Distinguishing preterminal and terminal cognitive decline

Martin John Sliwinski, Robert S. Stawski, Charles B. Hall, Mindy Katz, Joe Verghese, Richard Lipton

Research output: Contribution to journalReview articlepeer-review

81 Scopus citations


This paper reviews different methodological approaches taken to examine terminal decline in cognitive function, and presents new findings from the Bronx Aging Study (BAS). Numerous approaches have been taken to assess mortality effects on cognition: comparing survivors and decedents level and rate of change in cognition, and identifying individual differences in cognition associated with time-to-death. However, few studies have actually modeled within-person change in cognition as a function of time-to-death. Using linear mixed models with a change point, intraindividual change in episodic memory was modeled as a function of both age and timeto-death. A dramatic increase in the rate of decline was identified at 8.4 years prior to death, providing clear evidence of a terminal-decline phase that is much longer than previously estimated. These results emphasize the importance of modeling the time course and effects of terminal cognitive decline for understanding cognitive change in aging adults.

Original languageEnglish (US)
Pages (from-to)172-181
Number of pages10
JournalEuropean Psychologist
Issue number3
StatePublished - Aug 31 2006

All Science Journal Classification (ASJC) codes

  • Arts and Humanities (miscellaneous)
  • General Psychology


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