Predicting progression of Alzheimer's disease
Predicting progression of Alzheimer's disease
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DOI：
10.1186/alzrt38
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发表时间：
2010-01-01
影响因子：
9
通讯作者：
Chan, Wenyaw
中科院分区：
文献类型：
--
作者：
Doody, Rachelle S.;Pavlik, Valory;Chan, Wenyaw
简介：临床医生需要预测阿尔茨海默病（AD）的预后，研究人员需要进展模型来开发生物标志物和临床试验设计。我们测试了计算的初始进展率，看看它是否预测性能的认知，功能和行为随着时间的推移，并看看它是否预测survival.Methods：我们使用标准化的方法来评估基线特征和估计疾病的持续时间，并计算初始（进展前）率在597 AD患者随访长达15年。我们指定了缓慢、中间和快速进展组。使用混合效应回归分析，我们研究了进展前组对标准化测量的纵向表现的预测价值。结果：慢性组和中度组患者在认知功能（ADAScog和VSAT）、整体功能（CDR-SB）和复杂日常生活活动能力（IADL）方面均优于中度组（P <0.05），而慢性组和中度组患者在认知功能（ADAScog和VSAT）、整体功能（CDR-SB）和复杂日常生活活动能力（IADL）方面均优于中度组（P <0.05），而中度组患者在认知功能（ADAScog和VSAT）、整体功能（CDR-SB）和复杂日常生活活动能力（IADL）方面均优于中度组（P <0.05）。
Introduction: Clinicians need to predict prognosis of Alzheimer's disease (AD), and researchers need models of progression to develop biomarkers and clinical trials designs. We tested a calculated initial progression rate to see whether it predicted performance on cognition, function and behavior over time, and to see whether it predicted survival.Methods: We used standardized approaches to assess baseline characteristics and to estimate disease duration, and calculated the initial (pre-progression) rate in 597 AD patients followed for up to 15 years. We designated slow, intermediate and rapidly progressing groups. Using mixed effects regression analysis, we examined the predictive value of a pre-progression group for longitudinal performance on standardized measures. We used Cox survival analysis to compare survival time by progression group.Results: Patients in the slow and intermediate groups maintained better performance on the cognitive (ADAScog and VSAT), global (CDR-SB) and complex activities of daily living measures (IADL) (P values