title: Terminal pathologies affect rates of decline to different extents and age accelerates the effects of terminal pathology on cognitive decline.
abstract: OBJECTIVE
  To test whether different terminal pathologies are associated with different rates of age-related decline in fluid and crystallized mental abilities and whether pathology-associated declines are accelerated by age.
  
  
  METHODS
  During a 20-year longitudinal study, 6203 participants were quadrennially assessed on the Heim's (Heim, A 1970) The AH4 series of intelligence tests Slough, U.K.: NEP) AH4-1 and AH4-2 tests of fluid intelligence and on the Raven's (Raven, J. C. 1965) The Mill Hill Vocabulary Scale London: H.K. Lewis) Mill Hill A and B tests of recognition and production vocabulary. Dates and proximate causes of death were logged for 2499 participants. Multilevel modelling compared rates of decline after effects of sex, demographics, and practice were taken into consideration.
  
  
  RESULTS
  Rates of cognitive decline markedly differed across pathologies, being most rapid for dementias and infections, slower for malignancies, and most prolonged for cardiovascular conditions. Pathologies were associated with faster declines in older individuals.
  
  
  CONCLUSIONS
  After sex, age, and demographics have also been considered, different terminal pathologies are associated with markedly different rates of decline. Age accelerates pathology-related decline. This raises the further question as to whether any, or how much of, age-related cognitive decline is brought about by other causes than an increasing burden of pathologies.
authors.affiliation: Neurocognitive Development Unit, School of Psychology, University of Western Australia.
authors.forename: Patrick
authors.initials: P
authors.lastname: Rabbitt
authors.forename: Mary
authors.initials: M
authors.lastname: Lunn
authors.forename: Neil
authors.initials: N
authors.lastname: Pendleton
authors.forename: Ghasem
authors.initials: G
authors.lastname: Yardefagar
mesh_terms: D000368:Aged; D000375:Aging / Q000523:psychology*; D002423:Cause of Death; D003072:Cognition Disorders / Q000175:diagnosis* / Q000523:psychology; D005260:Female; D006801:Humans; D007807:Language Tests; D008137:Longitudinal Studies; D008297:Male; D012307:Risk Factors