Journal of Alzheimer's Disease · Jul 11, 2026

Multidomain cognitive impairment, along with comorbidities and psychiatric hospitalizations, shorten survival time of patients with Alzheimer's disease dementia: A long term, naturalistic follow-up study

By Doganyigit B, Schurr T, Hofer A et al.

BackgroundThe survival time following an initial Alzheimer's disease dementia (ADD) diagnosis is influenced by various demographic, cognitive and clinical factors. Cognitive clusters are more detailed than individual cognitive measures, but they are rarely used as predictors in survival analyses.ObjectiveWe conducted a long-term retrospective study following patients from the time of their initial ADD diagnosis until their death. Cognitive clusters as well as clinical data were assessed as predictors of survival time.MethodsWe used hierarchical clustering to identify cognitive clusters based on the results of neuropsychological examinations (CERAD-Plus). We fitted a Cox regression model with cognitive clusters and clinical covariates (e.g., age, sex, Mini-Mental State Examination [MMSE] score, annual rate of hospitalizations, and pre-existing diseases) to predict survival time.ResultsData from 202 patients (mean age = 77.79 ± 5.35 years; mean survival time 74.04 ± 41.03 months) were analyzed. Two cognitive clusters were identified: the amnestic cluster (AC, N = 89) and the mixed cluster (MC, N = 80). The Cox regression models identified the following variables as most predictive of shorter survival times: higher age (HR = 1.04) and lower MMSE score at baseline (HR = 0.92), pre-diagnosed atrial fibrillation (HR = 2.06) and delirium (HR = 3.13), and a higher annual rate of psychiatric (HR = 4.84) and somatic (HR = 1.67) hospitalizations. Patients in the MC had a shorter survival time than those in the AC group (HR = 1.45).ConclusionsThis study provides evidence that a detailed analysis of neuropsychological profiles at the time of ADD diagnosis can predict disease progression. Preventing psychiatric hospitalizations, especially, could positively influence the survival of ADD patients.

doi.org/10.1177/13872877261468789 Open access PubMed 42434908 Populations