Cognitive and functional progression of dementia in two longitudinal studies

Yuwei Wang, Miriam L Haaksma, Inez H G B Ramakers, Frans R J Verhey, Wiesje M van de Flier, Philip Scheltens, Ingrid van Maurik, Marcel G M Olde Rikkert, Jeannie-Marie S Leoutsakos, René J F Melis

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

OBJECTIVES: Previous studies have identified several subgroups (ie, latent trajectories) with distinct disease progression among people with dementia. However, the methods and results were not always consistent. This study aims to perform a coordinated analysis of latent trajectories of cognitive and functional progression in dementia across two datasets.

METHODS: Included and analyzed using the same statistical approach were 1628 participants with dementia from the US National Alzheimer's Coordinating Center (NACC) and 331 participants with dementia from the Dutch Clinical Course of Cognition and Comorbidity study (4C-Study). Trajectories of cognition and instrumental activities of daily living (IADL) were modeled jointly in a parallel-process growth mixture model.

RESULTS: Cognition and IADL tended to decline in unison across the two samples. Slow decline in both domains was observed in 26% of the US sample and 74% of the Dutch sample. Rapid decline in cognition and IADL was observed in 7% of the US sample and 26% of the Dutch sample. The majority (67%) of the US sample showed moderate cognitive decline and rapid IADL decline.

CONCLUSIONS: Trajectories of slow and rapid dementia progression were identified in both samples. Despite using the same statistical methods, the number of latent trajectories was not replicated and the relative class sizes differed considerably across datasets. These results call for careful consideration when comparing progression estimates in the literature. In addition, the observed discrepancy between cognitive and functional decline stresses the need to monitor dementia progression across multiple domains.

Original languageEnglish
JournalInternational Journal of Geriatric Psychiatry
DOIs
Publication statusE-pub ahead of print - 18 Jul 2019

Cite this

Wang, Y., Haaksma, M. L., Ramakers, I. H. G. B., Verhey, F. R. J., van de Flier, W. M., Scheltens, P., ... Melis, R. J. F. (2019). Cognitive and functional progression of dementia in two longitudinal studies. International Journal of Geriatric Psychiatry. https://doi.org/10.1002/gps.5175
Wang, Yuwei ; Haaksma, Miriam L ; Ramakers, Inez H G B ; Verhey, Frans R J ; van de Flier, Wiesje M ; Scheltens, Philip ; van Maurik, Ingrid ; Olde Rikkert, Marcel G M ; Leoutsakos, Jeannie-Marie S ; Melis, René J F. / Cognitive and functional progression of dementia in two longitudinal studies. In: International Journal of Geriatric Psychiatry. 2019.
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title = "Cognitive and functional progression of dementia in two longitudinal studies",
abstract = "OBJECTIVES: Previous studies have identified several subgroups (ie, latent trajectories) with distinct disease progression among people with dementia. However, the methods and results were not always consistent. This study aims to perform a coordinated analysis of latent trajectories of cognitive and functional progression in dementia across two datasets.METHODS: Included and analyzed using the same statistical approach were 1628 participants with dementia from the US National Alzheimer's Coordinating Center (NACC) and 331 participants with dementia from the Dutch Clinical Course of Cognition and Comorbidity study (4C-Study). Trajectories of cognition and instrumental activities of daily living (IADL) were modeled jointly in a parallel-process growth mixture model.RESULTS: Cognition and IADL tended to decline in unison across the two samples. Slow decline in both domains was observed in 26{\%} of the US sample and 74{\%} of the Dutch sample. Rapid decline in cognition and IADL was observed in 7{\%} of the US sample and 26{\%} of the Dutch sample. The majority (67{\%}) of the US sample showed moderate cognitive decline and rapid IADL decline.CONCLUSIONS: Trajectories of slow and rapid dementia progression were identified in both samples. Despite using the same statistical methods, the number of latent trajectories was not replicated and the relative class sizes differed considerably across datasets. These results call for careful consideration when comparing progression estimates in the literature. In addition, the observed discrepancy between cognitive and functional decline stresses the need to monitor dementia progression across multiple domains.",
author = "Yuwei Wang and Haaksma, {Miriam L} and Ramakers, {Inez H G B} and Verhey, {Frans R J} and {van de Flier}, {Wiesje M} and Philip Scheltens and {van Maurik}, Ingrid and {Olde Rikkert}, {Marcel G M} and Leoutsakos, {Jeannie-Marie S} and Melis, {Ren{\'e} J F}",
note = "{\circledC} 2019 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.",
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Wang, Y, Haaksma, ML, Ramakers, IHGB, Verhey, FRJ, van de Flier, WM, Scheltens, P, van Maurik, I, Olde Rikkert, MGM, Leoutsakos, J-MS & Melis, RJF 2019, 'Cognitive and functional progression of dementia in two longitudinal studies' International Journal of Geriatric Psychiatry. https://doi.org/10.1002/gps.5175

