Differences in rate of functional decline across three dementia types

Dawn P. Gill, Rebecca A. Hubbard, Thomas D. Koepsell, Michael J. Borrie, Robert J. Petrella, David S Knopman, Walter A. Kukull

Research output: Contribution to journalArticle

17 Citations (Scopus)

Abstract

Background: The purpose of this study was to estimate differences in rates of functional decline in Alzheimer's disease (AD), dementia with Lewy bodies (DLB), and vascular dementia (VaD) and whether differences vary by age or sex. Methods: Data came from 32 U.S. Alzheimer's Disease Centers. The cohort of participants (n = 5848) were ≥60 years of age and had clinical dementia with a primary etiologic diagnosis of probable AD, DLB, or probable VaD; a Clinical Dementia Rating-Sum of Boxes score <16; and a duration of symptoms ≤10 years. Dementia diagnoses were assigned using standard criteria. Annual mean rate of change of the Functional Activities Questionnaire (FAQ) score was modeled using multiple linear regression with generalized estimating equations adjusted for demographics, comorbidities, years since onset, and cognitive status (mean follow-up = 2.0 years). Results: FAQ declined more slowly over time in those with VaD compared with AD (difference in mean annual rate of change: -0.91; 95% confidence interval [CI]: -1.68, -0.14). VaD participants also declined at a slower rate than DLB participants, but this difference was not statistically significant (-0.61; 95% CI: -1.45, 0.24). There was no significant difference between DLB and AD. Within each group, rate of decline was more rapid for the youngest participants. Conclusions: In this sample, findings suggested that VaD patients declined in their functional abilities at a slower rate compared with AD patients and that there were no significant differences in rate of functional decline between patients with DLB compared with those with either AD or VaD. These results may provide guidance to clinicians about average expected rates of functional decline in three common dementia types.

Original languageEnglish (US)
JournalAlzheimer's and Dementia
Volume9
Issue number5 SUPPL.
DOIs
StatePublished - Oct 2013

Fingerprint

Dementia
Alzheimer Disease
Vascular Dementia
Lewy Body Disease
Confidence Intervals
Lewy Bodies
Aptitude
Comorbidity
Linear Models
Demography

Keywords

  • Alzheimer's disease
  • Dementia with Lewy bodies
  • Disease progression
  • Functional decline
  • Instrumental activities of daily living
  • Vascular dementia

ASJC Scopus subject areas

  • Health Policy
  • Epidemiology
  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Cellular and Molecular Neuroscience
  • Developmental Neuroscience
  • Clinical Neurology

Cite this

Gill, D. P., Hubbard, R. A., Koepsell, T. D., Borrie, M. J., Petrella, R. J., Knopman, D. S., & Kukull, W. A. (2013). Differences in rate of functional decline across three dementia types. Alzheimer's and Dementia, 9(5 SUPPL.). https://doi.org/10.1016/j.jalz.2012.10.010

Differences in rate of functional decline across three dementia types. / Gill, Dawn P.; Hubbard, Rebecca A.; Koepsell, Thomas D.; Borrie, Michael J.; Petrella, Robert J.; Knopman, David S; Kukull, Walter A.

In: Alzheimer's and Dementia, Vol. 9, No. 5 SUPPL., 10.2013.

Research output: Contribution to journalArticle

Gill, DP, Hubbard, RA, Koepsell, TD, Borrie, MJ, Petrella, RJ, Knopman, DS & Kukull, WA 2013, 'Differences in rate of functional decline across three dementia types', Alzheimer's and Dementia, vol. 9, no. 5 SUPPL.. https://doi.org/10.1016/j.jalz.2012.10.010
Gill, Dawn P. ; Hubbard, Rebecca A. ; Koepsell, Thomas D. ; Borrie, Michael J. ; Petrella, Robert J. ; Knopman, David S ; Kukull, Walter A. / Differences in rate of functional decline across three dementia types. In: Alzheimer's and Dementia. 2013 ; Vol. 9, No. 5 SUPPL.
@article{5f8eeee8a43a4722aaf1354c6ebc364c,
title = "Differences in rate of functional decline across three dementia types",
abstract = "Background: The purpose of this study was to estimate differences in rates of functional decline in Alzheimer's disease (AD), dementia with Lewy bodies (DLB), and vascular dementia (VaD) and whether differences vary by age or sex. Methods: Data came from 32 U.S. Alzheimer's Disease Centers. The cohort of participants (n = 5848) were ≥60 years of age and had clinical dementia with a primary etiologic diagnosis of probable AD, DLB, or probable VaD; a Clinical Dementia Rating-Sum of Boxes score <16; and a duration of symptoms ≤10 years. Dementia diagnoses were assigned using standard criteria. Annual mean rate of change of the Functional Activities Questionnaire (FAQ) score was modeled using multiple linear regression with generalized estimating equations adjusted for demographics, comorbidities, years since onset, and cognitive status (mean follow-up = 2.0 years). Results: FAQ declined more slowly over time in those with VaD compared with AD (difference in mean annual rate of change: -0.91; 95{\%} confidence interval [CI]: -1.68, -0.14). VaD participants also declined at a slower rate than DLB participants, but this difference was not statistically significant (-0.61; 95{\%} CI: -1.45, 0.24). There was no significant difference between DLB and AD. Within each group, rate of decline was more rapid for the youngest participants. Conclusions: In this sample, findings suggested that VaD patients declined in their functional abilities at a slower rate compared with AD patients and that there were no significant differences in rate of functional decline between patients with DLB compared with those with either AD or VaD. These results may provide guidance to clinicians about average expected rates of functional decline in three common dementia types.",
keywords = "Alzheimer's disease, Dementia with Lewy bodies, Disease progression, Functional decline, Instrumental activities of daily living, Vascular dementia",
author = "Gill, {Dawn P.} and Hubbard, {Rebecca A.} and Koepsell, {Thomas D.} and Borrie, {Michael J.} and Petrella, {Robert J.} and Knopman, {David S} and Kukull, {Walter A.}",
year = "2013",
month = "10",
doi = "10.1016/j.jalz.2012.10.010",
language = "English (US)",
volume = "9",
journal = "Alzheimer's and Dementia",
issn = "1552-5260",
publisher = "Elsevier Inc.",
number = "5 SUPPL.",

