The DOI matches its Crossref record; 47 of the 48 references it cites were found in a registry or an index; 6 of the 34 sources its claims cite were checked for support.
Progression of Cognitive, Functional, and Neuropsychiatric Symptom Domains in a Population Cohort With Alzheimer Dementia: The Cache County Dementia Progression Study
Open accessAbstract
Objectives Progression of Alzheimer’s dementia (AD) is highly variable. Most estimates derive from convenience samples from dementia clinics or research centers where there is substantial potential for survival bias and other distortions. In a population-based sample of incident AD cases, we examined progression of impairment in cognition, function, and neuropsychiatric symptoms, and the influence of selected variables on these domains. Design Longitudinal, prospective cohort study Setting Cache County (Utah) Participants 328 persons diagnosed with Possible/Probable AD Measurements Mini-Mental State Exam (MMSE), Clinical Dementia Rating sum-of-boxes (CDR-sb), and Neuropsychiatric Inventory (NPI). Results Over a mean follow-up of 3.80 (range 0.07–12.90) years, the mean (S.D.) annual rates of change were −1.53 (2.69) on the MMSE, 1.44 (1.82) on the CDR-sb, and 2.55 (5.37) scale points on the NPI. Among surviving participants, 30–58% progressed less than one point/year on these measures, even 5–7 years after dementia onset. Rates of change were correlated between MMSE and CDR-sb (r=−0.62, df=201, p<0.001) and between the CDR-sb and NPI (r=0.20, df=206, p<0.004). Females (LR χ2=8.7, df=2, p=0.013) and those with younger onset (LR χ2=5.7, df=2, p=0.058) declined faster on the MMSE. Although one or more APOE ε4 alleles and ever-use of FDA-approved anti-dementia medications were associated with initial MMSE scores, neither was related to the rate of progression in any domain. Conclusions A significant proportion of persons with AD progresses slowly. The results underscore differences between population- vs. clinic-based samples and suggest ongoing need to identify factors that may slow the progression of AD.
Overview
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Written from the paper’s full text.
TL;DR
In a population-based incident Alzheimer dementia cohort, cognitive, functional, and neuropsychiatric symptoms worsened on average, but a substantial minority of survivors declined slowly. The authors argue that progression estimates from clinic-based samples may differ from population-based estimates.
Key findings
- Over mean follow-up of 3.80 years (range 0.07–12.90), mean annual rates of change were −1.53 (SD 2.69) on MMSE, +1.44 (SD 1.82) on CDR-sb, and +2.55 (SD 5.37) on NPI.
- Among survivors, 30–58% progressed less than one point/year on these measures even 5–7 years after dementia onset; this represented 5–10% of the entire cohort.
- MMSE and CDR-sb rates were correlated (r=−0.62, df=201, p<0.001), CDR-sb and NPI weakly correlated (r=0.20, df=206, p=0.004), and MMSE and NPI were not correlated (r=0.052, df=195, p=0.469).
- Females declined faster on MMSE (LR χ2=8.7, df=2, p=0.013), and younger onset showed faster MMSE decline (LR χ2=5.7, df=2, p=0.058); APOE ε4 and ever-use of FDA-approved anti-dementia medications were associated with initial MMSE scores but not rate of progression in any domain.
Methods
- Longitudinal prospective population cohort from Cache County, Utah: 328 persons diagnosed with Possible/Probable AD, followed from near dementia onset.
- Progression measured with MMSE, CDR sum-of-boxes, and Neuropsychiatric Inventory; predictors included age of onset, gender, education, and APOE ε4.
- Analyses calculated annual rates of change/slopes and used mixed-effects models with time and time-squared terms, plus secondary analyses of anti-dementia medication use.
Limitations
- Stated: single measures of cognition, function, and NPS; missing MMSE scores due to sensory/motor impairment in 9%; lack of follow-up among 29% (mostly death); cursory examination of anti-dementia medications; and a primarily Caucasian population of northern European descent, limiting generalizability.
- Stated: the study did not consider duration or consistency of anti-dementia medication use.
- Evident: the text also reports that 112 participants (34%) lacked any follow-up, mostly due to death, and that these individuals were older and had lower diagnostic MMSE scores than those with follow-up.
Model-written summary. Check it against the paper before relying on it.
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Claims the paper makes
6 of 34 cited sources checked · 3 supported · 0 flagged · accuracy not yet measured
Every source the paper cites for this claim was checked and supports it.
In the paper
“Progression of Alzheimer’s dementia (AD) is highly variable.”
- Also stated in: § Conclusions · plain
“Numerous studies report significant variability in the rate of cognitive and functional decline in AD.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > Abstract > Objectives
What the sources say
- Supportedcites [2] Behl, 2005, Progress in clinical neurosciences: cognitive markers of progression in Alzheimer's disease, Can J Neurol Sci source
The Abstract says longitudinal studies have revealed the “complex nature and heterogeneity” of Alzheimer’s disease progression. That supports the claim that progression is highly variable. (LLM, conf=0.93)
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes- Also stated in: § Conclusions · plain
Every source the paper cites for this claim was checked and supports it.
