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Terminal Cognitive Decline: Accelerated Loss of Cognition in the Last Years of Life

From the Rush Alzheimer’s Disease Center (R.S.W., D.A.B.) and Rush Institute for Healthy Aging (T.L.B., J.L.B.) and the Departments of Neurological Sciences (R.S.W., D.A.B.), Behavioral Sciences (R.S.W.), and Internal Medicine (J.L.B.), Rush University Medical Center, Chicago, IL.

View larger version (12K): [in this window] [in a new window]   Figure 1. Log-likelihood, an indicator of goodness of fit, from a series of analyses allowing terminal decline to begin at different points before death in global cognition (upper left), episodic memory (upper right), semantic memory (middle left), working memory (middle right), perceptual speed (lower left), and visuospatial ability (lower right).

View larger version (5K): [in this window] [in a new window]   Figure 2. Predicted 5-year paths of change for two typical participants, one who survived (solid line) and one who died after 5 years (dotted line).

View larger version (16K): [in this window] [in a new window]   Figure 3. Predicted paths of global cognitive decline in those who died (upper panel) and an equal number of persons randomly selected from survivors (lower panel).

View larger version (6K): [in this window] [in a new window]   Figure 4. Predicted 5-year paths of change in global cognition for two typical participants who died after 5 years, one with (dotted line) and one without (solid line) an apolipoprotein E 4 allele.