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Review
. 2019 Mar;32(2):123-129.
doi: 10.1097/YCO.0000000000000482.

Understanding and predicting the longitudinal course of dementia

René J F Melis  1 , Miriam L Haaksma  1 , Graciela Muniz-Terrera  2
Affiliations
Review

Understanding and predicting the longitudinal course of dementia

René J F Melis et al. Curr Opin Psychiatry. 2019 Mar.

Abstract

Purpose of review: To date, most research in dementia has focused either on the identification of dementia risk prediction or on understanding changes and predictors experienced by individuals before diagnosis. Despite little is known about how individuals change after dementia diagnosis, there is agreement that changes occur over different time scales and are multidomain. In this study, we present an overview of the literature regarding the longitudinal course of dementia.

Recent findings: Our review suggests the evidence is scarce and findings reported are often inconsistent. We identified large heterogeneity in dementia trajectories, risk factors considered and modelling approaches employed. The heterogeneity of dementia trajectories also varies across outcomes and domains investigated.

Summary: It became clear that dementia progresses very differently, both between and within individuals. This implies an average trajectory is not informative to individual persons and this needs to be taken into account when communicating prognosis in clinical care. As persons with dementia change in many more ways during their patient journey, heterogeneous disease progressions are the result of disease and patient characteristics. Prognostic models would benefit from including variables across a number of domains. International coordination of replication and standardization of the research approach is recommended.

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    2. This study used longitudinal data from PWD from NACC to study the predictors of multidimensional progression of dementia. Studying multiple outcomes simultaneously (in this case cognition and daily functioning) sets out this study from most other studies in the field. Also showing the impact of sociodemographic characteristics is both fairly unique and important.