In the paper
“Our findings are consistent with recent work suggesting that APOE ε4 exerts deleterious effects early in the disease course.(12)”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
What the sources say
- Supportedcites [12] Cosentino, 2008, APOE epsilon 4 allele predicts faster cognitive decline in mild Alzheimer disease, Neurology source
The Conclusion states that APOE ε4 may influence cognitive decline most significantly in the earliest stages of AD. The Discussion reports more rapid decline among ε4 carriers in incident AD, supporting the citing sentence’s qualified description of deleterious effects early in the disease course. (LLM, conf=0.93)
Strength:hedged· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passes- Supported
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“between the CDR-sb and NPI (r=0.20, df=206, p<0.004)”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > Abstract > Results
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Females (LR χ2=8.7, df=2, p=0.013) and those with younger onset (LR χ2=5.7, df=2, p=0.058) declined faster on the MMSE.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > Abstract > Results
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Rates of change were correlated between MMSE and CDR-sb (r=−0.62, df=201, p<0.001)”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > Abstract > Results
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“−1.53 (2.69) on the MMSE”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > Abstract > Results
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“1.44 (1.82) on the CDR-sb”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > Abstract > Results
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although one or more APOE ε4 alleles and ever-use of FDA-approved anti-dementia medications were associated with initial MMSE scores, neither was related to the rate of progression in any domain.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > Abstract > Results
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Among surviving participants, 30–58% progressed less than one point/year on these measures, even 5–7 years after dementia onset.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > Abstract > Results
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesA result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Although one or more APOE ε4 alleles and ever-use of FDA-approved anti-dementia medications were associated with initial MMSE scores, neither was related to the rate of progression in any domain.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > Abstract > Results
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passes
- Probably not a substantial claim. 32
- It may state two separate claims as one. 10
- The quote only partly states this claim. 1
Every source the paper cites for this claim was checked and supports it.
In the paper
“a recent review reported that the mean annual rate of change (ARC) on the Mini-Mental State Exam (MMSE), a global measure of cognition, varied from 0.8 to 4.4 points.(2)”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > Abstract > Conclusions
What the sources say
- Supportedcites [2] Behl, 2005, Progress in clinical neurosciences: cognitive markers of progression in Alzheimer's disease, Can J Neurol Sci source
The MMSE table in the Mini-Mental Status Examination section reports mean annual rates of change of 0.8 and 4.4 points per year across studies, supporting the cited review’s range. One entry is 4.46, slightly above the stated upper bound. (LLM, conf=0.88)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Some measures (e.g., MMSE) have been criticized for differential performance in classifying the cognitive status of individuals from different ages and educational backgrounds, and for significant floor effects when studying persons with severe dementia (reviewed in (43)).”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
What the sources say
- Could not verifycites [43] Norton, 2009, Caregiver-recipient closeness and symptom progression in Alzheimer disease. The Cache County Dementia Progression Study, J Gerontol B Psychol Sci Soc Sci sourceExperimental — accuracy not yet measured
The Outcomes section (page unavailable) describes administering the MMSE to participants with advanced dementia and occasionally discontinuing it because of poor comprehension. It does not discuss floor effects. Searches for floor effects and the MMSE’s ability to detect further decline in advanced dementia found no passage supporting the attributed criticism. (LLM, conf=0.72)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Could not verify
The cited sources support only part of this claim — read each source’s verdict below.
In the paper
“Variables available from the CCSMA included age of dementia onset, gender, education, and presence of one or two APOE ε4 alleles, determined from buccal DNA.(24)”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS > Predictor Variables
What the sources say
- Partly supportedcites [24] Saunders, 1993, Association of apolipoprotein E allele epsilon 4 with late-onset familial and sporadic Alzheimer's disease, Neurology sourceExperimental — accuracy not yet measured
The Methods and Genomic DNA sections describe age-of-onset information and APOE genotyping, supporting those elements of the sentence. They do not describe CCSMA variables, gender or education data, or buccal DNA; the paper instead reports DNA from blood samples and brain tissue. (LLM, conf=0.85)
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
- Partly supported
The cited sources that could be checked couldn’t confirm or dispute this claim.
In the paper
“Some measures (e.g., MMSE) have been criticized for differential performance in classifying the cognitive status of individuals from different ages and educational backgrounds, and for significant floor effects when studying persons with severe dementia (reviewed in (43)).”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
What the sources say
- Could not verifycites [43] Norton, 2009, Caregiver-recipient closeness and symptom progression in Alzheimer disease. The Cache County Dementia Progression Study, J Gerontol B Psychol Sci Soc Sci sourceExperimental — accuracy not yet measured
The Outcomes section (page not provided) describes the MMSE as a cognitive screening test, while the Analysis and Cognitive Trajectory sections examine age and education as predictors of MMSE scores or decline. None of these passages criticizes the MMSE for classifying cognitive status differently across age or educational groups. Searches for differential classification, age and education bias, and MMSE limitations found no such statement in our copy. (LLM, conf=0.77)
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
- Could not verify
A result the paper reports from its own data — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Older age was associated with worse cognition and function at baseline, while women declined more rapidly (in cognition) than men.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesThe quote only partly states this claim.
The paper states this without a source or data behind it here, so there is nothing to check it against. The quote shows it is in the paper.
In the paper
“Finally, the Cache County population is primarily Caucasian and of northern European descent.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim.
