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.
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 ADpatients 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 ADpatients. The influence of age and baseline cognitive impairment should always be carefully considered when designing AD trials and defining study populations.
Authors: Richard Sherva; Alden Gross; Shubhabrata Mukherjee; Ryan Koesterer; Philippe Amouyel; Celine Bellenguez; Carole Dufouil; David A Bennett; Lori Chibnik; Carlos Cruchaga; Jorge Del-Aguila; Lindsay A Farrer; Richard Mayeux; Leanne Munsie; Ashley Winslow; Stephen Newhouse; Andrew J Saykin; John S K Kauwe; Paul K Crane; Robert C Green Journal: Alzheimers Dement Date: 2020-06-23 Impact factor: 16.655
Authors: Kirsty Forsyth; Catherine Henderson; Lucy Davis; Anusua Singh Roy; Barbara Dunk; Eleanor Curnow; Rebecca Gathercole; Natalie Lam; Emma Harper; Iracema Leroi; John Woolham; Chris Fox; John O'Brien; Andrew Bateman; Fiona Poland; Peter Bentham; Alistair Burns; Anna Davies; Richard Gray; Rosie Bradley; Martin Knapp; Stanton Newman; Rupert McShane; Craig Ritchie; Emma Talbot; Emma Hooper; Rachel Winson; Bethany Scutt; Victoria Ordonez; Samantha Nunn; Grace Lavelle; Robert Howard Journal: Alzheimers Dement (N Y) Date: 2019-09-03