Disease progression meta‐analysis model in Alzheimer's disease

Abstract

Baseline ADAS-cog is a significant covariate affecting the rate of disease progression, and it describes or at least explains the different rates of deterioration evident in early or late stages of the disease. There was no significant impact of publication year in the model, suggesting that disease progression has not slowed in more recent trials.

Efficacy of a medical food on cognition in Alzheimer's Disease: Results from secondary analyses of a randomized, controlled trial

“…this may be due to the poor psychometric properties of the adascog measure, such as inadequate assessment of cognitive domains such as attention, working memory and executive function (19,20) and the presence of floor effects (17). Furthermore, several recent studies have reported slower rates of placebo decline in ad patients than traditionally assumed by older models and clinical trials (12,(21)(22)(23); they have also shown that baseline adas-cog significantly affects the rate of ad progression (23,24).…”

“…to account for this issue, an ongoing study to investigate the efficacy of souvenaid in ad with adas-cog as the primary outcome measure (s-cONNect; NtR1683) includes patients with more moderate cognitive dysfunction (mmse 14-24) than the original study (mmse [20][21][22][23][24][25][26]. certainly, in the current analysis when the subgroup of ad patients with 'high' adas-cog scores at baseline was analyzed using Rmm, the data showed that souvenaid provided beneficial effects compared with control for up to 24 weeks.…”

Risk Factors for Disease Progression in Alzheimer's Disease

“…3 yrs (Bhargava et al, 2006). Ito et al observed an average MMSE loss of 5.5 pts/yr in mild to moderate AD in a metaanalysis (Ito et al, 2010). Encouraging a discussion and attempt to reach a consensus on the term "rapid cognitive decline", a threshold of 3 or more MMSE pt loss per six months has been proposed (Schmidt et al, 2011;Soto et al, 2008).…”

“…Several factors such as genetic properties, environmental circumstances, cerebral atherosclerosis, cognitive reserve, medical and social support contribute to disease progression (Etiene et al, 1998 Ito et al, 2010(576) Marra et al, 2000 sex (male) Roselli et al, 2009 (162) The role of comorbidity is subject to controversy. Diseases of the cardiovascular system and diabetes mellitus are commonly accepted as AD disease risk modulators.…”

“…The baseline level of cognition does not necessarily correlate with mortality, nonetheless, the cognitive decline rate features a considerable variability in some longitudinal studies (Hui et al, 2003). Recently a metaanalysis showed baseline ADAS-Cog values to be covariates of speed of decline (Ito et al, 2010). Santillan and coworkers proposed the use of a scale, consisting of the educational level, insight assessment, the presence of psychosis, the activities of daily living as well as MMSE.…”