].”
From Brain aging, Alzheimer's disease, and mitochondria (2011) · cites this paper as [85]
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- Authors
- Wilson, R. S., Leurgans, S. E., Boyle, P. A., & Bennett, D. A.
- Affiliations
- Rush University Medical Center (US)
- Venue
- Archives of Neurology
- Publisher
- American Medical Association (AMA)
- Published
- 2011-03-01
- Volume
- 68
- Issue
- 3
- Pages
- 351-6
- ISSN
- 0003-9942 (ISSN-L)
- PMC
- PMC3100533
- OpenAlex
- W2067128590
- Cited by
- 346
- References
- 41
- Citations by year
- 2026: 17 · 2025: 19 · 2024: 31 · 2023: 19 · 2022: 35 · 2021: 25 · 2020: 27 · 2019: 21 · 2018: 12 · 2017: 16 · 2016: 26 · 2015: 22 · 2014: 19 · 2013: 25 · 2012: 19
- FWCI
- 16.00
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Archives of Neurology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (R01AG017917, R01AG015819, P30AG010161, R01AG024871, R01AG034374)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Keywords
- prodromal Alzheimer's disease, mild cognitive impairment, cognitive decline, Alzheimer's disease, dementia, semantic memory, working memory, amnestic mild cognitive impairment, non-amnestic mild cognitive impairment, longitudinal cohort, older adults, disease onset timing
- MeSH terms
- Aged, Alzheimer Disease, Cognition, Cognition Disorders, Female, Humans, Longitudinal Studies, Male, Memory, Memory, Short-Term, Middle Aged, Neuropsychological Tests, Psychomotor Performance, Visual Perception, Cohort Studies, Disease Progression
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