In the paper
“The Mini-Mental State Exam (MMSE), a measure of global cognitive functioning,(22)”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS > Measures of Dementia Progression
What the sources say
- Not checked — no full text of the sourcecites [22] Folstein, 1975, “Mini-mental state.” A practical method for grading the cognitive state of patients for the clinician, J Psychiatr Res source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Other limitations included the missing MMSE scores at baseline and/or follow-up owing to sensory/motor impairments among 9% of the sample, the lack of follow-up among 29% of the sample (mostly due to death(44)), and our cursory examination of the effects of anti-dementia medications on dementia progression.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
What the sources say
- Not checked — no full text of the sourcecites [44] Treiber, 2008, Vascular factors and risk for neuropsychiatric symptoms in Alzheimer's disease: the Cache County Study, Int Psychogeriatr source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
In the paper
“in a U.S. county recognized for its residents’ longevity”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS
What the sources say
- Not checked — no full text of the sourcecites [13] Breitner, 1999, APOE-epsilon4 count predicts age when prevalence of AD increases, then declines: the Cache County Study, Neurology source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The CDR was scored by a trained research nurse at each visit, considering the caregiver’s report of symptoms and the participant’s neuropsychological test performance.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS > Measures of Dementia Progression
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A geriatric psychiatrist conducted the initial training and performed periodic reviews of the RN ratings.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS > Measures of Dementia Progression
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
In the paper
“The instrument screens for the presence of each symptom and follows positive responses with a series of standardized questions to characterize the symptom, its frequency, severity, and degree of change from premorbid characteristics.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS > Measures of Dementia Progression
What the sources say
- Not checked — no full text of the sourcecites [23] Cummings, 1994, The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia, Neurology source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A study neuropsychologist trained these individuals and periodically reviewed audiotaped test sessions to ensure consistent techniques of standardized administration.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS > Measures of Dementia Progression
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“Similar variability is seen in functional decline,(3)”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > Abstract > Conclusions
What the sources say
- Not checked — no full text of the sourcecites [3] Aguero-Torres, 1998, Natural history of Alzheimer's disease and other dementias: review of the literature in the light of the findings from the Kungsholmen Project, Int J Geriatr Psychiatry source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“which has examined the prevalence, incidence, and risk factors for dementia”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS
What the sources say
- Not checked — no full text of the sourcecites [13] Breitner, 1999, APOE-epsilon4 count predicts age when prevalence of AD increases, then declines: the Cache County Study, Neurology source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Other limitations included the missing MMSE scores at baseline and/or follow-up owing to sensory/motor impairments among 9% of the sample, the lack of follow-up among 29% of the sample (mostly due to death(44)), and our cursory examination of the effects of anti-dementia medications on dementia progression.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
Strength:plain· not yet calibratedCausal:direct· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“we calculated an adjusted MMSE score by discarding items missed because of sensory or motor impairment (e.g., severe vision or hearing loss, motor weakness, tremor, etc.), noting the percent correct, and rescaling the final score on a 30-point scale.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS > Measures of Dementia Progression
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
In the paper
“the longitudinal, population-based Cache County Study on Memory in Aging (CCSMA)”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS
What the sources say
- Not checked — no full text of the sourcecites [13] Breitner, 1999, APOE-epsilon4 count predicts age when prevalence of AD increases, then declines: the Cache County Study, Neurology source
Load-bearingStrength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Participants whose sensory or motor impairments affected more than 3 points were excluded from the analyses (n=30, 9%).”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS > Measures of Dementia Progression
Strength:plain· not yet calibratedn = 30Tests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“most individuals with incident dementia have been followed prospectively by the DPS”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“Differences in results may also reflect sample differences in years of education and the timing of observations along the course of dementia.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
Strength:hedged· not yet calibratedCausal:conditional· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“NPS in AD are marked by increasing incidence over time and by an episodic course.(4)”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > Abstract > Conclusions
What the sources say
- Not checked — no full text of the sourcecites [4] Chung, 2000, Neurobehavioral and neuropsychiatric symptoms in Alzheimer's disease: characteristics and treatment, Neurol Clin source
Strength:plain· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it. It may state two separate claims as one.
A claim is checked only against the cited paper’s full text, never its abstract, and none is available for its sources.
