Journal
NEUROLOGY
Volume 71, Issue 12, Pages 882-887Publisher
LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/01.wnl.0000312379.02302.ba
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Funding
- Swedish Medical Research Council
- Delegation for Social Research within the Ministry of Health and Social Affairs
- Bank of Sweden Tercentenary Foundation
- Goteborg Medical Services and Social Services Administrations
- Stiftelsen Soderstrom-Konigska sjukhemmet
- Konung Gustaf V:s och Drottning Victorias Stiftelse
- Stiftelsen for Gamla Tjanarinnor
- Handlanden Hjalmar Svenssons Forskningsfond
- Swedish Brain Power
- Swedish Council for Working Life and Social Research
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Objective: To identify time of onset and rate of mortality-related change (terminal decline) in cognitive abilities in later life. Method: The sample consisted of 288 individuals without dementia (born 1901-1902) drawn from the population of Go teborg, Sweden. Participants were followed from age 70 until death, with up to 12 measurement occasions on three cognitive abilities. Change-point analysis was performed using an automated piecewise linear mixed modeling approach to identify the inflection point indicating accelerated within-person change related to mortality. A profile likelihood method was used to identify the change point that best fit the data for each of three cognitive abilities. Results: Onset of terminal decline was identified 6.6 years prior to death for verbal ability, 7.8 years for spatial ability, and 14.8 years for perceptual speed. Conclusions: There is substantial acceleration in cognitive decline many years prior to death among individuals without dementia. Time of onset and rate of terminal decline vary considerably across cognitive abilities.
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