Journal of Alzheimer’s Disease 33 (2013) 191–203 DOI 10.3233/JAD-2012-121123 IOS Press 191 The Comparison of Cognitive and Functional Performance in Children and Alzheimer’s Disease Supports the Retrogenesis Model Sandra Rubial- ´ Alvarez a,b,1 , Susana de Sola c,1 , Mar´ ıa-Clara Machado a , Elena Sintas a , Peter B ¨ ohm a,e , Gonzalo S´ anchez-Benavides a,c , Klaus Langohr c,d , Rub´ en Mu ˜ niz e and Jordi Pe ˜ na-Casanova a,c,∗ a Behavioral Neurology and Dementias Research Group, Neurosciences Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain b Centro de Promoci´ on de la Autonom´ ıa Personal de Bergondo, IMSERSO, Ministerio de Sanidad y Pol´ ıtica Social, Bergondo, A Coru˜ na, Spain c Human Pharmacology and Clinical Neurosciences Research Group, Neurosciences Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain d Departament d’Estad´ ıstica i Investigaci´ o Operativa, Universitat Polit` ecnica de Catalunya, Barcelona, Spain e Fundaci´ on Maria Wolff, Madrid, Spain Accepted 20 July 2012 Abstract. The retrogenesis model states that the progression of brain aging and Alzheimer’s disease (AD) deterioration proceeds inversely to human ontogenic acquisition patterns. Our aim was to assess if the progressive decline of cognitive abilities and functional capacity in AD follows an inverse sequence of acquisition compared to normal developmental patterns. One hundred eighty one children ranging in age from 4 to 12 years and 148 adults (cognitively normal, subjects with mild cognitive impairment, and mild-moderately severe AD) were assessed with the same cognitive and functional tools. The statistical analyses showed a progressive and inverse distribution on cognitive, functional, and mental age scores when comparing results of children classified by chronological age and patients by dementia staging. The pattern of cognitive acquisition in children showed a progressive development of overall cognitive function along all age ranges, in addition to a simultaneous acquisition of instrumental and basic daily living activities in the functional domain. AD patients showed a progressive decline in cognitive and functional domains, which concurs with the sequence of impairment reported in this dementia. Our findings provide support to the inverse and progressive pattern of functional and cognitive decline observed in AD patients compared to the developmental acquisition of these capacities in children, as stated by the retrogenesis model. Nonetheless, certain differences should be considered when comparing the sequence of acquisition during ontogenic development with that of progressive loss during the course of AD. Retrogenesis may account for the progressive loss of neocortical-related functions in AD. Keywords: Activities of daily living, aging, Alzheimer’s disease, child development, cognition, dementia Supplementary data available online: http://www.j-alz.com/issues/33/vol33-1.html#supplementarydata06 1 Both authors contributed equally to this work. ∗ Correspondence to: Jordi Pe ˜ na-Casanova, MD, Behavioral Neu- rology and Dementia Section, Neurology Department, Hospital del Mar, Passeig Maritim, 25-29, 08003 Barcelona, Spain. Tel.: +34 93 3160778; Fax: +34 93 3160723; E-mail: JPcasanova@parcdesalutmar.cat. INTRODUCTION Alzheimer’s disease (AD) is the most frequent neurodegenerative disease worldwide [1], with epi- demiological studies estimating that 18 to 22 million people were living with AD dementia in 2010 [2–4]. ISSN 1387-2877/13/$27.50 © 2013 – IOS Press and the authors. All rights reserved