In the paper
“More rapid decline among women with AD has been reported in some,(31) but not all studies.(32)”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
What the sources say
- Not checked — no full text of the sourcecites [31] Aguero-Torres, 1998, Prognostic factors in very old demented adults: a seven-year follow-up from a population-based survey in Stockholm, J Am Geriatr Soc source
- Not checked — no full text of the sourcecites [32] Mohs, 2000, Longitudinal studies of cognitive, functional and behavioural change in patients with Alzheimer's disease, Stat Med source
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“This finding contrasts with studies reporting more rapid decline among those with more years of education,(37) but is consistent with higher education conferring advantages early in the disease course.(38)”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
What the sources say
- Not checked — no full text of the sourcecites [37] Koepsell, 2008, Education, cognitive function, and severity of neuropathology in Alzheimer disease, Neurology source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“A trained research nurse administered the NPI (23) to the caregiver.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS > Measures of Dementia Progression
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The Neuropsychiatric Inventory (NPI) assesses NPS that commonly occur in dementia including delusions, hallucinations, agitation-aggression, depression-dysphoria, apathy-indifference, elation-euphoria, anxiety, disinhibition, irritability-lability, and aberrant motor behavior.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS > Measures of Dementia Progression
What the sources say
- Not checked — no full text of the sourcecites [23] Cummings, 1994, The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia, Neurology source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Here, we did not consider duration or consistency of medication use; a thorough examination of the effects of anti-dementia medications will be the topic of a subsequent paper on dementia treatments.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Among the study limitations are the use of single measures of cognition, function and NPS.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
In the paper
“The Clinical Dementia Rating (CDR(19)) is a measure of functional ability in six areas: memory, orientation, judgment/problem solving, community affairs, participation in home/hobbies, and personal care.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS > Measures of Dementia Progression
What the sources say
- Not checked — no full text of the sourcecites [19] Hughes, 1982, A new clinical scale for the staging of dementia, Br J Psychiatry source
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“Other limitations included the missing MMSE scores at baseline and/or follow-up owing to sensory/motor impairments among 9% of the sample, the lack of follow-up among 29% of the sample (mostly due to death(44)), and our cursory examination of the effects of anti-dementia medications on dementia progression.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“This approach allowed us to account for the dependence between within-subject repeated measures and for non-linear change with respect to time by incorporating time-squared effects.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > METHODS > Analyses
Tests✓ Asserted: passes✓ Checkable: passes✓ Load-bearing: passes✓ Based: passesProbably not a substantial claim. It may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The study strengths include its population base, its focus on incident cases, the characterization of course in the three domains of dementia, the extended follow-up after dementia onset, and the high participation rates observed in dementia ascertainment and over the period of observation.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The study strengths include its population base, its focus on incident cases, the characterization of course in the three domains of dementia, the extended follow-up after dementia onset, and the high participation rates observed in dementia ascertainment and over the period of observation.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. The paper’s conclusions may not depend on it.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The study strengths include its population base, its focus on incident cases, the characterization of course in the three domains of dementia, the extended follow-up after dementia onset, and the high participation rates observed in dementia ascertainment and over the period of observation.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
A conclusion the paper draws from its own results — it cites no other source for it, so there is none to check. The quote shows it is in the paper.
In the paper
“The present results in general suggest important differences between population- vs. clinic-based samples.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
Strength:hedged· not yet calibratedCausal:correlational· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes✗ Load-bearing: fails✗ Based: failsProbably not a substantial claim. The paper’s conclusions may not depend on it. The paper may give no reason why it holds.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The study strengths include its population base, its focus on incident cases, the characterization of course in the three domains of dementia, the extended follow-up after dementia onset, and the high participation rates observed in dementia ascertainment and over the period of observation.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✓ Checkable: passes? Load-bearing: unclear✓ Based: passesIt may state two separate claims as one.
What the paper did — it cites no source for this, so there is none to check. The quote shows it is in the paper.
In the paper
“The study strengths include its population base, its focus on incident cases, the characterization of course in the three domains of dementia, the extended follow-up after dementia onset, and the high participation rates observed in dementia ascertainment and over the period of observation.”
§ Progression of Cognitive, Functional and Neuropsychiatric Symptom Domains in a Population Cohort with Alzheimer’s Dementia The Cache County Dementia Progression Study > DISCUSSION
Strength:plain· not yet calibratedTests✓ Asserted: passes✗ Checkable: fails✗ Load-bearing: fails✓ Based: passesProbably not a substantial claim. It may be too vague to check against evidence. The paper’s conclusions may not depend on it.
The paper relies on this without support.
AD causes impairment not only in cognition and function, but also in behavior prompted by neuropsychiatric symptoms (NPS).
“AD causes impairment not only in cognition and function, but also in behavior prompted by neuropsychiatric symptoms (NPS).”
The paper relies on this without support.
Most studies of AD progression describe the course of prevalent cases.
“Also, most studies of AD progression describe the course of prevalent cases.”
The paper relies on this without support.
Few studies have examined cognition, function, and NPS simultaneously.
“Furthermore, few studies have examined cognition, function, and NPS simultaneously, so their descriptions of AD progression are incomplete.”
The paper relies on this without support.
Many studies encompass limited time of follow-up in their descriptions of dementia course.
“Finally, many studies encompass limited time of follow-up in their descriptions of dementia course.”
The paper relies on this without support.
The 3MS is a somewhat more sensitive measure than the MMSE.
“as a somewhat more sensitive measure, the 3MS, was employed in dementia screening in the Cache County population”
The paper relies on this without support.
The missing MMSE scores and loss to follow-up did not substantially bias the estimated progression.
“Other limitations included the missing MMSE scores at baseline and/or follow-up owing to sensory/motor impairments among 9% of the sample, the lack of follow-up among 29% of the sample (mostly due to death(44)), and our cursory examination of the effects of anti-dementia medications on dementia progression.”
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Our findings suggest that women are at risk for delayed identification of cognitive decline, yet more rapid trajectory of decline, suggesting increased risk of dementia and disability compared with men, consistent with research showing that women with mild cognitive impairment or AD have faster cognitive decline than men.32,33”
From Sex differences in cognitive decline among US adults (2021) · cites this paper as [32]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“Sex is an important factor that contributes to the clinical and biological heterogeneities in Alzheimer’s disease (AD)”
From Sex-specific DNA methylation differences in Alzheimer’s disease pathology (2021) · cites this paper as [4]
Experimental — accuracy not yet measuredThe source backs part of the claim, not all of it — or backs it for a different population, condition or comparison.
