Neuropsychiatric symptoms as predictors of progression to severe Alzheimer's dementia and death: the Cache County Dementia Progression Study.
Neuropsychiatric symptoms as predictors of progression to severe Alzheimer's dementia and death: the Cache County Dementia Progression Study.
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DOI：
10.1176/appi.ajp.2014.14040480
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发表时间：
2015-05
期刊：
影响因子：
--
通讯作者：
Lyketsos CG
中科院分区：
文献类型：
--
作者：
Peters ME;Schwartz S;Han D;Rabins PV;Steinberg M;Tschanz JT;Lyketsos CG
人们对影响阿尔茨海默氏痴呆症进展速度的因素知之甚少。利用卡什县痴呆进展研究的数据，我们研究了轻度阿尔茨海默氏痴呆的临床显着神经精神症状与进展为严重痴呆或死亡之间的联系。卡什县痴呆症进展研究是一项针对该病事件病例中痴呆症进展的纵向研究。生存分析包括未经调整的 Kaplan-Meier 图和多元 Cox 比例风险模型。风险比估计值受痴呆症发病年龄、基线痴呆持续时间、性别、教育水平、一般医疗健康评级和载脂蛋白 E epsilon 4 (APOE-ε4) 基因型控制。研究人员对三百三十五名患有阿尔茨海默氏痴呆症的患者进行了研究。六十八人（20%）在随访期间出现严重痴呆。精神病（风险比=2.007，p=0.028）、激越/攻击性（风险比=2.946，p=0.004）和任何一种临床上显着的神经精神症状（领域评分≥4，风险比=2.682，p=0.001）与更快进展为严重痴呆有关。精神病（风险比=1.537，p=0.011）、情感症状（风险比=1.510，p=0.003）、激越/攻击性（风险比=1.942，p=0.004）、轻度症状性神经精神症状（领域评分为1-3，风险比=1.448，p=0.024）和临床显着性神经精神症状（风险比=1.951，p=<0.001）与早期死亡相关。特定的神经精神症状与从轻度阿尔茨海默氏痴呆到重度痴呆和/或死亡的较短生存时间相关。应检查对轻度阿尔茨海默氏痴呆症的特定神经精神症状的治疗是否有可能延迟严重痴呆症或死亡的时间。
Little is known about factors influencing the rate of progression of Alzheimer’s dementia. Using data from the Cache County Dementia Progression Study, we examined the link between clinically significant neuropsychiatric symptoms in mild Alzheimer’s dementia and progression to severe dementia or death. The Cache County Dementia Progression Study is a longitudinal study of dementia progression in incident cases of the condition. Survival analyses included unadjusted Kaplan-Meier plots and multivariate Cox proportional hazard models. Hazard ratio estimates controlled for age of dementia onset, dementia duration at baseline, gender, education level, General Medical Health Rating, and apolipoprotein E epsilon 4 (APOE-ε4) genotype. Three hundred thirty-five patients with incident Alzheimer’s dementia were studied. Sixty-eight (20%) developed severe dementia over the follow-up. Psychosis (hazard ratio=2.007, p=0.028), agitation/aggression (hazard ratio=2.946, p=0.004), and any one clinically significant neuropsychiatric symptom (domain score of ≥4, hazard ratio=2.682, p=0.001) were associated with more rapid progression to severe dementia. Psychosis (hazard ratio=1.537, p=0.011), affective symptoms (hazard ratio=1.510, p=0.003), agitation/aggression (hazard ratio=1.942, p=0.004), mildly symptomatic neuropsychiatric symptoms (domain score of 1–3, hazard ratio=1.448, p=0.024), and clinically significant neuropsychiatric symptoms (hazard ratio=1.951, p=<0.001) were associated with earlier death. Specific neuropsychiatric symptoms are associated with shorter survival time from mild Alzheimer’s dementia to severe dementia and/or death. The treatment of specific neuropsychiatric symptoms in mild Alzheimer’s dementia should be examined for its potential to delay time to severe dementia or death.
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影响因子：
17.7
作者：
Steinberg, Martin;Lyketsos, Constantine G.
通讯作者：
Lyketsos, Constantine G.
影响因子：
9.9
作者：
Storandt, M;Grant, EA;Morris, JC
通讯作者：
Morris, JC
影响因子：
9.9
作者：
MCKHANN, G;DRACHMAN, D;STADLAN, EM
通讯作者：
STADLAN, EM
影响因子：
4.8
作者：
FOLSTEIN, MF;FOLSTEIN, SE;MCHUGH, PR
通讯作者：
MCHUGH, PR
DOI：
10.1111/j.1532-5415.1999.tb07245.x
发表时间：
1999-04-01
影响因子：
6.3
作者：
Lyketsos, CG;Galik, E;Brandt, J
通讯作者：
Brandt, J