Progression of Alzheimer's Disease: A Longitudinal Study in Norwegian Memory Clinics
Progression of Alzheimer's Disease: A Longitudinal Study in Norwegian Memory Clinics
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DOI：
10.3233/jad-170436
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发表时间：
2018-01-01
影响因子：
4
通讯作者：
Saltvedt, Ingvild
中科院分区：
文献类型：
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作者：
Eldholm, Rannveig Sakshaug;Barca, Maria Lage;Saltvedt, Ingvild
背景：阿尔茨海默病（AD）的病程因人而异。关于疾病进展的重要因素的证据有限。目的：主要目的是研究 AD 的进展，通过临床痴呆评定量表总和 (CDR-SB) 进行测量。次要目的是调查基线特征是否对进展差异很重要，并检查使用三种不同工具评估的进展之间的相关性：CDR-SB (0-18)、认知测试简易精神状态检查 (MMSE, 0-30) 和功能测量工具性日常生活活动 (IADL, 0-1)。方法：AD 进展和资源使用 (PADR) 研究是在三个挪威记忆诊所进行的纵向观察研究。结果：总的来说， 282 名 AD 患者（平均年龄 73.3 岁，54% 为女性）接受了平均 24 (16-37) 个月的随访。 CDR-SB 平均每年增加 1.6 (SD 1.8)，MMSE 评分平均下降 1.9 (SD 2.6)，IADL 评分平均下降 0.13 (SD 0.14)。在 282 名患者中，132 名（46.8%）进展缓慢，CDR-SB 每年增加不到 1 个百分点。基线认知测试结果预测了进展率，与年龄、ApoE、高血压病史和药物使用一起可以解释 17% 的进展率差异。 CDR-SB 和 IADL 评分之间的变化相关性最强，MMSE 和 IADL 评分之间的变化相关性最弱。 结论：AD 患者的进展率差异很大；大约一半的患者病情进展缓慢。基线认知测试结果是进展率的预测因子。
Background: The course of Alzheimer's disease (AD) varies considerably between individuals. There is limited evidence on factors important for disease progression.Objective: The primary aim was to study the progression of AD, as measured by the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB). Secondary aims were to investigate whether baseline characteristics are important for differences in progression, and to examine the correlation between progression assessed using three different instruments: CDR-SB (0-18), the cognitive test Mini-Mental State Examination (MMSE, 0-30), and the functional measure Instrumental Activities of Daily Living (IADL, 0-1).Methods: The Progression of AD and Resource use (PADR) study is a longitudinal observational study in three Norwegian memory clinics.Results: In total, 282 AD patients (mean age 73.3 years, 54% female) were followed for mean 24 (16-37) months. The mean annual increase in CDR-SB was 1.6 (SD 1.8), the mean decrease in MMSE score 1.9 (SD 2.6), and the mean decrease in IADL score 0.13 (SD 0.14). Of the 282 patients, 132 (46.8%) progressed slowly, with less than 1 point yearly increase in CDR-SB. Cognitive test results at baseline predicted progression rate, and together with age, ApoE, history of hypertension, and drug use could explain 17% of the variance in progression rate. The strongest correlation of change was found between CDR-SB and IADL scores, the weakest between MMSE and IADL scores.Conclusion: Progression rate varied considerably among AD patients; about half of the patients progressed slowly. Cognitive test results at baseline were predictors of progression rate.