In the citing paper
“After diagnosis, women also progress faster with more rapid cognitive and functional declines [3–8]”
From Sex-specific DNA methylation differences in Alzheimer’s disease pathology (2021) · cites this paper as [4]
Experimental — accuracy not yet measuredThe cited source says what the claim attributes to it.
In the citing paper
“Our findings are consistent with studies showing that women with mild cognitive impairment or AD have faster decline in global cognition than men.32,33”
From Sex differences in cognitive decline among US adults (2021) · cites this paper as [32]
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
Each contradiction between two passages listed here was confirmed by an independent check.
Conflicting percentages for participants without follow-up
MinorThe Results say 112 participants, or 34% of the cohort, lacked follow-up. The Discussion describes the lack of follow-up as affecting 29% of the sample.
“Individuals who lacked any follow-up numbered 112 (34%)”
“the lack of follow-up among 29% of the sample”
Citations
Cites
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Williams, J. B. W., & First, M. B. (2013) · Oxford University Press eBooks · doi:10.1093/acrefore/9780199975839.013.104 · Cited by 109,845
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“Measures of Dementia Progression The Mini-Mental State Exam (MMSE), a measure of global cognitive functioning,(22) was administered by trained neuropsychological technicians.”
MethodMcKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D., & Stadlan, E. M. (1984) · Neurology · doi:10.1212/wnl.34.7.939 · Cited by 27,915
The Neuropsychiatric Inventory: Comprehensive assessment of psychopathology in dementia
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A New Clinical Scale for the Staging of Dementia
Hughes, C. P., Berg, L., Danziger, W., Coben, L. A., & Martin, R. L. (1982) · British Journal of Psychiatry · doi:10.1192/bjp.140.6.566 · Cited by 7,056 · cited 2×
“The Clinical Dementia Rating (CDR(19)) is a measure of functional ability in six areas: memory, orientation, judgment/problem solving, community affairs, participation in home/ hobbies, and personal care.”
MethodDrake, M. M. (1988) · American Journal of Occupational Therapy · doi:10.5014/ajot.42.10.683b · Cited by 5,303
The Mini‐Mental State Examination: A Comprehensive Review
Tombaugh, T. N., & McIntyre, N. J. (1992) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1992.tb01992.x · Cited by 5,152 · cited 1×
“, MMSE) have been criticized for differential performance in classifying the cognitive status of individuals from different ages and educational backgrounds, and for significant floor effects when studying persons with severe dementia (reviewed in (43)).”
BackgroundJ Neuropsychiatry Clin Neurosci
Yudofsky, S. C., & Hales, R. E. (1992) · The Journal of Neuropsychiatry and Clinical Neurosciences · doi:10.1176/jnp.4.4.359 · Cited by 3,818
Association of apolipoprotein E allele ϵ4 with late‐onset familial and sporadic Alzheimer's disease
Saunders, A. M., Strittmatter, W. J., Schmechel, D., St. George-Hyslop, P. H., Pericak-Vance, M. A., Joo, S. H., Rosi, B. L., Gusella, J. F., Crapper-MacLachlan, D. R., Alberts, M. J., et al. (1993) · Neurology · doi:10.1212/wnl.43.8.1467 · Cited by 3,786
Forecasting the global burden of Alzheimer's disease
Brookmeyer, R., Johnson, E., Ziegler‐Graham, K., & Arrighi, H. M. (2007) · Alzheimer's & Dementia · doi:10.1016/j.jalz.2007.04.381 · Cited by 3,370 · cited 1×
“2 million by 2050,(1) unless a means of prevention can be identified.”
Background(1987) · PubMed · Cited by 2,657
Rate of memory decline in AD is related to education and occupation: Cognitive reserve?
Stern, Y., Albert, S., Tang, M.-X., & Tsai, W.-Y. (1999) · Neurology · doi:10.1212/wnl.53.9.1942 · Cited by 557
Morris, J. C., Edland, S., Clark, C., Galasko, D., Koss, E., Mohs, R., van Belle, G., Fillenbaum, G., & Heyman, A. (1993) · Neurology · doi:10.1212/wnl.43.12.2457 · Cited by 441
(1994) · American Journal of Psychiatry · doi:10.1176/ajp.151.3.390 · Cited by 408 · cited 1×
“Rate of decline is known to vary by stage of dementia severity,(8),(9) so that survival bias may produce different estimates in prevalent vs.”
BackgroundAPOE -ε4 count predicts age when prevalence of AD increases, then declines: The Cache County Study
Breitner, J. C. S., Wyse, B. W., Anthony, J. C., Welsh-Bohmer, K. A., Steffens, D. C., Norton, M. C., Tschanz, J. T., Plassman, B. L., Meyer, M. R., Skoog, I., et al. (1999) · Neurology · doi:10.1212/wnl.53.2.321 · Cited by 397
Self-citationVascular factors predict rate of progression in Alzheimer disease
Mielke, M. M., Rosenberg, P. B., Tschanz, J. T., Cook, L., Corcoran, C. M., Hayden, K. M., Norton, M. C., Rabins, P. V., Green, R. C., Welsh-Bohmer, K. A., et al. (2007) · Neurology · doi:10.1212/01.wnl.0000279520.59792.fe · Cited by 311
Self-citationPsychiatric Symptoms Vary With the Severity of Dementia in Probable Alzheimer's Disease
Lopez, O. L., Becker, J. T., Sweet, R. A., Klunk, W., Kaufer, D. I., Saxton, J., Habeych, M., & DeKosky, S. T. (2003) · The Journal of Neuropsychiatry and Clinical Neurosciences · doi:10.1176/jnp.15.3.346 · Cited by 286 · cited 1×
“(34) We also note that the occurrence of NPS varies with severity of dementia,(35) creating problems for cross-study comparisons, and that symptoms tend to be correlated.”
