Display options
Cite
Hamilton CA, Matthews FE, Donaghy PC, et al. Prospective predictors of decline . Psychol Med. 2020;51(15):2590-2598doi: 10.1017/S0033291720001130.
Hamilton, C. A., Matthews, F. E., Donaghy, P. C., Taylor, J. P., O'Brien, J. T., Barnett, N., Olsen, K., McKeith, I. G., & Thomas, A. J. (2021). Prospective predictors of decline . Psychological medicine, 51(15), 2590-2598. https://doi.org/10.1017/S0033291720001130
Hamilton, Calum A, et al. "Prospective predictors of decline ." Psychological medicine vol. 51,15 (2021): 2590-2598. doi: https://doi.org/10.1017/S0033291720001130
Hamilton CA, Matthews FE, Donaghy PC, Taylor JP, O'Brien JT, Barnett N, Olsen K, McKeith IG, Thomas AJ. Prospective predictors of decline . Psychol Med. 2021 Nov;51(15):2590-2598. doi: 10.1017/S0033291720001130. Epub 2020 May 05. PMID: 32366348.
Copy Download .nbib Format: NLM
Share it on

Psychol Med. 2021 Nov;51(15):2590-2598. doi: 10.1017/S0033291720001130. Epub 2020 May 05.

Prospective predictors of decline .

Psychological medicine

Calum A Hamilton, Fiona E Matthews, Paul C Donaghy, John-Paul Taylor, John T O'Brien, Nicola Barnett, Kirsty Olsen, Ian G McKeith, Alan J Thomas

Affiliations

  1. Translational and Clinical Research Institute, Biomedical Research Building, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
  2. Population Health Sciences Institute, Biomedical Research Building, Newcastle University, Newcastle upon Tyne, NE4 5PL, UK.
  3. Department of Psychiatry, Level E4, University of Cambridge School of Clinical Medicine, Cambridge, CB2 0SZ, UK.

PMID: 32366348 DOI: 10.1017/S0033291720001130

Abstract

BACKGROUND: Mild cognitive impairment (MCI) may gradually worsen to dementia, but often remains stable for extended periods of time. Little is known about the predictors of decline to help explain this variation. We aimed to explore whether this heterogeneous course of MCI may be predicted by the presence of Lewy body (LB) symptoms in a prospectively-recruited longitudinal cohort of MCI with Lewy bodies (MCI-LB) and Alzheimer's disease (MCI-AD).

METHODS: A prospective cohort (n = 76) aged ⩾60 years underwent detailed assessment after recent MCI diagnosis, and were followed up annually with repeated neuropsychological testing and clinical review of cognitive status and LB symptoms. Latent class mixture modelling identified data-driven sub-groups with distinct trajectories of global cognitive function.

RESULTS: Three distinct trajectories were identified in the full cohort: slow/stable progression (46%), intermediate progressive decline (41%) and a small group with a much faster decline (13%). The presence of LB symptomology, and visual hallucinations in particular, predicted decline v. a stable cognitive trajectory. With time zeroed on study end (death, dementia or withdrawal) where available (n = 39), the same subgroups were identified. Adjustment for baseline functioning obscured the presence of any latent classes, suggesting that baseline function is an important parameter in prospective decline.

CONCLUSIONS: These results highlight some potential signals for impending decline in MCI; poorer baseline function and the presence of probable LB symptoms - particularly visual hallucinations. Identifying people with a rapid decline is important but our findings are preliminary given the modest cohort size.

Keywords: Alzheimer's disease; dementia with Lewy bodies; latent class mixture modelling; longitudinal decline; mild cognitive impairment

Publication Types

Grant support