Risk Factors Associated with Cognitive, Functional, and Behavioral Trajectories of Newly Diagnosed Dementia Patients

Details

• Personal Author:
  Dowd B ; Gaugler JE ; Jutkowitz E ; Kane RL ; Kuntz KM ; MacLehose RF
• Description:
  Background: Dementia results in changes in cognition, function, and behavior. We examine the effect of sociodemographic and clinical risk factors on cognitive, functional, and behavioral declines in incident dementia patients. Methods: We used longitudinal data from the National Alzheimer's Coordinating Center to evaluate cognitive (Mini-Mental State Exam [MMSE]), functional (Functional Activities Questionnaire [FAQ]), and behavioral (Neuropsychiatric Inventory Questionnaire [NPI-Q] severity score) trajectories for incident dementia patients over an 8-year period. We evaluated trajectories of 457 patients with mixed effects linear regression models. Results: In the first year, cognition worsened by -1.518 (95% confidence interval [CI] -1.745, -1.291) MMSE points (0-30 scale). Education, race, and region of residence predicted cognition at diagnosis. Age of onset, geographic region of residence, and history of hypertension and congestive heart failure predicted cognitive changes. Function worsened by 3.464 (95% CI 3.131, 3.798) FAQ points in the first year (0-30 scale). Cognition, gender, race, region of residence and place of residence, and a history of stroke and hypercholesterolemia predicted function at diagnosis. Place of residence and a history of diabetes predicted functional changes. Behavioral symptoms worsened by 0.354 (95% CI 0.123, 0.585) NPI-Q points in the first year (0-36 scale). Age of onset, region of residence, and history of hypertension and psychiatric problems predicted behaviors at diagnosis. Cognition explained changes in behavior. Conclusions: Sociodemographic characteristics and clinical comorbidities predict cognitive and functional changes. Only cognitive status explains behavioral decline. Results provide an understanding of the characteristics that impact cognitive, functional, and behavioral decline. [Description provided by NIOSH]
• Subjects:
  Aging Behavior Demography Epidemiology Health Care Facilities Workforce And Services Nervous System Occupational Health Public Health Safety
• Keywords:
  Alzheimer's Author Keywords: Dementia Behavior Patterns Clinical Symptoms Cognitive Function Demographic Characteristics Health Services Longitudinal Study Public Health Sociological Factors
• ISSN:
  1079-5006
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Minnesota ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  251-258
• Volume:
  72
• Issue:
  2
• NIOSHTIC Number:
  nn:20064319
• Citation:
  J Geront, Ser A Biol Sci Med Sci 2017 Feb; 72(2):251-258
• Contact Point Address:
  Eric Jutkowitz, BA, Division of Health Policy and Management, School of Public Health, University of Minnesota, MMC 729, 420 Delaware Street SE, Minneapolis, MN 55455
• Email:
  Jutko001@umn.edu
• Federal Fiscal Year:
  2017
• Performing Organization:
  University of Minnesota Twin Cities
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  The Journals of Gerontology Series A: Biological Sciences and Medical Sciences
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:609181d7010c6116a8b22a2b1555e8c54bcf4307b39b5246d72d3e619a69f6a2c56d4208207962da3d7b4ce3291af4f5a272e203be60097f3464205e8808d6a1
• Download URL:
  https://stacks.cdc.gov/view/cdc/222810/cdc_222810_DS1.pdf
• File Type:
  [PDF - 331.61 KB ]