BackgroundLyketsos, C. G., Sheppard, J. E., Steinberg, M., Tschanz, J. A. T., Norton, M. C., Steffens, D. C., & Breitner, J. C. S. (2001) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.448 · Cited by 275 · cited 1×
“(34) We also note that the occurrence of NPS varies with severity of dementia,(35) creating problems for cross-study comparisons, and that symptoms tend to be correlated.(36) Hence, a global summary score may not be optimal for examining associations between NPS and other clinical features of AD.”
BackgroundSelf-citationA Validation Study of the Dementia Questionnaire
Kawas, C. H., Segal, J., Stewart, W. F., Corrada, M. M., & Thal, L. J. (1994) · Archives of Neurology · doi:10.1001/archneur.1994.00540210073015 · Cited by 231 · cited 1×
“This interview queried cognitive and functional impairments typical in dementia.(16) Participants whose interviews were suggestive of dementia or its prodrome, and those of the population subsample, were invited to undergo a clinical assessment (CA) by a trained research nurse and psychometric technician.”
MethodAPOE ε4 allele predicts faster cognitive decline in mild Alzheimer disease
Cosentino, S., Scarmeas, N., Helzner, E., Glymour, M. M., Brandt, J., Albert, M., Blacker, D., & Stern, Y. (2008) · Neurology · doi:10.1212/01.wnl.0000304038.37421.cc · Cited by 214
Han, L., Cole, M., Bellavance, F., McCusker, J., & Primeau, F. (2000) · International Psychogeriatrics · doi:10.1017/s1041610200006359 · Cited by 202 · cited 1×
“7).(30) To our knowledge, the Kungsholmen project is the only population-based study that has reported an ARC on the MMSE.”
BackgroundLyketsos, C. G., Galik, E. M., Steele, C., Steinberg, M., Rosenblatt, A., Warren, A., Leoutsakos, J., Baker, A. S., & Brandt, J. (1999) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1999.tb07245.x · Cited by 182 · cited 1×
“(20) Participants with suspected dementia were asked to undergo neuroimaging and laboratory studies as well as a geropsychiatric physician’s exam to provide differential diagnoses of dementia.”
MethodSelf-citationNEUROBEHAVIORAL AND NEUROPSYCHIATRIC SYMPTOMS IN ALZHEIMER'S DISEASE
Chung, J. A., & Cummings, J. L. (2000) · Neurologic Clinics · doi:10.1016/s0733-8619(05)70228-0 · Cited by 174 · cited 2×
“NPS in AD are marked by increasing incidence over time and by an episodic course.(4)”
BackgroundResultDementia: The leading predictor of death in a defined elderly population
Tschanz, J. T., Corcoran, C. M., Skoog, I. G., Khachaturian, A. S., Herrick, J. S., Hayden, K. M., Welsh-Bohmer, K. A., Calvert, T., Norton, M. C., Zandi, P. P., et al. (2004) · Neurology · doi:10.1212/01.wnl.0000118210.12660.c2 · Cited by 154
Self-citationAgüero‐Torres, H., Fratiglioni, L., Guo, Z., Viitanen, M., & Winblad, B. (1998) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1998.tb02464.x · Cited by 147 · cited 2×
“03 at the second follow-up after 3–7 more years).(31) We speculate that the Kungsholmen cases may not have entered the longitudinal analysis as shortly after diagnosis as the DPS cases, and that their case cohorts may therefore show some of the same phenomena (survival bias, entry into study when MMSE decline was more…”
BackgroundNorton, M. C., Piercy, K. W., Rabins, P. V., Green, R. C., Breitner, J. C. S., Ostbye, T., Corcoran, C., Welsh-Bohmer, K. A., Lyketsos, C. G., & Tschanz, J. T. (2009) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/gbp052 · Cited by 139
Self-citationEffects of Cardiovascular Medications on Rate of Functional Decline in Alzheimer Disease
Rosenberg, P. B., Mielke, M. M., Tschanz, J. T., Cook, L., Corcoran, C., Hayden, K. M., Norton, M. C., Rabins, P. V., Green, R. C., Welsh-Bohmer, K. A., et al. (2008) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e318181276a · Cited by 126
Self-citationPerson-specific paths of cognitive decline in Alzheimer's disease and their relation to age.
