BACKGROUND: We examined the prevalence of comorbid medical illnesses in Alzheimer's disease (AD) patients at different severity levels. We also examined the effect of cumulative medical comorbidity on cognition and function. METHODS: Analyses of data from 679 AD patients (Mini-Mental State Exam score range 0-30, mean +/- SD = 11.8 +/- 8) from 13 sites (four dementia centers assessing outpatients, four managed care organizations, two assisted living facilities, and three nursing homes) prospectively recruited using a stratification approach including dementia severity and care setting. Medical comorbidity was quantified using the Cumulative Illness Rating Scale-Geriatric. RESULTS: Across patients, 61% had three or more comorbid medical illnesses. Adjusting for age, gender, race, and care setting, medical comorbidity increased with dementia severity (mild to moderate, p <.01; moderate to severe, p <.001). Adjusting for age, educational level, gender, race, and care setting, higher medical comorbidity was associated with greater impairment in cognition (p <.001) and in self-care (p <.001). CONCLUSIONS: Despite the limitation of a cross-sectional design, our initial findings suggest that there is a strong association between medical comorbidity and cognitive status in AD. Optimal management of medical illnesses may offer potential to improve cognition in AD.
BACKGROUND: We examined the prevalence of comorbid medical illnesses in Alzheimer's disease (AD) patients at different severity levels. We also examined the effect of cumulative medical comorbidity on cognition and function. METHODS: Analyses of data from 679 ADpatients (Mini-Mental State Exam score range 0-30, mean +/- SD = 11.8 +/- 8) from 13 sites (four dementia centers assessing outpatients, four managed care organizations, two assisted living facilities, and three nursing homes) prospectively recruited using a stratification approach including dementia severity and care setting. Medical comorbidity was quantified using the Cumulative Illness Rating Scale-Geriatric. RESULTS: Across patients, 61% had three or more comorbid medical illnesses. Adjusting for age, gender, race, and care setting, medical comorbidity increased with dementia severity (mild to moderate, p <.01; moderate to severe, p <.001). Adjusting for age, educational level, gender, race, and care setting, higher medical comorbidity was associated with greater impairment in cognition (p <.001) and in self-care (p <.001). CONCLUSIONS: Despite the limitation of a cross-sectional design, our initial findings suggest that there is a strong association between medical comorbidity and cognitive status in AD. Optimal management of medical illnesses may offer potential to improve cognition in AD.
Authors: Jeannie-Marie S Leoutsakos; Sarah N Forrester; Christopher D Corcoran; Maria C Norton; Peter V Rabins; Martin I Steinberg; Joann T Tschanz; Constantine G Lyketsos Journal: Int J Geriatr Psychiatry Date: 2014-11-03 Impact factor: 3.485
Authors: Jeannie-Marie S Leoutsakos; Dingfen Han; Michelle M Mielke; Sarah N Forrester; JoAnn T Tschanz; Chris D Corcoran; Robert C Green; Maria C Norton; Kathleen A Welsh-Bohmer; Constantine G Lyketsos Journal: Int Psychogeriatr Date: 2012-06-12 Impact factor: 3.878
Authors: Christine R Kovach; Brent R Logan; Michelle R Simpson; Sheila Reynolds Journal: Am J Alzheimers Dis Other Demen Date: 2010-03-17 Impact factor: 2.035
Authors: Maria Vassilaki; Jeremiah A Aakre; Ruth H Cha; Walter K Kremers; Jennifer L St Sauver; Michelle M Mielke; Yonas E Geda; Mary M Machulda; David S Knopman; Ronald C Petersen; Rosebud O Roberts Journal: J Am Geriatr Soc Date: 2015-08-27 Impact factor: 5.562
Authors: Mary D Naylor; Karen B Hirschman; Kathryn H Bowles; M Brian Bixby; JoAnne Konick-McMahan; Caroline Stephens Journal: Home Health Care Serv Q Date: 2007
Authors: Andrea Bradford; Mark E Kunik; Paul Schulz; Susan P Williams; Hardeep Singh Journal: Alzheimer Dis Assoc Disord Date: 2009 Oct-Dec Impact factor: 2.703
Authors: Alistair Burns; Andrew Yeates; Latif Akintade; Megan Del Valle; Richard Y Zhang; Elias M Schwam; Carlos A Perdomo Journal: Drugs Aging Date: 2008 Impact factor: 3.923