}

TY - JOUR

T1 - Differences in rate of functional decline across three dementia types

AU - Gill, Dawn P.

AU - Hubbard, Rebecca A.

AU - Koepsell, Thomas D.

AU - Borrie, Michael J.

AU - Petrella, Robert J.

AU - Knopman, David S

AU - Kukull, Walter A.

PY - 2013/10

Y1 - 2013/10

N2 - Background: The purpose of this study was to estimate differences in rates of functional decline in Alzheimer's disease (AD), dementia with Lewy bodies (DLB), and vascular dementia (VaD) and whether differences vary by age or sex. Methods: Data came from 32 U.S. Alzheimer's Disease Centers. The cohort of participants (n = 5848) were ≥60 years of age and had clinical dementia with a primary etiologic diagnosis of probable AD, DLB, or probable VaD; a Clinical Dementia Rating-Sum of Boxes score <16; and a duration of symptoms ≤10 years. Dementia diagnoses were assigned using standard criteria. Annual mean rate of change of the Functional Activities Questionnaire (FAQ) score was modeled using multiple linear regression with generalized estimating equations adjusted for demographics, comorbidities, years since onset, and cognitive status (mean follow-up = 2.0 years). Results: FAQ declined more slowly over time in those with VaD compared with AD (difference in mean annual rate of change: -0.91; 95% confidence interval [CI]: -1.68, -0.14). VaD participants also declined at a slower rate than DLB participants, but this difference was not statistically significant (-0.61; 95% CI: -1.45, 0.24). There was no significant difference between DLB and AD. Within each group, rate of decline was more rapid for the youngest participants. Conclusions: In this sample, findings suggested that VaD patients declined in their functional abilities at a slower rate compared with AD patients and that there were no significant differences in rate of functional decline between patients with DLB compared with those with either AD or VaD. These results may provide guidance to clinicians about average expected rates of functional decline in three common dementia types.

AB - Background: The purpose of this study was to estimate differences in rates of functional decline in Alzheimer's disease (AD), dementia with Lewy bodies (DLB), and vascular dementia (VaD) and whether differences vary by age or sex. Methods: Data came from 32 U.S. Alzheimer's Disease Centers. The cohort of participants (n = 5848) were ≥60 years of age and had clinical dementia with a primary etiologic diagnosis of probable AD, DLB, or probable VaD; a Clinical Dementia Rating-Sum of Boxes score <16; and a duration of symptoms ≤10 years. Dementia diagnoses were assigned using standard criteria. Annual mean rate of change of the Functional Activities Questionnaire (FAQ) score was modeled using multiple linear regression with generalized estimating equations adjusted for demographics, comorbidities, years since onset, and cognitive status (mean follow-up = 2.0 years). Results: FAQ declined more slowly over time in those with VaD compared with AD (difference in mean annual rate of change: -0.91; 95% confidence interval [CI]: -1.68, -0.14). VaD participants also declined at a slower rate than DLB participants, but this difference was not statistically significant (-0.61; 95% CI: -1.45, 0.24). There was no significant difference between DLB and AD. Within each group, rate of decline was more rapid for the youngest participants. Conclusions: In this sample, findings suggested that VaD patients declined in their functional abilities at a slower rate compared with AD patients and that there were no significant differences in rate of functional decline between patients with DLB compared with those with either AD or VaD. These results may provide guidance to clinicians about average expected rates of functional decline in three common dementia types.

KW - Alzheimer's disease

KW - Dementia with Lewy bodies

KW - Disease progression

KW - Functional decline

KW - Instrumental activities of daily living

KW - Vascular dementia

UR - http://www.scopus.com/inward/record.url?scp=84885657619&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84885657619&partnerID=8YFLogxK

U2 - 10.1016/j.jalz.2012.10.010

DO - 10.1016/j.jalz.2012.10.010

M3 - Article

C2 - 23643459

AN - SCOPUS:84885657619

VL - 9

JO - Alzheimer's and Dementia

JF - Alzheimer's and Dementia

SN - 1552-5260

IS - 5 SUPPL.

ER -