Prodromal Alzheimer's disease: successive emergence of the clinical symptoms
Abstract
OBJECTIVE: Whereas cognitive deficits are known to be detectable long before the typical symptoms of Alzheimer's disease (AD) are evident, previous studies have failed to determine when cognitive functioning actually begins to decline before dementia. Utilizing the long follow-up of the PAQUID study, we examined the emergence of the first clinical symptoms over a 14-year period of follow-up before the dementia phase of AD. METHODS: This study relies on a case-control sample selected from the PAQUID cohort. Of the 3,777 initial subjects of the cohort, 350 subjects experienced development of AD during the 14 years of follow-up. The cases were matched to 350 elderly control subjects. The evolution of scores on cognitive, functional, and depression scales was described throughout the 14-year follow-up using a semiparametric extension of the mixed-effects linear model. RESULTS: The first decline in cognitive performances appeared as early as 12 years before dementia in measures of semantic memory and conceptual formation. Then, more global deficits appeared that were concomitant with an increase in memory complaints and depressive symptoms. About 2 years later, as a consequence of cognitive dysfunction, the subjects started to become slightly dependent in their activities of daily living. In the last 3 years, the impairment significantly worsened until the subjects reached the dementia phase. INTERPRETATION: This approach, describing the 14 years preceding dementia, provides a clear illustration of the particularly long and progressive prodromal phase of AD, and shows the successive emergence of cognitive deficits, depressive symptoms, and functional impairment during this phase.
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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 [86]
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- Authors
- Amieva, H., Le Goff, M., Millet, X., Orgogozo, J. M., Pérès, K., Barberger‐Gateau, P., Jacqmin‐Gadda, H., & Dartigues, J. F.
- Affiliations
- Inserm (FR)
- Corresponding author
- Amieva, Hélène
- Venue
- Annals of Neurology
- Publisher
- Wiley
- Published
- 2008-11
- Volume
- 64
- Issue
- 5
- Pages
- 492-498
- ISSN
- 0364-5134 (ISSN-L)
- 1531-8249
- OpenAlex
- W2107381357
- Cited by
- 737
- References
- 47
- Citations by year
- 2026: 26 · 2025: 34 · 2024: 30 · 2023: 32 · 2022: 45 · 2021: 38 · 2020: 51 · 2019: 41 · 2018: 45 · 2017: 43 · 2016: 40 · 2015: 58 · 2014: 56 · 2013: 58 · 2012: 43
- FWCI
- 21.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Annals of Neurology (publishedVersion)
- PubMed (publishedVersion)
- 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, Alzheimer's disease, dementia onset, cognitive decline, semantic memory, concept formation, memory impairment, depressive symptoms, activities of daily living, functional disability, PAQUID cohort, longitudinal follow-up
- MeSH terms
- Activities of Daily Living, Aged, Aged, 80 and over, Aging, Alzheimer Disease, Cognition Disorders, Depressive Disorder, Disability Evaluation, Female, Humans, Longitudinal Studies, Male, Memory Disorders, Neuropsychological Tests, Predictive Value of Tests, Time Factors, Cohort Studies, Comorbidity, Case-Control Studies, Disease Progression, Early Diagnosis
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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