Affiliations: [a] De Wever, Centre for Elderly Care, Tilburg, The Netherlands
| [b] Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, Nijmegen, The Netherlands
| [c] Florence, Mariahoeve, Centre for Specialized Care in Young-onset Dementia, Den Haag, The Netherlands
| [d] Radboud Alzheimer Centre, Radboud University, Medical Centre, Nijmegen, The Netherlands
| [e] School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University Medical Centre, Maastricht, The Netherlands
| [f] Department of Neurology and Alzheimer Centre, VU University Medical Centre, Amsterdam, The Netherlands
| [g] Joachim en Anna, Centre for Specialized Geriatric Care, Nijmegen, The Netherlands
Correspondence:
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Correspondence to: Adrie A.J. Gerritsen, MD, Department of Primary and Community Care, 117, Geriatric Care and Public Health, Radboud University Medical Centre, PO Box 9101, 6500 HB Nijmegen, The Netherlands. Tel.: +31 0 134644166; Fax: +31 0 134644433; E-mail: [email protected]
Abstract: Background:The progression of dementia in people with young-onset dementia (YOD) is relatively unknown. Objective:To investigate the progression of dementia and cognitive decline in the three most common subtypes in YOD and to explore which factors are associated with this course. Methods:The course of dementia was examined in 198 people with YOD. The primary outcomes were cognitive function, as assessed by the Mini-Mental State Examination (MMSE) and dementia severity, as assessed by the Global Deterioration Scale (GDS). Mixed-model analyses were used to explore factors associated with the course of dementia of the diagnostic sub-types. Results:The mean overall two-year progression of dementia severity was 0.9 GDS points, this was a statistically significant change (p = 0.012) and was not significantly different for the three dementia subtypes. The mean overall two-year decline in cognitive function was 1.6 points on the MMSE. The differences in cognitive decline were statistically significant (p = 0.046) among the three diagnosis groups, AD participants showed the greatest decline, of 2.3 points. In addition to lower education (p = 0.010), higher scores on the Neuropsychiatric Inventory (NPI) sub-syndromes psychosis (p < 0.001) and hyperactivity (p = 0.002) were associated with higher rates of cognitive decline. In contrast, higher scores on the NPI affect cluster were associated with lower levels of cognitive decline (p < 0.001). Conclusion:Different YOD subtypes show different rates of decline in cognitive functioning, and this decline seems less progressive compared to those observed in studies in late-onset AD. Further research is needed to evaluate whether managing neuropsychiatric symptoms can positively influence the decline of cognitive function.
Keywords: Cognitive decline, progression of dementia, young onset dementia
