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Terminal decline in cognitive function.

R S Wilson1, L A Beckett, J L Bienias

  • 1Rush Alzheimer's Disease Center and Rush Institute for Healthy Aging, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612, USA. rwilson@rush.edu

Neurology
|June 11, 2003
PubMed
Summary
This summary is machine-generated.

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Cognitive decline accelerates significantly in the final years of life. This study observed a sharp increase in the rate of cognitive decline in older adults approximately 43 months before death.

Area of Science:

  • Gerontology
  • Neuroscience
  • Cognitive Psychology

Background:

  • The relationship between impending death and age-related cognitive decline is not well understood.
  • Previous research has not extensively studied cognitive changes preceding death in older adults.

Purpose of the Study:

  • To investigate the association between impending death and cognitive decline in older adults.
  • To identify the timing and rate of cognitive decline in the period preceding death.

Main Methods:

  • Longitudinal study of 763 older adults (nuns, priests, brothers) without dementia at baseline.
  • Annual cognitive assessments using 19 tests over an average of 5.6 years.
  • Change point random effects models to identify accelerated cognitive decline before death.

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Main Results:

  • Individuals who died showed lower baseline global cognition and a sixfold increase in annual cognitive decline starting around 43 months before death.
  • Terminal cognitive decline was observed in most deceased participants, with significant acceleration in memory and processing speed.
  • Survivors exhibited minimal cognitive decline, highlighting the distinct pattern in those nearing death.

Conclusions:

  • Cognitive decline accelerates sharply in the final years of life.
  • This terminal decline is a common phenomenon, though rates vary individually.