{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T05:43:46Z","timestamp":1790401426640,"version":"4.1.0"},"reference-count":71,"publisher":"SAGE Publications","issue":"3","license":[{"start":{"date-parts":[[2017,3,10]],"date-time":"2017-03-10T00:00:00Z","timestamp":1489104000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Alzheimer\u2019s Disease"],"published-print":{"date-parts":[[2017,4,10]]},"abstract":"<jats:p>Background: The rate of cognitive and functional decline in Alzheimer\u2019s disease (AD) changes across individuals.<\/jats:p>\n                  <jats:p>Objectives: Our purpose was to assess whether the concept of \u201cfast decline\u201d really fits its definition and whether cognitive and functional variables at onset can predict the progression of AD.<\/jats:p>\n                  <jats:p>Methods: 324 AD patients were included. We retrospectively examined their Mini-Mental State Examination (MMSE) total score and sub-items, Activities of Daily Living (ADL), and Instrumental Activities of Daily Living (IADL) at baseline and every six months for a 4-year follow-up. Patients were divided into \u201cfast decliners\u201d ( n\u200a=\u200a62), defined by a loss \u22655 points on the MMSE score within the first year from the baseline; \u201cintermediate decliners\u201d ( n\u200a=\u200a37), by a loss \u22655 points after the first year and before the 18th month; or \u201cslow decliners\u201d ( n\u200a=\u200a225), composed of the remaining patients.<\/jats:p>\n                  <jats:p>Results: At baseline, the groups did not differ on demographic, clinical, and cognitive variables. The decline at the end of the 4-year follow-up period seems to be similar among the different decline clusters. Predictors of disease progression have not been identified; only the MMSE total score at 12 months &lt;14\/30 was indicative of a poor prognosis.<\/jats:p>\n                  <jats:p>Conclusions: Even with the limitation due to the small sample size, the lack of differences in the disease progression in time in the different clusters suggest the inconsistency of the so-called \u201cfast decliners\u201d. This study was unable to show any significant difference among clusters of AD progression within a 4-year time interval. Further studies should better clarify whether a more consistent distinction exists between slow and fast decliners.<\/jats:p>","DOI":"10.3233\/jad-161264","type":"journal-article","created":{"date-parts":[[2017,3,14]],"date-time":"2017-03-14T12:29:23Z","timestamp":1489494563000},"page":"775-786","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":31,"title":["The Progression of Alzheimer\u2019s Disease: Are Fast Decliners Really Fast? A\u00a0Four-Year Follow-Up"],"prefix":"10.1177","volume":"57","author":[{"given":"Federica","family":"Barocco","sequence":"first","affiliation":[{"name":"Section of Neurology, Department of Medicine and Surgery, University of Parma, Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marco","family":"Spallazzi","sequence":"additional","affiliation":[{"name":"Section of Neurology, Department of Medicine and Surgery, University of Parma, Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Letizia","family":"Concari","sequence":"additional","affiliation":[{"name":"ULSS 9, Ca\u2019 Foncello Hospital, Treviso, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simona","family":"Gardini","sequence":"additional","affiliation":[{"name":"Azienda Ospedaliero-Universitaria, Parma, 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