title: Rate of cognitive decline in preclinical Alzheimer's disease: the role of comorbidity.
abstract: We investigated the influence of individual-difference variables implicated as risk factors for Alzheimer's disease (AD) or known to be related to cognitive performance in normal aging (e.g., age, sex, years of education, previous and recent diseases, apolipoprotein E status, social network, and substance use) on rate of cognitive change from preclinical to clinical AD. With the use of data from a population-based study, 230 persons who were nondemented at baseline and diagnosed with AD at a 3-year follow-up were examined with the Mini-Mental State Examination (MMSE). Of all predictor variables examined, only number of diseases resulting in hospital admission during the follow-up period made an independent contribution to rate of MMSE change. These results suggest that many variables affecting the onset of the degenerative process as well as cognitive functioning in normal aging exert little influence on rate of cognitive change in preclinical AD. This may reflect the fact that the emerging dementia disease overshadows the role of these variables for cognitive functioning. A possible exception to this pattern is that an increasing number of concomitant health conditions may exacerbate the rate of cognitive decline during the final portion of the preclinical phase in AD.
authors.affiliation: Aging Research Center at the Karolinska Institute and Stockholm Gerontology Research Center, Stockholm, Sweden. lars.backman@neurotec.ki.se
authors.forename: Lars
authors.initials: L
authors.lastname: Bäckman
authors.forename: Sari
authors.initials: S
authors.lastname: Jones
authors.forename: Brent J
authors.initials: BJ
authors.lastname: Small
authors.forename: Hedda
authors.initials: H
authors.lastname: Agüero-Torres
authors.forename: Laura
authors.initials: L
authors.lastname: Fratiglioni
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007206:Individuality; D008297:Male; D008609:Mental Status Schedule; D010343:Patient Admission / Q000706:statistics & numerical data; D012307:Risk Factors; D013548:Sweden