Accelerated Weight Loss May Precede Diagnosis in Alzheimer Disease

Johnson, David K.; Wilkins, Consuelo H.; Morris, John C.

doi:10.1001/archneur.63.9.1312

Cited by 281 publications

(215 citation statements)

References 65 publications

(91 reference statements)

Supporting

Mentioning

192

Contrasting

Unclassified

Order By: Relevance

“…Our result regarding weight loss being associated with increased dementia related mortality risk fits with studies using clinical dementia as end point (10)(11)(12)(13)(14)(15)(16)(17)(18). Most previous studies investigate weight change in old age, typically above 65 years or older, where reverse causality might be a plausible explanation for the association between weight loss and dementia.…”

Section: Discussionsupporting

confidence: 86%

“…A better understanding of the association between body weight and dementia may be achieved by studying weight trajectories and patterns from midlife into old age (1). Studies with weight at multiple time points have generally reported weight loss (10)(11)(12)(13)(14)(15)(16)(17)(18) or weight instability (19) to be associated with increased dementia risk. However, many of these studies are limited to weight trajectories in old age, and might be prone to reverse causality because dementia and preclinical dementia might cause weight loss (1,20).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Weight Change in Midlife and Risk of Mortality From Dementia up to 35 Years Later

Strand

Wills

Langballe

et al. 2016

GERONA

View full text Add to dashboard Cite

Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 99%

Weight Change in Midlife and Risk of Mortality From Dementia up to 35 Years Later

Strand

Wills

Langballe

et al. 2016

GERONA

View full text Add to dashboard Cite

“…34,35 There are also somatic changes that precede the onset of dementia that may provide important clues, including accelerated weight loss, 36 gait disturbances, physical frailty, 37 and slowed psychomotor speed 36 (Table 1). Memory complaints are thus the most reliable and easiest to test for signs of early AD.…”

Section: Ad Diagnosis Algorithmmentioning

confidence: 99%

Practical Guidelines for the Recognition and Diagnosis of Dementia

Galvin

Sadowsky²

2012

The Journal of the American Board of Family Medicine

156

120

View full text Add to dashboard Cite

To date, user-friendly, practical guidelines for dementia have not been available for busy family physicians. However, the growing number of patients with dementia means that primary care physicians will have an increasingly important role in the diagnosis and subsequent management of dementia. This article provides practical guidance for the recognition and diagnosis of dementia and is aimed at family physicians, who are usually the first clinicians to whom patients present with dementia symptoms. Because Alzheimer disease (AD) is the most common form of dementia, this condition is the main focus of this article. We review the pathophysiology of AD and discuss recommended diagnostic protocols and the importance of early diagnosis. An AD diagnostic algorithm is provided, with clearly defined steps for screening and diagnosing AD and assessing daily functioning, behavioral symptoms, and caregiver sta- Dementia: an OverviewAlzheimer disease (AD) is the most common form of dementia, accounting for approximately 60% of all cases, 1,2 and it is therefore the main focus of this article. AD destroys brain cells, causing problems with memory, thinking, and behavior severe enough to affect work, family, and social relationships and, eventually, the most basic activities of daily living (ADLs). AD and related disorders are a growing public health problem in the United States, with a prevalence ranging from 3% to 11% among people aged 65 years and older and from 25% to 47% among those aged older than 85 years. 3,4 There are an estimated 5.3 million cases of dementia in the United States, 5 and this number is expected to increase to 18.5 million by 2050. 6 The number of those afflicted is increasing annually as a result of the aging population. Dementia leads to a high burden of suffering for patients, families, and society, with an annual estimated cost of $172 billion. 5 People with dementia usually present first to their family physician, although an estimated 39% present to specialist clinics (neurologists, psychiatrists and geriatricians). 7 The primary care physician (PCP) is often the first physician to observe patients with possible dementia and often the only physician involved in making the diagnosis. 8 Because of the key role that PCPs play in the longterm management of elderly individuals with chronic disease, the growing number of patients with dementia will have a significant impact on these health professionals. 9 The rising number of patients with dementia means that family physicians will have an increasingly important role in recognizing early signs and symptoms of disease, ordering appropriate tests, formally diagnosing, and, finally, treating these patients. However, at present, diagnosing AD can be Funding: none. Conflict of interest:Dr Sadowsky has served as a consultant to Novartis Pharmaceuticals Corporation, has served as a speaker for Novartis Pharmaceuticals Corporation and Forest Pharmaceuticals and Accera, and has received honoraria from these companies. James E Galvin is a paid consultant for ...

show abstract

“…In a sample of clinically well-characterized older adults who were cognitively healthy at enrollment, an acceleration in the rate of weight loss was a harbinger of the change from nondemented status to AD [9]. Luchsinger et al also reported a relation between weight loss and a higher dementia risk in an elderly sample (hazard ratio: 1.8; 95% confidence interval: 1.2-2.9) [10].…”

mentioning

confidence: 98%