FACTORS AFFECTING COURSE AND SURVIVAL IN ALZHEIMERS-DISEASE - A 9-YEAR LONGITUDINAL-STUDY
FACTORS AFFECTING COURSE AND SURVIVAL IN ALZHEIMERS-DISEASE - A 9-YEAR LONGITUDINAL-STUDY
复制标题
DOI：
10.1001/archneur.1994.00540240057016
复制
发表时间：
1994-12-01
影响因子：
--
通讯作者：
AMADUCCI, L
中科院分区：
文献类型：
--
作者：
BRACCO, L;GALLATO, R;AMADUCCI, L
目的：评估阿尔茨海默病（AD）患者队列的平均生存率并确定预后因素。设计图：多中心9年队列分析研究：设置：1982年4月至1984年1月间意大利的7个神经科。患者：我们招募了145名可能患有AD的患者的连续样本（意大利痴呆症多中心研究方案，国家神经疾病和中风-阿尔茨海默病及相关疾病协会标准研究所）。5人被误诊，21人不能参加纵向研究。119例入组患者（49例男性，70例女性;平均年龄64.7岁; SD 4.1年;平均病程3.1年; SD 1.8年）的临床人口统计学特征与26例排除患者无差异。所有患者每6个月进行一次广泛的临床神经心理学测试，至少持续2年，直到患者死亡或我们的调查结束（1991年4月30日）。平均随访5.1年（标准差，2.5年）。主要结果指标：死亡、严重功能损害（幸福痴呆量表评分大于或等于7）和严重认知障碍（信息-记忆-注意力测试的分数小于或等于7）。结果：通过Kaplan-Meier方法获得的生存曲线表明：（1）早发性和迟发性疾病患者并列，65岁之前或之后）在相对生存率或达到预定功能和认知终点的时间方面没有差异;（2）重度失语症患者发生深度痴呆的时间显著早于轻中度失语症患者（P
Objective: To evaluate mean survival and to identify prognostic factors in a cohort of patients with Alzheimer's disease (AD). Design: Multicentric 9-year cohort analytic study.Setting: Seven neurology departments throughout Italy between April 1982 and January 1984.Patients: We recruited a consecutive sample of 145 patients affected by probable AD (Multicenter Italian Study on Dementia protocol, National Institute of Neurological Disorders and Stroke-Alzheimer's Disease and Related Disorders Association criteria). Five were misdiagnosed, and 21 could not participate in the longitudinal study. The clinicodemographic characteristics of the 119 enrolled patients (49 men, 70 women; mean age, 64.7 years; SD, 4.1 years; mean duration of disease, 3.1 years; SD, 1.8 years) did not differ from those of the 26 excluded patients. All underwent extensive cliniconeuropsychological testing every 6 months for at least 2 years until the patient died or our survey ended (April 30, 1991). Mean follow-up was 5.1 years (SD, 2.5 years).Main Outcome Measures: Death, severe functional impairment (a score greater than or equal to 7 on the Blessed Dementia Scale),and severe cognitive impairment (a score of less than or equal to 7 on the Information-Memory-Concentration Test).Results: Survival curves obtained by the Kaplan-Meier method indicated that (1) patients with early- and late-onset disease tie, before or after age 65 years) showed no difference either in relative survival or in time to reach predetermined functional and cognitive end points; (2) severely aphasic patients became profoundly demented significantly sooner than those with mild to moderate aphasia (P