Determinants of Progression and Mortality in Alzheimers disease: A Systematic Review

Modrego, Pedro J.; Lobò, Antonio

doi:10.4172/neuropsychiatry.1000479

Cited by 11 publications

(20 citation statements)

References 75 publications

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“…Construct validity of the domains was shown through testing of an a priori hypothesis of their association with recognised outcomes. A record of a marker such as psychosis within the Severe Neuropsychiatric domain increased risk of all outcomes, concordant with a previously identified link of behavioural and psychological symptoms and/or antipsychotic use with risk of hospitalisation, nursing home admission, and mortality [28–31]. The Increased Multimorbidity, Comorbidity, and Symptoms domains were commonly recorded and strongly associated with the outcomes, supporting reviews showing increases in comorbidity and health‐related burden related to poor dementia outcomes [30,32,33].…”

Section: Discussionsupporting

confidence: 77%

“…A record of a marker such as psychosis within the Severe Neuropsychiatric domain increased risk of all outcomes, concordant with a previously identified link of behavioural and psychological symptoms and/or antipsychotic use with risk of hospitalisation, nursing home admission, and mortality [28–31]. The Increased Multimorbidity, Comorbidity, and Symptoms domains were commonly recorded and strongly associated with the outcomes, supporting reviews showing increases in comorbidity and health‐related burden related to poor dementia outcomes [30,32,33]. The Care domain showed associations across all outcomes; research shows that caregiver coping and stress is associated with poor outcomes in the person with dementia [30,34], but also will be reflective of increased provision of care as demonstrated by the strong association with palliative care.…”

Section: Discussionsupporting

confidence: 75%

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Indicators of dementia disease progression in primary care: An electronic health record cohort study

Rathod‐Mistry

Marshall

Campbell

et al. 2021

Euro J of Neurology

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Background and purpose The objectives were to assess the feasibility and validity of using markers of dementia‐related health as indicators of dementia progression in primary care, by assessing the frequency with which they are recorded and by testing the hypothesis that they are associated with recognised outcomes of dementia. The markers, in 13 domains, were derived previously through literature review, expert consensus, and analysis of regional primary care records. Methods The study population consisted of patients with a recorded dementia diagnosis in the Clinical Practice Research Datalink, a UK primary care database linked to secondary care records. Incidence of recorded domains in the 36 months after diagnosis was determined. Associations of recording of domains with future hospital admission, palliative care, and mortality were derived. Results There were 30,463 people with diagnosed dementia. Incidence of domains ranged from 469/1000 person‐years (Increased Multimorbidity) to 11/1000 (Home Pressures). An increasing number of domains in which a new marker was recorded in the first year after diagnosis was associated with hospital admission (hazard ratio for ≥4 domains vs. no domains = 1.24; 95% confidence interval = 1.15–1.33), palliative care (1.87; 1.62–2.15), and mortality (1.57; 1.47–1.67). Individual domains were associated with outcomes with varying strengths of association. Conclusions Feasibility and validity of potential indicators of progression of dementia derived from primary care records are supported by their frequency of recording and associations with recognised outcomes. Further research should assess whether these markers can help identify patients with poorer prognosis to improve outcomes through stratified care and targeted support.

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Section: Discussionsupporting

confidence: 77%

Section: Discussionsupporting

confidence: 75%

Indicators of dementia disease progression in primary care: An electronic health record cohort study

Rathod‐Mistry

Marshall

Campbell

et al. 2021

Euro J of Neurology

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“…Полученные данные о большей тяжести деменции при первичном обращении и относительном увеличении доли мужчин в завершённых случаях совпадают с прогностическими оценками роли этих факторов при изучении показателей смертности в работах других авторов [18,15].…”

