TY - JOUR
T1 - CCCDTD5 recommendations on early non cognitive markers of dementia
T2 - A Canadian consensus
AU - Montero-Odasso, Manuel
AU - Pieruccini-Faria, Frederico
AU - Ismail, Zahinoor
AU - Li, Karen
AU - Lim, Andrew
AU - Phillips, Natalie
AU - Kamkar, Nellie
AU - Sarquis-Adamson, Yanina
AU - Speechley, Mark
AU - Theou, Olga
AU - Verghese, Joe
AU - Wallace, Lindsay
AU - Camicioli, Richard
N1 - Funding Information:
: The CCCCDTD5 meeting was supported financially by the Canadian Consortium on Neurodegeneration in Aging, the Réseau des cliniques mémoire du Québec, and the Réseau Québecois de Recherche sur le Vieillissement. Funding information
Publisher Copyright:
© 2020 The Authors. Alzheimer's & Dementia: Translational Research & Clinical Interventions published by Wiley Periodicals LLC on behalf of Alzheimer's Association
PY - 2020
Y1 - 2020
N2 - Introduction: Cognitive impairment is the hallmark of Alzheimer's disease (AD) and related dementias. However, motor decline has been recently described as a prodromal state that can help to detect at-risk individuals. Similarly, sensory changes, sleep and behavior disturbances, and frailty have been associated with higher risk of developing dementia. These clinical findings, together with the recognition that AD pathology precedes the diagnosis by many years, raises the possibility that non-cognitive changes may be early and non-invasive markers for AD or, even more provocatively, that treating non-cognitive aspects may help to prevent or treat AD and related dementias. Methods: A subcommittee of the Canadian Consensus Conference on Diagnosis and Treatment of Dementia reviewed areas of emerging evidence for non-cognitive markers of dementia. We examined the literature for five non-cognitive domains associated with future dementia: motor, sensory (hearing, vision, olfaction), neuro-behavioral, frailty, and sleep. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assign the strength of the evidence and quality of the recommendations. We provide recommendations to primary care clinics and to specialized memory clinics, answering the following main questions: (1) What are the non-cognitive and functional changes associated with risk of developing dementia? and (2) What is the evidence that sensory, motor, behavioral, sleep, and frailty markers can serve as potential predictors of dementia?. Results: Evidence supported that gait speed, dual-task gait speed, grip strength, frailty, neuropsychiatric symptoms, sleep measures, and hearing loss are predictors of dementia. There was insufficient evidence for recommending assessing olfactory and vision impairments as a predictor of dementia. Conclusions: Non-cognitive markers can assist in identifying people at risk for cognitive decline or dementia. These non-cognitive markers may represent prodromal symptoms and several of them are potentially amenable to treatment that might delay the onset of cognitive decline.
AB - Introduction: Cognitive impairment is the hallmark of Alzheimer's disease (AD) and related dementias. However, motor decline has been recently described as a prodromal state that can help to detect at-risk individuals. Similarly, sensory changes, sleep and behavior disturbances, and frailty have been associated with higher risk of developing dementia. These clinical findings, together with the recognition that AD pathology precedes the diagnosis by many years, raises the possibility that non-cognitive changes may be early and non-invasive markers for AD or, even more provocatively, that treating non-cognitive aspects may help to prevent or treat AD and related dementias. Methods: A subcommittee of the Canadian Consensus Conference on Diagnosis and Treatment of Dementia reviewed areas of emerging evidence for non-cognitive markers of dementia. We examined the literature for five non-cognitive domains associated with future dementia: motor, sensory (hearing, vision, olfaction), neuro-behavioral, frailty, and sleep. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assign the strength of the evidence and quality of the recommendations. We provide recommendations to primary care clinics and to specialized memory clinics, answering the following main questions: (1) What are the non-cognitive and functional changes associated with risk of developing dementia? and (2) What is the evidence that sensory, motor, behavioral, sleep, and frailty markers can serve as potential predictors of dementia?. Results: Evidence supported that gait speed, dual-task gait speed, grip strength, frailty, neuropsychiatric symptoms, sleep measures, and hearing loss are predictors of dementia. There was insufficient evidence for recommending assessing olfactory and vision impairments as a predictor of dementia. Conclusions: Non-cognitive markers can assist in identifying people at risk for cognitive decline or dementia. These non-cognitive markers may represent prodromal symptoms and several of them are potentially amenable to treatment that might delay the onset of cognitive decline.
KW - behavior
KW - biomarker
KW - cognitive impairment
KW - dementia
KW - frailty
KW - gait
KW - hearing
KW - olfaction
KW - parkinsonism
KW - prediction
KW - risk
KW - sleep
KW - vision
UR - http://www.scopus.com/inward/record.url?scp=85095935669&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85095935669&partnerID=8YFLogxK
U2 - 10.1002/trc2.12068
DO - 10.1002/trc2.12068
M3 - Article
AN - SCOPUS:85095935669
SN - 2352-8737
VL - 6
JO - Alzheimer's and Dementia: Translational Research and Clinical Interventions
JF - Alzheimer's and Dementia: Translational Research and Clinical Interventions
IS - 1
M1 - e12068
ER -
