Predicting the Rate of Cognitive Decline in Alzheimer Disease: Data From the ICTUS Study
Predicting the Rate of Cognitive Decline in Alzheimer Disease: Data From the ICTUS Study
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DOI：
10.1097/wad.0000000000000124
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发表时间：
2016-07-01
影响因子：
2.1
通讯作者：
Cesari, Matteo
中科院分区：
文献类型：
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作者：
Canevelli, Marco;Kelaiditi, Eirini;Cesari, Matteo
背景：在阿尔茨海默病（AD）患者中观察到不同的认知进展率。本研究的目的是评估是否可以预测AD的认知恶化率广泛提供和易于评估的factors.Methods：轻度至中度AD患者招募的ICTUS研究。进行多项逻辑回归分析，以测量几个社会人口统计学和临床变量与3种不同的认知下降率之间的相关性，随访1年后，简易精神状态检查（MMSE）评分：（1）进展缓慢，MMSE评分下降1分;（2）中度进展，MMSE评分下降2 ~ 5分;（3）快速进展，MMSE评分下降6分。总体而言，大多数研究参与者（52%）表现出缓慢的认知过程。基线时较高的ADAS-Cog评分与中度和快速下降显著相关。相反，年龄的增加与认知功能的快速恶化呈负相关。结论：认知功能下降的缓慢进展是常见的AD患者。在设计AD试验和定义研究人群时，应始终仔细考虑年龄和基线认知障碍的影响。
Background:Different rates of cognitive progression have been observed among Alzheimer disease (AD) patients. The present study aimed at evaluating whether the rate of cognitive worsening in AD may be predicted by widely available and easy-to-assess factors.Methods:Mild to moderate AD patients were recruited in the ICTUS study. Multinomial logistic regression analysis was performed to measure the association between several sociodemographic and clinical variables and 3 different rates of cognitive decline defined by modifications (after 1 year of follow-up) of the Mini Mental State Examination (MMSE) score: (1) slow progression, as indicated by a decrease in the MMSE score 1 point; (2) intermediate progression, decrease in the MMSE score between 2 and 5 points; and (3) rapid progression, decrease in the MMSE score 6 points.Results:A total of 1005 patients were considered for the present analyses. Overall, most of the study participants (52%) exhibited a slow cognitive course. Higher ADAS-Cog scores at baseline were significantly associated with both intermediate and rapid decline. Conversely, increasing age was negatively associated with rapid cognitive worsening.Conclusions:A slow progression of cognitive decline is common among AD patients. The influence of age and baseline cognitive impairment should always be carefully considered when designing AD trials and defining study populations.