Neuropsychiatric symptoms and gait/balance are predictors of functional trajectories in dementias.

UNLABELLED: Dementias have heterogeneous functional decline trajectories, but little is known about the factors that shape this differential progression.

OBJECTIVE

To identify relevant predictors of functional decline in patients with dementia.

METHODS

A total of 76 subjects were included in this longitudinal retrospective, observational study. Functional outcome was assessed using the Technology-Activities of Daily Living Questionnaire (T-ADLQ), a 33-item scale encompassing basic, instrumental, and advanced activities of daily living (ADLs), with higher scores indicating greater deterioration. Participants were assessed three times: at baseline, and after a mean follow-up of 6.2 and 11.2 months, respectively. Cognitive and noncognitive variables were evaluated as predictors of functional decline using a linear mixed-effect model.

RESULTS

Females represented 63.2% of the sample. Subjects had a mean age of 79.5 (±7.9) years, 6.2 (±4.3) years of education, and a Global Deterioration Scale (GDS) score of 4.7 (±0.68) (median 5; range, 4-6). The linear mixed-effect model (R2=0.387) identified global cognition (Mini-Mental State Examination - MMSE), neuropsychiatric symptoms (NPI-Q), and gait/balance (Tinetti test and gait speed) as independent predictors of functional decline, with 𝛽 coefficients of -0.305, 0.299, and -0.281, respectively.

CONCLUSION

This study underscores the importance of noncognitive predictors of functional trajectories in established dementia. In particular, neuropsychiatric symptoms and gait should be considered during the follow-up of people living with dementia to ensure tailored interventions and counseling for patients and their families. These findings support the inclusion of gait variables in further longitudinal studies on dementia prognosis.