Wilson, R. S., Gilley, D. W., Bennett, D., Beckett, L. A., & Evans, D. A. (2000) · Psychology and Aging · doi:10.1037//0882-7974.15.1.18 · Cited by 120 · cited 1×
“We also assess the influence of several variables reported to affect progression, including age of onset, gender, education, and APOE genotype.(11),(12)”
BackgroundTschanz, J. T., Welsh-Bohmer, K. A., Plassman, B. L., Norton, M. C., Wyse, B. W., & Breitner, J. C. S. (2002) · PubMed · Cited by 117
Self-citationEducation, cognitive function, and severity of neuropathology in Alzheimer disease
Koepsell, T. D., Kurland, B. F., Harel, O., Johnson, E. A., Zhou, X. H., & Kukull, W. A. (2008) · Neurology · doi:10.1212/01.wnl.0000284603.85621.aa · Cited by 115 · cited 1×
“This finding contrasts with studies reporting more rapid decline among those with more years of education,(37) but is consistent with higher education conferring advantages early in the disease course.(38) Differences in results may also reflect sample differences in years of education and the timing of observations a…”
ResultCortes, F., Nourhashémi, F., Guérin, O., Cantet, C., Guyonnet, S., Andrieu, S., Ousset, P., Vellas, B. J., & REAL-FR Group (2008) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2007.10.018 · Cited by 106 · cited 1×
“By contrast, the multi-center French Network on Alzheimer Disease (REAL-FR) consisting of a volunteer sample of 686 individuals reported that 23% of their sample could be characterized as “slow” progressors.(27) The French study also reported that 89% of their participants were receiving treatment for AD (cf.”
ResultImpact of referral bias on clinical and epidemiological studies of Alzheimer's disease
Kokmen, E., Özsarfati, Y., Beard, C. M., O'Brien, P. C., & Rocca, W. A. (1996) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(95)00031-3 · Cited by 105 · cited 1×
“educational and occupational attainment, are more often married and living with a spouse, (5) are more likely to be carriers of the Apolipoprotein E (APOE) ε4 allele,(6) and tend to suffer from fewer co-morbid conditions.”
BackgroundRacial and Ethnic Disparities in the Treatment of Dementia Among Medicare Beneficiaries
Zuckerman, I. H., Ryder, P. T., Simoni-Wastila, L., Shaffer, T., Sato, M., Zhao, L., & Stuart, B. (2008) · The Journals of Gerontology Series B: Psychological Sciences and Social Sciences · doi:10.1093/geronb/63.5.s328 · Cited by 102 · cited 1×
“(28) Nonetheless, our analyses suggest that slow dementia progression is not attributable to treatment with anti-dementia medications.”
Massoud, F., Devi, G., Stern, Y., Lawton, A., Goldman, J. E., Liu, Y., Chin, S. S., & Mayeux, R. (1999) · Archives of Neurology · doi:10.1001/archneur.56.11.1368 · Cited by 91 · cited 1×
“educational and occupational attainment, are more often married and living with a spouse, (5) are more likely to be carriers of the Apolipoprotein E (APOE) ε4 allele,(6) and tend to suffer from fewer co-morbid conditions.(7) The few available population-based studies report lower ARCs in cognition or function.”
BackgroundClinical Features Distinguishing Large Cohorts with Possible AD, Probable AD, and Mixed Dementia
Corey‐Bloom, J., Galasko, D. R., Hofstetter, C. R., Jackson, J. E., & Thal, L. J. (1993) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1993.tb05944.x · Cited by 81 · cited 2×
“86) for Probable AD in patients at California AD Centers.(29) A meta-analysis of studies primarily from clinical/university research centers or hospitals reported a pooled ARC on the MMSE of of −3.”
BackgroundInfluentialPerson-specific paths of cognitive decline in Alzheimer's disease and their relation to age.
Wilson, R. S., Gilley, D. W., Bennett, D. A., et al. (2000) · Psychology and Aging · doi:10.1037/0882-7974.15.1.18 · Cited by 78
Treiber, K. A., Lyketsos, C. G., Corcoran, C., Steinberg, M., Norton, M., Green, R. C., Rabins, P., Stein, D. M., Welsh-Bohmer, K. A., Breitner, J. C. S., et al. (2008) · International Psychogeriatrics · doi:10.1017/s1041610208006704 · Cited by 73
Self-citationTsuang, D., Kukull, W., Sheppard, L., Barnhart, R. L., Peskind, E., Edland, S. D., Schellenberg, G., Raskind, M., & Larson, E. B. (1996) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1996.tb01836.x · Cited by 69
Dementia diagnoses from clinical and neuropsychological data compared
Tschanz, J. T., Welsh-Bohmer, K. A., Skoog, I. G., West, N., Norton, M. C., Wyse, B. W., Nickles, R., & Breitner, J. C. S. (2000) · Neurology · doi:10.1212/wnl.54.6.1290 · Cited by 67 · cited 1×
“The CA included a structured physical and neurological examination and a battery of neuropsychological tests.(17) A knowledgeable informant provided information regarding the participant’s history of cognitive or functional impairment, medical history, and psychiatric symptoms.”
MethodSelf-citationPredictors of Cognitive Decline in the Early Stage of Probable Alzheimer’s Disease
Marra, C., Silveri, M. C., & Gainotti, G. (2000) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000017239 · Cited by 53 · cited 1×
“, (25),(26)), but studies of incident cases from populations are lacking.”
BackgroundProgress in Clinical Neurosciences: Cognitive Markers of Progression in Alzheimer's Disease
Behl, P., Stefurak, T. L., & Black, S. E. (2005) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/s0317167100003917 · Cited by 43 · cited 1×
“4 points.(2) Similar variability is seen in functional decline,(3) although comparisons across studies are impeded by differences in instrumentation.”
BackgroundPrognosis of Alzheimer’s Disease: The Rotterdam Study
Ruitenberg, A., Kalmijn, S., de Ridder, M. A. J., Redekop, W. K., van Harskamp, F., Hofman, A., Launer, L. J., & Breteler, M. M. B. (2001) · Neuroepidemiology · doi:10.1159/000054786 · Cited by 41 · cited 1×
“incident samples.(10) Furthermore, few studies have examined cognition, function, and NPS simultaneously, so their descriptions of AD progression are incomplete.”
