Understanding and predicting the longitudinal course of dementia

Abstract

Purpose of review To date, most research in dementia has focused either on the identification of dementia risk prediction or on understanding changes and predictors experienced by individuals before diagnosis. Despite little is known about how individuals change after dementia diagnosis, there is agreement that changes occur over different time scales and are multidomain. In this study, we present an overview of the literature regarding the longitudinal course of dementia. Recent findings Our review suggests the evidence is scarce and findings reported are often inconsistent. We identified large heterogeneity in dementia trajectories, risk factors considered and modelling approaches employed. The heterogeneity of dementia trajectories also varies across outcomes and domains investigated.

Orthostatic Blood Pressure Recovery Is Associated With the Rate of Cognitive Decline and Mortality in Clinical Alzheimer’s Disease

“…Irrespective of the pathophysiology, our work has clear clinical relevance because it provides the field with an easily performable test to identify a higher risk of disease progression. The clinical course of AD is known to be very heterogenous and being able to identify factors associated with accelerated decline can help care providers and families of people with dementia ( 1 ).…”

“…With increasing numbers of people to be affected by Alzheimer’s disease (AD) and in the absence of drugs that have a disease-modifying effect, there also is an increasing need to identify potentially modifiable factors that predict the longitudinal course of the disease ( 1 ). The progression of AD is very heterogenous, and understanding which factors contribute to this can identify targets for disease modification, help clinical decision making, and inform patients and their families ( 2 ).…”

Cognitive and functional progression of dementia in two longitudinal studies

“…However, we did not observe any differences in duration of education across the identified classes within each dataset (Table ). Importantly, persons with dementia may change over the course of the dementia: They may or may not develop additional comorbidity or frailty, and these intercurrent exposures may result in more variable disease courses …”

The Role of Macrophage Migration Inhibitory Factor in Alzheimer′s Disease: Conventionally Pathogenetic or Unconventionally Protective?

“…AD usually appears in a subacute manner in the preclinical phase characterized by reduced memory, cognition, and multiple personality changes. The course of the disease is usually progressive over a different period of time ranging from mild cognitive impairment to overt dementia that leads to complete cognitive impairment and physical disability and death, due to immobility [4,5] (Figure 1). From the histopathological point of view, atrophy of the cerebral cortex and loss of neurons, associated with the presence of amyloid-β (Aβ) plaques and neurofibrillary tangles (NFTs), are the main features of AD [3].…”