Home › Research › Getting a diagnosis
Decoding the Clinical Features that Associate with Progression, Causes, and Outcomes in Patients with Suspected Rapidly Progressive Dementia
Yoav D. Piura, Nihal Satyadev, Nick Corriveau‐Lecavalier, Lindsey A. Kuchenbecker, Lauren Elaine Haydu, Michael D. Geschwind, Philip W. Tipton, Neill R. Graff‐Radford et al.. Annals of Neurology, 2025-06-20
Topic: Risk, prevention and care in population studies
Objective To determine the clinical features that identify patients with suspected rapidly progressive dementia (RPD) who will develop RPD. Methods Patients with suspected RPD were enrolled and followed at Mayo Clinic (Jacksonville, FL; January 2020 to October 2023) and Washington University (Saint Louis, MO; June 2016 to December 2019). Two dementia specialists independently reviewed clinical data and assigned diagnoses. Patients were diagnosed with RPD if they developed dementia within 1 year or incapacitation within 2 years of symptom onset. The associations between clinical features and causes and outcomes were explored via univariate and multivariate comparisons. Results Of 248 patients with suspected RPD, 185 (74.6%) met criteria for RPD. Patients with RPD were older (62.6 ± 14.5 vs 55.2 ± 18.1 years; p < 0.001), and more frequently diagnosed with Alzheimer's disease or related dementias (OR 3.13, 95% CI 1.40, 7.31) or Creutzfeldt–Jakob disease (OR 4.67, 95% CI 1.38, 15.75). Visual agnosia (15/183; 8.2%), substantial brain atrophy (27/182; 14.8%), and periodic epileptiform discharges (11/151; 7.3%) were exclusively detected in patients with RPD. After controlling for age, intensive care unit admission (OR 4.77, 95% CI 1.61, 14.12), lack of seizures (OR 2.47, 95% CI 1.15, 5.31), abnormal brain magnetic resonance imaging (OR 2.01, 95% CI 0.997, 4.05), and cerebrospinal fluid white blood cell count ≤5 cells/mm 3 (OR 3.30, 95% CI 1.60, 6.82) were also independently associated with RPD. Patients with RPD were more likely to die or develop severe dementia (mean time to outcome, 36.1 months; 95% CI 31.2–41.0). Interpretation Selected clinical features may identify patients with suspected RPD who are likely to continue to decline. Early recognition of these features may improve diagnostic accuracy and inform prognosis. ANN NEUROL 2025;98:764–776
Key findings
- Results Of 248 patients with suspected RPD, 185 (74.6%) met criteria for RPD.
- After controlling for age, intensive care unit admission (OR 4.77, 95% CI 1.61, 14.12), lack of seizures (OR 2.47, 95% CI 1.15, 5.31), abnormal brain magnetic resonance imaging (OR 2.01, 95% CI 0.997, 4.05), and cerebrospinal fluid white blood cell count ≤5 cells/mm 3 (OR 3.30, 95% CI 1.60, 6.82) were also independently associated with RPD.
Why it matters
Among 248 patients with suspected rapidly progressive dementia, 185 met criteria for it, and certain clinical features were associated with developing it. This study is about identifying features that predict progression and causes, not about treating, curing or preventing Alzheimer's disease.
New to this subject? Start with our plain-English guide: Getting a diagnosis →
Study details
- Participants248
- Effect size74.6%; OR 3.13; OR 4.67
- Evidence strengthLow
How this study scored 52/100
Published in a leading specialty journal. Scored zero for study design and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 9 / 10 | Tier 2 — leading specialty journal (Annals of Neurology) |
| Journal's citation record | 3 / 4 | Annals of Neurology: journal h-index 437 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 4 / 5 | 2025 — within 3 year(s) of the newest study here |
| Sample size | 2 / 4 | 248 participants |
| Effect reported | 3 / 3 | Effect reported with a statistic (interval, p-value, ratio or similar) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 2 / 7 | Cited 6 times (OpenAlex, 2026-10-10) |
| Citations per year | 1 / 5 | 2.0 citations a year over 3 year(s) since 2025 |
| Impact for its field and year | 3 / 6 | Cited 3.8× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 1 / 6 | Cited by 2 other studies in this library |
| Still being cited | 1 / 4 | Cited 6 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 2 / 4 | Last-listed author Gregory Scott Day: h-index 43 (OpenAlex, whole career) |
| Institution's track record | 2 / 3 | University of California, San Francisco: institution h-index 1,915 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 40539812) |
| Free to read | 2 / 2 | Free to read |
| Total | 52 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
Full text: free to read — OpenAlex lists this copy as free to read: the link above (checked 6 Feb 1020).
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record's author list ends in “et al.”, so not every author is named. Check the citation against the original before you use it.
APA 7th
Piura, Y. D., Satyadev, N., Corriveau‐Lecavalier, N., Kuchenbecker, L. A., Haydu, L. E., Geschwind, M. D., et al. (2025). Decoding the Clinical Features that Associate with Progression, Causes, and Outcomes in Patients with Suspected Rapidly Progressive Dementia. Annals of Neurology. https://doi.org/10.1002/ana.27297
Vancouver
Piura YD, Satyadev N, Corriveau‐Lecavalier N, Kuchenbecker LA, Haydu LE, Geschwind MD, et al. Decoding the Clinical Features that Associate with Progression, Causes, and Outcomes in Patients with Suspected Rapidly Progressive Dementia. Annals of Neurology. 2025. doi:10.1002/ana.27297. PMID: 40539812.
BibTeX
@article{piura2025-40539812,
author = {Piura, Yoav D. and Satyadev, Nihal and Corriveau‐Lecavalier, Nick and Kuchenbecker, Lindsey A. and Haydu, Lauren Elaine and Geschwind, Michael D. and Tipton, Philip W. and Graff‐Radford, Neill R. and others},
title = {{Decoding the Clinical Features that Associate with Progression, Causes, and Outcomes in Patients with Suspected Rapidly Progressive Dementia}},
journal = {Annals of Neurology},
year = {2025},
doi = {10.1002/ana.27297},
pmid = {40539812},
url = {https://doi.org/10.1002/ana.27297}
}
Studies this one cites
Referenced by this study and also in the alzhub library, so you can read them here.
Later studies that cite this one
2 studies in the alzhub library list this one in their references.