Section: Discussionunclassified

Dementia in old age: from diagnosis to fatal outcome

Mikhailova¹,

Sokolova²

2020

V.M. BEKHTEREV REVIEW OF PSYCHIATRY AND MEDICAL PSYCHOLOGY

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Background: It is well known, that old age dementias steadily grow progressively worse and inevitably lead to fatal outcome. Mortality indices in foreign research largely vary, they are practically absent in domestic scientific studies, and official statistical data on the prevalence of dementia and the cause of death do not reflect the real situation. The Objective of the study was to perform the analysis of completed cases of late age dementias from the materials of observations in Alzheimer’s disease center of the Mental Health Research Center.Patients and Methods: Observational study, using prospective method of out-patient observation of subjects with dementias, who consulted Alzheimer’s disease center in 2007-2016 for the first time, made it possible to obtain reliable data on 217 patients, who died during this period.Results: More than one third of such cases (39%) referred to nosologically various dementias with an early onset of the disease. In more than half of the cases (58%) the cause of death was medical pathology. In the rest of the patients severe or terminal stage of the basic disease was noticed toward the end of life under conditions of home care.Conclusions: Holistic view of the clinical picture of old age dementias (from the onset of the disease till the fatal outcome) is necessary for creation of incidence registers and obtaining of science-based statistical indices of survival, mortality and causes of death. It is necessary to develop measures of assistance to families of patients with the most severe stage of dementias, creation of out-patient and in-patient network of hospices for this contingent of patients.

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“…Противоречивые результаты получены в отношении применения антипсихотиков у больных деменцией. По данным обзора 42 исследований атипичные антипсихотики не обнаружили влияния на уменьшение сроков дожития, но их применение обнаружило ассоцииацию с более быстрым когнитивным снижением [54].…”

Section: некогнитивные (поведенческие и психопатологические) симптомыunclassified

“…Изложенные в настоящем обзоре результаты изучения влияния отдельных факторов на скорость прогрессирования деменции варьируются от вполне ожидаемых в соответствии с клиническим опытом до значительных расхождений в представлениях, что находит подтверждение в других обзорах и обосновывает необходимость дальнейших многоаспектных клинико-биологических исследований [50,52,54]. Ведение больных деменцией в практике предусматривает учет различных факторов, влияющих на скорость прогрессирования деменции, для планирования объема и характера лечебной помощи.…”

Section: заключениеunclassified

Old Age Dementias: Factors Associated with Dementia Progression Rate. Part 2

Mikhailova¹

2020

Psychiatry

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Background: steady progression of dementia is characterized with various rates, which specified clinical differentiation of dementias with rapid and slow increase of cognitive decline severity. The search for clinical factors, hypothetically responsible for differences in late age dementia progression rate, is one of the aspects of investigation of late age dementias.The objective was to generalize the results of the study of separate clinical factors effect on the differences in the late age dementia progression rate.Material and methods: papers in MEDLINE/PubMed bases from 1990 to 2020 were selected and analyzed according to the key words: “late age”, “dementia”, “progression rate”, “age of onset”, “non-cognitive disorders”, “nosomodifying therapy”, as well as relevant papers in the literature of the analyzed works.Conclusion: various parameters of the disease were studied as associated with dementia progression pattern. As regards part of them the results achieved compliance in recognition of association with dementia progression rate. As for the others this evidence is ambiguous. There are large discrepancies in attitudes to gender differences, while early age of disease onset, initially great intensity of neuropsychiatric disorders are concordantly admitted as associated with dementia rapid progression. The researchers are united with steady idea of nonlinear character of dementia progression at the stages of mild, moderate and severe dementia.The results of study of comorbidity are basically similar with regard to recognition of SFD influence, first of all, of arterial hypertension on dementia progression rate. The evidence of the efficacy of nosomodifying therapy, decelerating dementia progression, is unanimously considered an urgent problem. The development of new dementia pathogenesis concepts and the search for new therapy targets, are conducive to the solution of this problem. The results of the investigated direction of studies confirm the hypothesis of the fact that dementia progression occurs according to various pathogenetic mechanisms, which determine the dementia increasing rate. The management of patients with dementia in practice presupposes taking into account of various factors, influencing dementia progression rate, for planning of the volume and character of medical care.

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Determinants of Progression and Mortality in Alzheimers disease: A Systematic Review

Cited by 11 publications

References 75 publications

Indicators of dementia disease progression in primary care: An electronic health record cohort study

Indicators of dementia disease progression in primary care: An electronic health record cohort study

Dementia in old age: from diagnosis to fatal outcome

Old Age Dementias: Factors Associated with Dementia Progression Rate. Part 2

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