David A González1,2,3, Zachary J Resch4, Mitzi M Gonzales1,2, Jason R Soble4,5. 1. Department of Neurology. 2. Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Science Center at San Antonio, San Antonio, TX. 3. Department of Neurological Sciences, Rush University Medical Center, Chicago, IL. 4. Departments of Psychiatry. 5. Neurology, University of Illinois College of Medicine.
Abstract
OBJECTIVE: The aim was to set syndrome stage-specific (eg, cognitively unimpaired, severe dementia) metrics for functional change. METHODS: We selected 18,097 individuals who participated in 2 National Alzheimer's Coordinating Center visits between June 2005 and May 2020, with completed collateral rating of functioning on activities of daily living assessed by the Functional Activities Questionnaire.Both distribution-based (ie, regression-based reliable change indices) and anchor-based (ie, typical change associated with advancing a syndromal stage for clinically meaningful difference) methods were applied for individuals classified as: unimpaired cognition, mild cognitive impairment, mild dementia, moderate dementia, or severe dementia. RESULTS: There were marked differences in the distribution of functional ratings depending on their syndromal stage. There were also differences in the functional change associated with advancing across different syndromal stages. These informed stage-specific metrics for reliable change indices and clinically meaningful differences. CONCLUSIONS: Our indices provide a hitherto unavailable method that allows clinicians to determine whether observed functional change is reliable or meaningful based on syndromal stage.
OBJECTIVE: The aim was to set syndrome stage-specific (eg, cognitively unimpaired, severe dementia) metrics for functional change. METHODS: We selected 18,097 individuals who participated in 2 National Alzheimer's Coordinating Center visits between June 2005 and May 2020, with completed collateral rating of functioning on activities of daily living assessed by the Functional Activities Questionnaire.Both distribution-based (ie, regression-based reliable change indices) and anchor-based (ie, typical change associated with advancing a syndromal stage for clinically meaningful difference) methods were applied for individuals classified as: unimpaired cognition, mild cognitive impairment, mild dementia, moderate dementia, or severe dementia. RESULTS: There were marked differences in the distribution of functional ratings depending on their syndromal stage. There were also differences in the functional change associated with advancing across different syndromal stages. These informed stage-specific metrics for reliable change indices and clinically meaningful differences. CONCLUSIONS: Our indices provide a hitherto unavailable method that allows clinicians to determine whether observed functional change is reliable or meaningful based on syndromal stage.
Authors: Steve Balsis; Lisa Geraci; Jared Benge; Deborah A Lowe; Tabina K Choudhury; Robert Tirso; Rachelle S Doody Journal: J Gerontol B Psychol Sci Soc Sci Date: 2018-08-14 Impact factor: 4.077
Authors: Roos J Jutten; Sietske A M Sikkes; Rebecca E Amariglio; Rachel F Buckley; Michael J Properzi; Gad A Marshall; Dorene M Rentz; Keith A Johnson; Charlotte E Teunissen; Bart N M Van Berckel; Wiesje M Van der Flier; Philip Scheltens; Reisa A Sperling; Kathryn V Papp Journal: J Int Neuropsychol Soc Date: 2020-10-13 Impact factor: 2.892
Authors: Gil D Rabinovici; Maria C Carrillo; Mark Forman; Susan DeSanti; David S Miller; Nicholas Kozauer; Ronald C Petersen; Christopher Randolph; David S Knopman; Eric E Smith; Maria Isaac; Niklas Mattsson; Lisa J Bain; James A Hendrix; John R Sims Journal: Alzheimers Dement (N Y) Date: 2016-09-20