Cognitive and functional progression of dementia in two longitudinal studies. / Wang, Yuwei; Haaksma, Miriam L; Ramakers, Inez H G B; Verhey, Frans R J; van de Flier, Wiesje M; Scheltens, Philip; van Maurik, Ingrid; Olde Rikkert, Marcel G M; Leoutsakos, Jeannie-Marie S; Melis, René J F.

In: International Journal of Geriatric Psychiatry, 18.07.2019.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Cognitive and functional progression of dementia in two longitudinal studies

AU - Wang, Yuwei

AU - Haaksma, Miriam L

AU - Ramakers, Inez H G B

AU - Verhey, Frans R J

AU - van de Flier, Wiesje M

AU - Scheltens, Philip

AU - van Maurik, Ingrid

AU - Olde Rikkert, Marcel G M

AU - Leoutsakos, Jeannie-Marie S

AU - Melis, René J F

N1 - © 2019 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.

PY - 2019/7/18

Y1 - 2019/7/18

N2 - OBJECTIVES: Previous studies have identified several subgroups (ie, latent trajectories) with distinct disease progression among people with dementia. However, the methods and results were not always consistent. This study aims to perform a coordinated analysis of latent trajectories of cognitive and functional progression in dementia across two datasets.METHODS: Included and analyzed using the same statistical approach were 1628 participants with dementia from the US National Alzheimer's Coordinating Center (NACC) and 331 participants with dementia from the Dutch Clinical Course of Cognition and Comorbidity study (4C-Study). Trajectories of cognition and instrumental activities of daily living (IADL) were modeled jointly in a parallel-process growth mixture model.RESULTS: Cognition and IADL tended to decline in unison across the two samples. Slow decline in both domains was observed in 26% of the US sample and 74% of the Dutch sample. Rapid decline in cognition and IADL was observed in 7% of the US sample and 26% of the Dutch sample. The majority (67%) of the US sample showed moderate cognitive decline and rapid IADL decline.CONCLUSIONS: Trajectories of slow and rapid dementia progression were identified in both samples. Despite using the same statistical methods, the number of latent trajectories was not replicated and the relative class sizes differed considerably across datasets. These results call for careful consideration when comparing progression estimates in the literature. In addition, the observed discrepancy between cognitive and functional decline stresses the need to monitor dementia progression across multiple domains.

AB - OBJECTIVES: Previous studies have identified several subgroups (ie, latent trajectories) with distinct disease progression among people with dementia. However, the methods and results were not always consistent. This study aims to perform a coordinated analysis of latent trajectories of cognitive and functional progression in dementia across two datasets.METHODS: Included and analyzed using the same statistical approach were 1628 participants with dementia from the US National Alzheimer's Coordinating Center (NACC) and 331 participants with dementia from the Dutch Clinical Course of Cognition and Comorbidity study (4C-Study). Trajectories of cognition and instrumental activities of daily living (IADL) were modeled jointly in a parallel-process growth mixture model.RESULTS: Cognition and IADL tended to decline in unison across the two samples. Slow decline in both domains was observed in 26% of the US sample and 74% of the Dutch sample. Rapid decline in cognition and IADL was observed in 7% of the US sample and 26% of the Dutch sample. The majority (67%) of the US sample showed moderate cognitive decline and rapid IADL decline.CONCLUSIONS: Trajectories of slow and rapid dementia progression were identified in both samples. Despite using the same statistical methods, the number of latent trajectories was not replicated and the relative class sizes differed considerably across datasets. These results call for careful consideration when comparing progression estimates in the literature. In addition, the observed discrepancy between cognitive and functional decline stresses the need to monitor dementia progression across multiple domains.

U2 - 10.1002/gps.5175

DO - 10.1002/gps.5175

M3 - Article

JO - International Journal of Geriatric Psychiatry

JF - International Journal of Geriatric Psychiatry

SN - 0885-6230

ER -