The Consortium to Establish a Registry for Alzheimer's Disease (CERAD): Part IV. Rates of cognitive change in the longitudinal assessment of probable Alzheimer's disease
Abstract
Reliable information on rate of progression of cognitive impairment in probable Alzheimer's disease (AD) is important for evaluating possible beneficial effects of therapeutic agents and in planning long-term care for patients with this chronic illness. However, wide variability exists in published rates of change for psychometric measures of the dementing process, and there is need for an accurate analysis of large numbers of persons with the disorder studied over long periods. Utilizing the large, well-characterized sample of the Consortium to Establish a Registry for Alzheimer's Disease and employing a least squares regression method to adjust for different levels of impairment and periods of observation, we report rates of change on the Short Blessed Test, Mini-Mental State Examination, Blessed Dementia Scale, Clinical Dementia Rating, and other cognitive measures in 430 patients with probable AD (mean age at entry = 70.9 +/- 8.0 SD years) studied for up to 4 years. We found that rate-of-change determinations are less reliable when the observation period is 1 year or less, that dementia progression may be nonlinear when described by certain measures, and that simple change scores do not accurately characterize the rate of decline. We also found that rate of progression in AD is determined by the severity of cognitive impairment: the less severe the dementia, the slower the rate of decline.
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Without any treatment, an individual with a diagnosis of mild dementia of Alzheimer's disease would progressively worsen into severe dementia in about 3 years.
“Without any treatment, an individual with a diagnosis of mild dementia of AD would progressively worsen into severe dementia in about 3 years.8”
From A 2025 update on treatment strategies for the Alzheimer’s disease spectrum (2025) · cites this paper as [8]
Rate of decline is known to vary by stage of dementia severity.
“Rate of decline is known to vary by stage of dementia severity,(8),(9)”
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White, H., Pieper, C., & Schmader, K. (1998) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1998.tb04537.x · Cited by 323 · see citing works
Clark, C. M. (1999) · Archives of Neurology · doi:10.1001/archneur.56.7.857 · Cited by 298 · see citing works
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Aevarsson, Ó., & Skoog, I. (2000) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000017231 · Cited by 94 · see citing works
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Haldenwanger, A., Eling, P., Kastrup, A., & Hildebrandt, H. (2010) · Journal of Alzheimer's Disease · doi:10.3233/jad-2010-101203 · Cited by 54 · see citing works
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Gillette-Guyonnet, S., Andrieu, S., Cortes, F., Nourhashemi, F., Cantet, C., Ousset, P.-J., Reynish, E., Grandjean, H., & Vellas, B. (2006) · The Journals of Gerontology Series A: Biological Sciences and Medical Sciences · doi:10.1093/gerona/61.5.516 · Cited by 41 · see citing works
Stein, J., Luppa, M., Luck, T., Maier, W., Wagner, M., Daerr, M., van den Bussche, H., Zimmermann, T., Köhler, M., Bickel, H., et al. (2012) · The American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e318209dd08 · Cited by 35 · see citing works
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- Authors
- Morris, J. C., Edland, S., Clark, C., Galasko, D., Koss, E., Mohs, R., van Belle, G., Fillenbaum, G., & Heyman, A.
- Affiliations
- Duke University (US)
- Washington University School of Medicine (Dr. Morris), St. Louis, MO; the University of Washington (S. Edland and Dr. van Belle), Seattle, WA; the University of Pennsylvania (Dr. Clark), Philadelphia, PA; the University of California at San Diego (Dr. Galasko), La Jolla, CA, Case Western Reserve University (Dr. Koss), Cleveland, OH; Mount Sinai/Bronx Veterans Administration Medical Center (Dr. Mohs), New York, NY; and Duke University Medical Center (Drs. Fillenbaum and Heyman), Durham, NC.
- Venue
- Neurology
- Published
- 1993-12
- Volume
- 43
- Issue
- 12
- Pages
- 2457-2457
- ISSN
- 0028-3878 (ISSN-L)
- 1526-632X
- OpenAlex
- W2128136330
- Cited by
- 441
- References
- 0
- Citations by year
- 2026: 3 · 2025: 6 · 2024: 20 · 2023: 10 · 2022: 5 · 2021: 12 · 2020: 11 · 2019: 9 · 2018: 12 · 2017: 16 · 2016: 10 · 2015: 12 · 2014: 9 · 2013: 11 · 2012: 10
- FWCI
- 12.54
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Neurology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute on Aging (NIA AG 0670)
- 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
- Alzheimer's disease, dementia progression, Mini-Mental State Examination, Clinical Dementia Rating, cognitive impairment severity, longitudinal cognitive assessment
- MeSH terms
- Aged, Alzheimer Disease, Cognition, Female, Humans, Longitudinal Studies, Male, Memory, Mental Status Schedule, Neuropsychological Tests, Registries, Severity of Illness Index, Cohort Studies
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