ArticleNeurology2020
Proportion of cognitive loss attributable to terminal decline.
Article in Neurology, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
17 citing papers in PubMed, 18 citations in OpenAlex.
- Functional decline in the final years of life: A multicohort study.BMC medicine · 2026Article
- Predicting Autopsy-Confirmed Neuropathology across Clinical, Neuroimaging, and CSF Biomarkers using Machine Learning.bioRxiv : the preprint server for biology · 2026Article
- Association between intrinsic capacity and disability before death among older adults: a decedent cohort study.The lancet. Healthy longevity · 2026Article
- Trajectories of psychological and social well-being preceding death.BMJ mental health · 2025Article
- Sex differences in the executive and behavioral reserve of autosomal dominant frontotemporal dementia.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2025Article
- Life-Course Pathways to Exceptional Longevity: Evidence From the Lothian Birth Cohort of 1921.The journals of gerontology. Series A, Biological sciences and medical sciences · 2024Article
- Terminal trajectory of HbAFrontiers in endocrinology · 2024Article
- Quantifying longitudinal cognitive resilience to Alzheimer's disease and other neuropathologies.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2022Article
- Potential Mechanisms Underlying Resistance to Dementia in Non-Demented Individuals with Alzheimer's Disease Neuropathology.Journal of Alzheimer's disease : JAD · 2022Review
- Similar mortality risk in incident cognitive impairment and dementia: Evidence from the ASPirin in Reducing Events in the Elderly (ASPREE) trial.Journal of the American Geriatrics Society · 2021Article
- The "cognitive clock": A novel indicator of brain health.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2021Article
- To what degree is late life cognitive decline driven by age-related neuropathologies?Brain : a journal of neurology · 2021Article
- Terminal decline in objective and self-reported measures of motor function before death: 10 year follow-up of Whitehall II cohort study.BMJ (Clinical research ed.) · 2021Article
- Consumption of dietary nuts in midlife and risk of cognitive impairment in late-life: the Singapore Chinese Health Study.Age and ageing · 2021Article
- Neuropathologic burden and the degree of frailty in relation to global cognition and dementia.Neurology · 2020Article
- Normative Cognitive Decline in Old Age.Annals of neurology · 2020Article
- Association of Low Systolic Blood Pressure with Postmortem Amyloid-β and Tau.Journal of Alzheimer's disease : JAD · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
objectiveTo estimate the proportion of late-life cognitive loss attributable to impending death.
methodsOlder persons (n = 1,071) in a longitudinal cohort study without dementia at enrollment underwent annual cognitive assessments (mean 10.6 years, SD 4.6, range 4-24) prior to death. We estimated the onset of terminal acceleration in cognitive decline and rates of decline before and after this point in change point models that allowed calculation of the percent of cognitive loss attributable to terminal decline. Outcomes were composite measures of global and specific cognitive functions. We also estimated dementia and mild cognitive impairment (MCI) incidence before and during the terminal period.
resultsA mean of 3.7 years before death (95% credible interval [CI] -3.8 to -3.5), the rate of global cognitive decline accelerated to -0.313 unit per year (95% CI -0.337 to -0.290), a more than 7-fold increase indicative of terminal decline. The mean global cognitive score dropped 0.377 unit (SD 0.516) assuming no terminal decline and 1.192 units (SD 1.080) with terminal decline. As a result, 71% (95% bootstrapped CI 0.70, 0.73) of overall global cognitive loss was terminal. In subsequent analyses, terminal decline accounted for 70% of episodic memory loss, 65% of semantic memory loss, 57% of working memory loss, 52% of perceptual speed loss, and 53% of visuospatial loss. MCI incidence in the preterminal and terminal periods was similar, but dementia incidence was more than 6-fold higher in the terminal period than preterminal.
conclusionMost late-life cognitive loss is driven by terminal decline.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.