BACKGROUND/AIMS: To determine the predictive value of the 6-month evolution of the ADAS-cog score in initially mild to moderate Alzheimer's disease (AD) patients on the risk of death or severe dementia (MMSE <10) within 2 years. METHODS: Cognition was assessed every 6 months using the ADAS-cog scale in the Real.fr study, a cohort of AD patients. Six classes of ADAS-cog evolution were distinguished, from the severest deterioration (decline >or=7 points) to the greatest cognitive improvement (gain >or=4 points). RESULTS: Among 536 AD patients, 53 (9.9%) had a 6-month decline of 7 points or more. This group with the severest deterioration was significantly associated with the risk of severe dementia or death at 2 years (relative risk, RR = 3.8, 95% confidence interval, CI = 2.1-6.8), even after adjustment for baseline MMSE, disability and ADAS-cog score (RR = 2.6, 95% CI = 1.4-5.0). In addition, subjects with a decline by at least 4 points were also at greater risk of severe dementia. CONCLUSION: These results confirm the value of the ADAS-cog scale as a judgement criterion in clinical trials since it is a good surrogate marker of long-term prognosis. The proportion of fast decliners on the ADAS-cog could be a helpful judgement criterion for future trials in AD.
BACKGROUND/AIMS: To determine the predictive value of the 6-month evolution of the ADAS-cog score in initially mild to moderate Alzheimer's disease (AD) patients on the risk of death or severe dementia (MMSE <10) within 2 years. METHODS: Cognition was assessed every 6 months using the ADAS-cog scale in the Real.fr study, a cohort of ADpatients. Six classes of ADAS-cog evolution were distinguished, from the severest deterioration (decline >or=7 points) to the greatest cognitive improvement (gain >or=4 points). RESULTS: Among 536 ADpatients, 53 (9.9%) had a 6-month decline of 7 points or more. This group with the severest deterioration was significantly associated with the risk of severe dementia or death at 2 years (relative risk, RR = 3.8, 95% confidence interval, CI = 2.1-6.8), even after adjustment for baseline MMSE, disability and ADAS-cog score (RR = 2.6, 95% CI = 1.4-5.0). In addition, subjects with a decline by at least 4 points were also at greater risk of severe dementia. CONCLUSION: These results confirm the value of the ADAS-cog scale as a judgement criterion in clinical trials since it is a good surrogate marker of long-term prognosis. The proportion of fast decliners on the ADAS-cog could be a helpful judgement criterion for future trials in AD.
Authors: M E Soto; S Andrieu; C Arbus; M Ceccaldi; P Couratier; T Dantoine; J-F Dartigues; S Gillette-Guyonnet; F Nourhashemi; P-J Ousset; M Poncet; F Portet; J Touchon; B Vellas Journal: J Nutr Health Aging Date: 2008-12 Impact factor: 4.075
Authors: L Carcaillon; G Berrut; F Sellal; J F Dartigues; S Gillette; J J Pere; I Bourdeix Journal: J Nutr Health Aging Date: 2011-05 Impact factor: 4.075
Authors: Madhav Thambisetty; Andrew Simmons; Latha Velayudhan; Abdul Hye; James Campbell; Yi Zhang; Lars-Olof Wahlund; Eric Westman; Anna Kinsey; Andreas Güntert; Petroula Proitsi; John Powell; Mirsada Causevic; Richard Killick; Katie Lunnon; Steven Lynham; Martin Broadstock; Fahd Choudhry; David R Howlett; Robert J Williams; Sally I Sharp; Cathy Mitchelmore; Catherine Tunnard; Rufina Leung; Catherine Foy; Darragh O'Brien; Gerome Breen; Simon J Furney; Malcolm Ward; Iwona Kloszewska; Patrizia Mecocci; Hilkka Soininen; Magda Tsolaki; Bruno Vellas; Angela Hodges; Declan G M Murphy; Sue Parkins; Jill C Richardson; Susan M Resnick; Luigi Ferrucci; Dean F Wong; Yun Zhou; Sebastian Muehlboeck; Alan Evans; Paul T Francis; Christian Spenger; Simon Lovestone Journal: Arch Gen Psychiatry Date: 2010-07