Prognostic calculators for patients with Alzheimers disease and related dementias

摘要： 考虑阿尔茨海默病及其相关疾病所有阶段患者的预后和预期寿命 痴呆症会提高决策能力。老年人的决定受预后的影响很大 阿尔茨海默病和相关痴呆症包括癌症筛查、疗养院财务规划 安置和临终关怀资格。尽管预后很重要，但没有广泛适用的， 准确、有效的工具来评估阿尔茨海默病及其相关疾病所有阶段的预后 为居住在社区的患者提供痴呆症。现有型号要么专为有以下情况的人设计 疗养院中的晚期痴呆症，过时的，或患有小样本或不可推广的样本。我们的 目标是开发一套专门针对阿尔茨海默病患者的临床有用的预后模型 以及相关的痴呆症。为了最大限度地提高忙碌的临床医生访问这些模型的可能性，我们将 将这些模型嵌入我们的预测计算器在线汇编ePrognosis.org上。我们将发展 估计预期寿命、入住疗养院的时间和6岁以内死亡风险的预测模型 为阿尔茨海默病和相关痴呆症患者在全国有代表性的健康和 退休研究。我们将使用阿尔茨海默病患者和 国家健康和老龄化趋势研究登记了相关痴呆症患者。经过验证，这些模型可以 被广泛用于为数百万患有阿尔茨海默病的美国人提供临床和政策层面的决策 以及相关的痴呆症。

Abstract: Considering prognosis and life expectancy in patients across all stages of Alzheimer's disease and related dementias improves decision-making. Decisions that are highly influenced by prognosis for older adults with Alzheimer's disease and related dementias include cancer screening, planning financially for nursing home placement, and hospice eligibility. Despite the importance of prognosis, there are no widely-applicable, accurate, and validated tools to estimate prognosis across all stages of Alzheimer's disease and related dementias for patients living in the community. Existing models are either exclusively for persons with advanced dementia in nursing homes, outdated, or suffer from small size or non-generalizable samples. Our goal is to develop a set of clinically useful prognostic models specifically for persons with Alzheimer's disease and related dementias. To maximize the likelihood that these models are accessible to busy clinicians, we will embed these models on eprognosis.org, our online compendium of prognostic calculators. We will develop prognostic models that estimate life expectancy, time to nursing home admission, and risk of death within 6 months for persons with Alzheimer's disease and related dementias in the nationally representative Health and Retirement Study. We will externally validate these models using persons with Alzheimer's disease and related dementias enrolled in the National Health and Aging Trends Study. After validation, these models can be widely used to inform clinical and policy-level decisions for millions of Americans with Alzheimer's disease and related dementias.