Abstract
Cognitive changes in normal aging can be similar to the alterations that take place in the initial stages of a dementia process. Longitudinal studies can provide a better understanding of this progression.ObjectivesTo evaluate the cognitive and functional evolution of community-dwelling individuals without dementia through a three-year longitudinal study.Methods168 individuals were evaluated in 2006. Three years later in 2009, 73 of these subjects were reevaluated as regards cognition and functionality using the Mini Mental State Examination (MMSE), Brief Cognitive Battery (BCB) and the Pfeffer Functional Activities Questionnaire. The statistical analysis included descriptive measurements, the Wilcoxon’s test for intra-group comparison, and the Spearman’s correlation coefficient test for comparing cognitive and functionality scores.ResultsAfter three years, the Wilcoxon’s test showed a discreet yet significant cognitive decline (MMSE: –0.7 points; p=0.02; Z= –2.29; and global score on the BCB: +3.6 points; p=0.02; Z= –2.29), in addition to functional decline (Pfeffer: +0.7 points; p= 0.001; Z= –3.38).ConclusionsAfter three years of follow-up we observed a discreet yet significant functional and cognitive decline in the subjects. Longitudinal cognitive screening represents an important strategy in the early identification of changes from normal conditions to a dementia process.
Highlights
Cognitive changes in normal aging can be similar to the alterations that take place in the initial stages of a dementia process
Given that the cognitive alterations typical of aging are not always easy to distinguish from the changes seen in the early stages of dementia, longitudinal studies are a sensitive means of detecting the progression from cognitive decline to a possible condition of dementia, in individuals with better performance on neuropsychological tests.[8,9]
Based on the data from the 2006 and 2009 assessments, the Wilcoxon test detected that the subjects presented a mild yet significant cognitive decline, according to the Mini Mental State Examination (MMSE) score and global score on the Brief Cognitive Battery (BCB)
Summary
Abstract – Cognitive changes in normal aging can be similar to the alterations that take place in the initial stages of a dementia process. In spite of the consensus regarding neuropsychological, neuropathological and neuroimaging criteria to distinguish between normal and pathological states, this differential diagnosis poses a major challenge in clinical practice.[1] Longitudinal studies provide relevant information concerning cognitive alterations in normal aging, mild cognitive impairment, and the early stage of dementia.[2,3] Among cognitively preserved individuals, the mental processes and functionality remain devoid of clinically relevant alterations, for instance in episodic memory, semantic memory, working memory, visuospatial ability, and perceptual speed.[2] In addition, the category called cognitive impairment non-dementia includes cases which not fulfill the criteria for dementia. Given that the cognitive alterations typical of aging are not always easy to distinguish from the changes seen in the early stages of dementia, longitudinal studies are a sensitive means of detecting the progression from cognitive decline to a possible condition of dementia, in individuals with better performance on neuropsychological tests.[8,9]
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