Summary: Initial memory problems are linked with a slower rate of decline in Alzheimer’s disease. Those with symptoms including language difficulties or judgment changes had a more rapid rate of decline than those with memory problems alone.
Source: Clevland Clinic
New Cleveland Clinic research finds that initial memory problems are linked with a slower rate of decline in Alzheimer’s disease and related dementias.
The research team analyzed longitudinal data from 2,400 patients in the National Alzheimer Coordinating Center database to compare rates of decline in patients with Alzheimer’s disease, Lewy Body Dementia and mixed dementia.
The study, published in Alzheimer’s & Dementia: The Journal of the Alzheimer’s Association, found that people with initial symptoms such as language difficulties or judgment changes had a more rapid course of disease than those with memory loss alone.
“This is the first study to evaluate the impact of the nature of early cognitive symptoms on future rate of cognitive decline,” said Jagan Pillai, M.D., of Cleveland Clinic’s Center for Brain Health and lead author of the study.

“These results hold importance in both designing future clinical trials design and individual patient management among dementia patients.”
About this Alzheimer’s disease research news
Author: Press Office
Source: Clevland Clinic
Contact: Press Office – Clevland Clinic
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Original Research: Open access.
“Initial non‐amnestic symptoms relate to faster rate of functional and cognitive decline compared to amnestic symptoms in neuropathologically confirmed dementias” by Jagan A Pillai et al. Alzheimer’s & Dementia
Abstract
Initial non‐amnestic symptoms relate to faster rate of functional and cognitive decline compared to amnestic symptoms in neuropathologically confirmed dementias
Introduction
The relationship between initial cognitive symptoms and subsequent rate of clinical decline is important in clinical care and the design of dementia clinical trials.
Methods
This retrospective longitudinal, autopsy-confirmed, cohort study among 2426 participants in the National Alzheimer’s Coordinating Center database included Alzheimer’s disease (AD) pathology, n = 1187; Lewy body pathology (LBP), n = 331; and mixed pathology (AD-LBP), n = 904. The predominant initial cognitive symptom was assessed clinically. Linear mixed models evaluated the longitudinal outcome of the Clinical Dementia Rating-Sum of Boxes (CDR-SB) score.
Results
Non-amnestic initial symptoms had a faster rate of decline than amnestic symptoms in all three groups. Language symptoms had a faster rate of decline in all three groups. Executive symptoms had a faster rate of decline than amnestic in AD and AD-LBP. There was a similar trend for visuospatial symptoms in AD-LBP.
Discussion
Initial cognitive symptoms, despite varied underlying pathology, are a predictor of longitudinal functional outcomes among dementias.