Trajectories of cognitive decline in different types of dementia
Open accessAbstract
Background.: To investigate trajectories of cognitive decline in patients with different types of dementia compared to controls in a longitudinal study. Method.: In 199 patients with Alzheimer's disease (AD), 10 with vascular dementia (VaD), 26 with dementia with Lewy bodies (DLB), 20 with behavioural variant frontotemporal dementia (bvFTD), 15 with language variant frontotemporal dementia (lvFTD) and 112 controls we assessed five cognitive domains: memory, language, attention, executive and visuospatial functioning, and global cognition (Mini-Mental State Examination, MMSE). All subjects had at least two neuropsychological assessments (median 2, range 2–7). Neuropsychological data were standardized into z scores using baseline performance of controls as reference. Linear mixed models (LMMs) were used to estimate baseline cognitive functioning and cognitive decline over time for each group, adjusted for age, gender and education. Results.: At baseline, patients with dementia performed worse than controls in all cognitive domains ( p < 0.05) except visuospatial functioning, which was only impaired in patients with AD and DLB ( p < 0.001). During follow-up, patients with AD declined in all cognitive domains ( p < 0.001). DLB showed decline in every cognitive domain except language and global cognition. bvFTD showed rapid decline in memory, language, attention and executive functioning (all p < 0.01) whereas visuospatial functioning remained fairly stable. lvFTD declined mostly in attention and executive functioning ( p < 0.01). VaD showed decline in attention and executive functioning. Conclusions.: We show cognitive trajectories of different types of dementia. These estimations of natural disease course have important value for the design of clinical trials as neuropsychological measures are increasingly being used as outcome measures.
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Despite cognitive heterogeneity, disease progression in bvFTD has been marked by decline in executive functioning, memory, language and attention (1 to 8 years).
“Despite cognitive heterogeneity, disease progression in bvFTD has been marked by decline in executive functioning, memory, language and attention (1 to 8 years) (Blair et al., 2007; Wicklund et al., 2007; Smits et al., 2015; Ramanan et al., 2017).”
From The pursuit for markers of disease progression in behavioral variant frontotemporal dementia: a scoping review to optimize outcome measures for clinical trials (2024) · cites this paper as Smits et al., 2015
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- Authors
- Smits, L. L., van Harten, A. C., Pijnenburg, Y. A. L., Koedam, E. L. G. E., Bouwman, F. H., Sistermans, N., Reuling, I. E. W., Prins, N. D., Lemstra, A. W., Scheltens, P., & van der Flier, W. M.
- Affiliations
- Amsterdam UMC Location Vrije Universiteit Amsterdam (NL)
- Corresponding author
- Smits, L. L.
- Venue
- Psychological Medicine
- Publisher
- Cambridge University Press (CUP)
- Published
- 2014-09-17
- Volume
- 45
- Issue
- 5
- Pages
- 1051-1059
- ISSN
- 0033-2917 (ISSN-L)
- 1469-8978
- OpenAlex
- W2078970715
- Cited by
- 134
- References
- 34
- Citations by year
- 2026: 10 · 2025: 18 · 2024: 21 · 2023: 11 · 2022: 14 · 2021: 9 · 2020: 12 · 2019: 14 · 2018: 11 · 2017: 5 · 2016: 5 · 2015: 4
- FWCI
- 3.56
- Type
- journal article
- Language
- en
- Open access
- green
- pure.amsterdamumc.nl
- Licence
- Locations
- Psychological Medicine (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion)
- Pure Amsterdam UMC (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Funders
- Vanderbilt University Medical Center
- EU Joint Programme – Neurodegenerative Disease Research
- European Commission
- Stichting Dioraphte
- Alzheimer Nederland
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Social Sciences › Psychology › Clinical Psychology › Historical and Modern Theater Studies
- Keywords
- cognitive decline, Alzheimer's disease, vascular dementia, dementia with Lewy bodies, behavioral variant frontotemporal dementia, visuospatial functioning, executive function, attention, memory, clinical trial design
- MeSH terms
- Aged, Alzheimer Disease, Cognition Disorders, Female, Humans, Language, Longitudinal Studies, Male, Memory, Middle Aged, Neuropsychological Tests, Prospective Studies, Dementia, Vascular, Case-Control Studies, Disease Progression, Lewy Body Disease, Executive Function, Frontotemporal Dementia
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