BackgroundJohnsen, S., Hughes, S., Bullock, R. A., et al. (2003) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000072813 · Cited by 8 · cited 1×
“, (25),(26)), but studies of incident cases from populations are lacking.”
BackgroundCorcoran, C. D., Pieper, C. F., Zandi, P. P., et al. (2008) · Alzheimer s & Dementia · doi:10.1016/j.jalz.2008.05.969 · Cited by 3 · cited 1×
“Alternate methods that characterize the non-linear nature of progression in each domain may reveal stronger associations.(34) We also note that the occurrence of NPS varies with severity of dementia,(35) creating problems for cross-study comparisons, and that symptoms tend to be correlated.”
MethodSelf-citation
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Dementia prevention, intervention, and care
Livingston, G., Sommerlad, A., Orgeta, V., Costafreda, S. G., Huntley, J., Ames, D., Ballard, C., Banerjee, S., Burns, A., Cohen-Mansfield, J., et al. (2017) · The Lancet · doi:10.1016/s0140-6736(17)31363-6 · Cited by 6,072
Defeating Alzheimer's disease and other dementias: a priority for European science and society
Winblad, B., Amouyel, P., Andrieu, S., Ballard, C., Brayne, C., Brodaty, H., Cedazo-Minguez, A., Dubois, B., Edvardsson, D., Feldman, H., et al. (2016) · The Lancet Neurology · doi:10.1016/s1474-4422(16)00062-4 · Cited by 1,676
Behavioral and psychological symptoms of dementia
Cerejeira, J., Lagarto, L., & Mukaetova-Ladinska, E. B. (2012) · Frontiers in Neurology · doi:10.3389/fneur.2012.00073 · Cited by 1,425
Education and cognitive functioning across the life span
Lövdén, M., Fratiglioni, L., Glymour, M. M., Lindenberger, U., & Tucker-Drob, E. M. (2020) · Psychological Science in the Public Interest · doi:10.1177/1529100620920576 · Cited by 1,224
“Three studies (total N = 587) reported no education-related differences in declines in performance on the MMSE (Aguero-Torres, Fratiglioni, Guo, Viitanen, & Winblad, 1998; Small, Viitanen, Winblad, & Bäckman, 1997; Tschanz et al., 2011).”
BackgroundInfluentialClinical epidemiology of Alzheimer’s disease: assessing sex and gender differences
Mielke, M., Vemuri, P., & Rocca, W. (2014) · Clinical Epidemiology · doi:10.2147/clep.s37929 · Cited by 1,021
“Interestingly, women also have a faster rate of cognitive and functional decline after a diagnosis of AD.(63,64)”
Self-citation
Metadata
- Authors
- Tschanz, J. T., Corcoran, C. D., Schwartz, S., Treiber, K., Green, R. C., Norton, M. C., Mielke, M. M., Piercy, K., Steinberg, M., Rabins, P. V., Leoutsakos, J.-M., Welsh-Bohmer, K. A., Breitner, J. C. S., & Lyketsos, C. G.
- Affiliations
- Utah State University (US)
- Boston University (US)
- Johns Hopkins University (US)
- Duke University (US)
- University of Washington (US)
- Corresponding author
- Tschanz, JoAnn T.
- ORCID
- Venue
- The American Journal of Geriatric Psychiatry
- Publisher
- Elsevier BV
- Published
- 2011-06
- Volume
- 19
- Issue
- 6
- Pages
- 532-542
- ISSN
- 1064-7481 (ISSN-L)
- PMC
- PMC3101372
- OpenAlex
- W2014196617
- Semantic Scholar
- f0884283b020871180f9799273ae1011ce074273
- Cited by
- 244
- References
- 48
- Citations by year
- 2026: 7 · 2025: 13 · 2024: 8 · 2023: 11 · 2022: 21 · 2021: 23 · 2020: 24 · 2019: 14 · 2018: 17 · 2017: 21 · 2016: 16 · 2015: 22 · 2014: 11 · 2013: 13 · 2012: 19
- FWCI
- 6.96
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- American Journal of Geriatric Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (submittedVersion)
- PubMed Central (submittedVersion)
- Funders
- National Institutes of Health (5p30ag028377-05)
- National Institute on Aging (R01 AG 11380, T32AG 027668, P-30 AG028377, R01AG018712, R01 AG011380, R01AG021136, R01 AG18712, K24AG027841, P30AG013846, R01 AG 21136, P30-AG13846))
- National Human Genome Research Institute (R01 HG02213, R01 HG002213)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Oncology › Cancer-related cognitive impairment studies
- Keywords
- Alzheimer's disease, dementia progression, cognitive decline, functional decline, neuropsychiatric symptoms, Mini-Mental State Examination, Clinical Dementia Rating, Neuropsychiatric Inventory, sex differences, age of onset, APOE ε4, population-based cohort
- MeSH terms
- Aged, 80 and over, Alleles, Alzheimer Disease, Cognition Disorders, Female, Humans, Male, Psychiatric Status Rating Scales, Sex Characteristics, Utah, Cohort Studies, Age of Onset, Disease Progression, Apolipoprotein E4
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.
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