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. 2015 Oct;70(10):1221-5.
doi: 10.1093/gerona/glv062. Epub 2015 May 2.

Rate of Cognitive Decline Before and After the Onset of Functional Limitations in Older Persons

Kumar B Rajan  1 , Liesi E Hebert  2 , Paul A Scherr  2 , Carlos F Mendes de Leon  3 , Denis A Evans  2
Affiliations

Rate of Cognitive Decline Before and After the Onset of Functional Limitations in Older Persons

Kumar B Rajan et al. J Gerontol A Biol Sci Med Sci. 2015 Oct.

Abstract

Background: Loss in physical function is indicative of deterioration in physiological health that may also be associated with deterioration in neurological health. The objective of this study was to examine whether the onset of functional limitations and their severity is associated with increases in cognitive decline among older adults.

Methods: The study sample consists of 3825 (65% African Americans and 53% females) participants over the age of 65 with no functional limitations. Cognitive function was assessed using a standardized global cognitive score, and functional limitations using a summary measure of 8 Rosow-Breslau and Nagi limitations (ROS-B/Nagi). Cognitive decline before and after the onset of limitations were analyzed using a linear piecewise change point model.

Results: During follow-up, 2682 (70%) participants reported limitations in ROS-B/Nagi measure. The rate of cognitive decline was 0.053-units per year before any limitations, and increased to 0.069-units per year after one or more limitations in ROS-B/Nagi measure. This was about 30% (95% Confidence Interval [CI]: 18 - 42%) increase in the rate of cognitive decline comparing before and after the onset of limitations in ROS-B/Nagi measure. Also, higher number of limitations in ROS-B/Nagi measure at the time of onset was associated with faster cognitive decline.

Conclusions: The rate of cognitive decline was significantly higher following functional limitations. This study suggests that self-reported measures of functional limitations may serve as an important marker of cognitive decline.

Keywords: Cognitive decline; Cognitive function; Cohort studies; Functional limitations; Neurodegeneration.

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Figures

Figure 1.
Figure 1.
Rate of change in cognitive function for onset of ROS-B/Nagi functional limitations and absolute number of limitations
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