Apathy, gait slowness, and executive dysfunction (AGED) triad: opportunities to predict and delay dementia onset

Frederico Pieruccini-Faria; Vladimir Hachinski; Surim Son; Manuel Montero-Odasso

doi:10.1007/s11357-024-01372-0

Apathy, gait slowness, and executive dysfunction (AGED) triad: opportunities to predict and delay dementia onset

Geroscience. 2024 Oct 10. doi: 10.1007/s11357-024-01372-0. Online ahead of print.

Authors

Frederico Pieruccini-Faria^{1

2

3}, Vladimir Hachinski⁴, Surim Son^{5

6}, Manuel Montero-Odasso^{7

8

9

10

11}

Affiliations

¹ Gait and Brain Lab, St. Joseph's Health London Care, Parkwood Institute and Lawson Health Research Institute, Main Building Parkwood Institute, 550 Wellington Rd, Room A3-116, London, ON, N6C 0A7, Canada.
² Schulich School of Medicine & Dentistry, Department of Medicine and Division of Geriatric Medicine, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada.
³ Parkwood Institute, Main Building, 550 Wellington Rd South, Room A3-122A, London, ON, N6C 0A7, Canada.
⁴ Department of Clinical Neurological Sciences, Robarts Research Institute and University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada.
⁵ University Hospital London Health Sciences Centre, 339 Windermere Road London, London, ON, N6A 5A5, Canada.
⁶ Department of Epidemiology and Biostatistics, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada.
⁷ Gait and Brain Lab, St. Joseph's Health London Care, Parkwood Institute and Lawson Health Research Institute, Main Building Parkwood Institute, 550 Wellington Rd, Room A3-116, London, ON, N6C 0A7, Canada. mmontero@uwo.ca.
⁸ Schulich School of Medicine & Dentistry, Department of Medicine and Division of Geriatric Medicine, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada. mmontero@uwo.ca.
⁹ Parkwood Institute, Main Building, 550 Wellington Rd South, Room A3-122A, London, ON, N6C 0A7, Canada. mmontero@uwo.ca.
¹⁰ University Hospital London Health Sciences Centre, 339 Windermere Road London, London, ON, N6A 5A5, Canada. mmontero@uwo.ca.
¹¹ Department of Epidemiology and Biostatistics, University of Western Ontario, 1151 Richmond St, London, ON, N6A 3K7, Canada. mmontero@uwo.ca.

PMID: 39384733
DOI: 10.1007/s11357-024-01372-0

Abstract

This study investigates whether older adults diagnosed with the apathy, gait impairment, and executive dysfunction (AGED) triad, frequently associated with cerebrovascular disease and confounded with depression, have earlier dementia onset. We followed 322 community-dwelling older individuals (mean age 72.0 ± 6.4 years; 58.3% women) free of dementia at baseline for up to 9 years. The AGED triad was identified when gait slowness (< 1 m/s), apathy (assessed by Geriatric Depression Scale-3A with ≥ 2 items), and executive dysfunction (assessed by the 75th percentile of Trail Making Test-part B by age range) were simultaneously present. Incident dementia was diagnosed using the clinical dementia rating scale. Over the 9-year follow-up (mean 45.1 ± 28.6 months), 44 participants (13.6%) converted to dementia. Sixteen participants (5.0%) were diagnosed with AGED triad + and showed a significantly higher risk of earlier conversion to dementia compared with AGED triad- (hazard ratio = 5.08, 95%CI 2.16-11.97; p = 0.0001), as well as to those with only one AGED factor or fewer AGED factors. Hypertension and diabetes were 2 and 3 times more prevalent, respectively, in individuals with AGED triad + . These findings suggest that the AGED triad serves as a simplified and effective behavioral marker for accelerated progression to dementia.

Keywords: Apathy; Dementia; Executive function; Gait slowness; Vascular risk factors.

Abstract

Grants and funding