Rate of Cognitive Decline before and after the Onset of Functional Limitations in Older Persons

Kumar Rajan, Liesi E. Hebert, Paul A. Scherr, Carlos F. Mendes De Leon, Denis A. Evans

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


Background: Loss in physical function is indicative of deterioration in physiological health that may also be associated with deterioration in neurological health. The objective of this study was to examine whether the onset of functional limitations and their severity is associated with increases in cognitive decline among older adults. Methods: The study sample consists of 3825 (65% African Americans and 53% females) participants over the age of 65 with no functional limitations. Cognitive function was assessed using a standardized global cognitive score, and functional limitations using a summary measure of 8 Rosow-Breslau and Nagi limitations (ROS-B/Nagi). Cognitive decline before and after the onset of limitations were analyzed using a linear piecewise change point model. Results: During follow-up, 2682 (70%) participants reported limitations in ROS-B/Nagi measure. The rate of cognitive decline was 0.053-units per year before any limitations, and increased to 0.069-units per year after one or more limitations in ROS-B/Nagi measure. This was about 30% (95% Confidence Interval [CI]: 18 - 42%) increase in the rate of cognitive decline comparing before and after the onset of limitations in ROS-B/Nagi measure. Also, higher number of limitations in ROS-B/Nagi measure at the time of onset was associated with faster cognitive decline. Conclusions: The rate of cognitive decline was significantly higher following functional limitations. This study suggests that self-reported measures of functional limitations may serve as an important marker of cognitive decline.

Original languageEnglish (US)
Pages (from-to)1221-1225
Number of pages5
JournalJournals of Gerontology - Series A Biological Sciences and Medical Sciences
Issue number10
StatePublished - Jan 1 2014
Externally publishedYes


  • Neurodegeneration; Functional limitations; Cognitive decline; Cognitive function; Cohort studies

ASJC Scopus subject areas

  • Aging
  • Geriatrics and Gerontology


Dive into the research topics of 'Rate of Cognitive Decline before and after the Onset of Functional Limitations in Older Persons'. Together they form a unique fingerprint.

Cite this