Tchalla AE, et al. - Researchers sought to investigate the factors connected with rapid cognitive decline (RCD) in Alzheimer's disease (AD) patients aged ≥65 years. Findings illustrated that an MMSE score < 20 at treatment onset, female gender, psychotic symptoms, malnutrition, and a family history of dementia were linked to RCD. This information could be directly pertinent to patients, their families, and physicians, assisting in early anticipation of problematic clinical trajectories and poor functional outcomes.

Methods

• This was a 12-month, prospective, multi-center cohort study.
• Eligible candidates included community-living individuals aged ≥65 years with mild-to-moderate AD.
• RCD was defined as the loss of ≥3 points/year in the Mini-Mental State Examination (MMSE) score.
• Potential individual-level predictors were collected at baseline.

Results

• Enrollment consisted of 521 subjects and the mean age was 80.8 ± 9.0 years and 66.0% were females.
• Average baseline MMSE score was 20.5 ± 4.5.
• Incidence of RCD was 40.9% (95% confidence interval [CI], 36.7-45.1).
• RCD appeared to be more common in patients with moderate (53.5%) vs mild (22.3%) AD.
• A parental history of dementia (odds ratio [OR], 2.32 [95% CI, 1.24-4.21], p=0.011), psychotic symptoms (OR, 2.06 [95% CI, 1.22-3.48], p=0.007), malnutrition (OR, 1.61 [95% CI, 1.06-2.63], p=0.028), and the female gender (OR, 1.48 [95% CI, 1.03-2.15], p=0.036) were all linked to RCD.
• Additionally, an MMSE score < 20 at treatment onset was connected with RCD (p < 0.001).