Progression of Alzheimer's disease during a three-year follow-up using the CERAD-NB total score: Kuopio ALSOVA study

Hallikainen, Ilona; Hänninen, Tuomo; Fraunberg, Mikael von und zu; Hongisto, Kristiina; Välimäki, Tarja; Hiltunen, Asta; Karppi, Pertti; Sivenius, Juhani; Koivisto, Anne M.

doi:10.1017/s1041610213000653

Cited by 27 publications

(45 citation statements)

References 27 publications

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“…Although AD is a progressive disorder, we found that a large proportion of patients experienced no or little decline during two years of follow-up, which is consistent with other studies [5,6,8,9]. The large proportion of slow progressors illustrates the need to look beyond the mean progression rates to understand the considerable variance in disease course in AD.…”

Section: Discussionsupporting

confidence: 90%

“…Consistent with this finding, two memory clinic studies found that 25-30% of the patients were stable over a period of two to three years [5,8].…”

Section: Introductionsupporting

confidence: 57%

“…A mean yearly change in CDR-SB between 1.4 and 2.3 points is reported for patients with AD. Disease progression in AD is generally described as slower in the initial stages than in a more advanced stage of the disease, with yearly progression in CDR-SB of 0.5 to 1.9 points among patients with amnestic MCI (aMCI) or very mild dementia (CDR 0.5) and 1.3 to 1.9 points among patients with mild dementia (CDR 1) [3][4][5][6]. There is considerable individual variation in progression rates [7,8].…”

Section: Introductionmentioning

confidence: 99%

“…There is considerable individual variation in progression rates [7,8]. Using the Mini-Mental State Examination (MMSE) to measure cognition, the average loss is between 1.5 and 2.3 points per year [5,6,8,9]. A rapid cognitive decline, defined as a decrease of 3 to 5 points per year on the MMSE [8], has been shown in 10-30% of AD cases, depending on the threshold set and the population studied [8,10].…”

Section: Introductionmentioning

confidence: 99%

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Progression of Alzheimer’s Disease: A Longitudinal Study in Norwegian Memory Clinics

Eldholm

Barca

Persson

et al. 2018

JAD

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Abstract.Background: The course of Alzheimer's disease (AD) varies considerably between individuals. There is limited evidence on factors important for disease progression. Objective: The primary aim was to study the progression of AD, as measured by the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB). Secondary aims were to investigate whether baseline characteristics are important for differences in progression, and to examine the correlation between progression assessed using three different instruments: CDR-SB (0-18), the cognitive test Mini-Mental State Examination (MMSE, 0-30), and the functional measure Instrumental Activities of Daily Living (IADL, 0-1). Methods: The Progression of AD and Resource use (PADR) study is a longitudinal observational study in three Norwegian memory clinics. Results: In total, 282 AD patients (mean age 73.3 years, 54% female) were followed for mean 24 (16-37) months. The mean annual increase in CDR-SB was 1.6 (SD 1.8), the mean decrease in MMSE score 1.9 (SD 2.6), and the mean decrease in IADL score 0.13 (SD 0.14). Of the 282 patients, 132 (46.8%) progressed slowly, with less than 1 point yearly increase in CDR-SB. Cognitive test results at baseline predicted progression rate, and together with age, ApoE, history of hypertension, and drug use could explain 17% of the variance in progression rate. The strongest correlation of change was found between CDR-SB and IADL scores, the weakest between MMSE and IADL scores.

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Section: Discussionsupporting

confidence: 90%

“…Consistent with this finding, two memory clinic studies found that 25-30% of the patients were stable over a period of two to three years [5,8].…”

Section: Introductionsupporting

confidence: 57%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Progression of Alzheimer’s Disease: A Longitudinal Study in Norwegian Memory Clinics

Eldholm

Barca

Persson

et al. 2018

JAD

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“…A longitudinal decline in instrumental ADLs usually precedes the decline of basic/self-care ADLs. 21,22 Although predictors Figure 1 A) Estimated marginal means for fine motor dexterity (summed time of four trials in 9HPT) and cognitive functioning (DRS total score) after covariating for age (mean, 74.2) and education (mean, 4.6). Significant group differences in fine motor dexterity were found between controls and MDaMC (p = 0.009), controls and AD (p o 0.001), and aMCI and AD (p = 0.004).…”

Section: Discussionmentioning

confidence: 99%

Impairment of fine motor dexterity in mild cognitive impairment and Alzheimer’s disease dementia: association with activities of daily living

Paula

Albuquerque

Lage

et al. 2016

Rev. Bras. Psiquiatr.

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Objective: Cognitive impairment is a hallmark of mild cognitive impairment (MCI) and Alzheimer's disease dementia (AD). Although the cognitive profile of these patients and its association with activities of daily living (ADLs) is well documented, few studies have assessed deficits in fine motor dexterity and their association with ADL performance. The objective of this research paper is to evaluate fine motor dexterity performance among MCI and AD patients and to investigate its association with different aspects of ADLs. Methods: We assessed normal aging controls, patients with multiple-and single-domain amnestic MCI (aMCI), and patients with mild AD. Fine motor dexterity was measured with the Nine-Hole Peg Test and cognitive functioning by the Mattis Dementia Rating Scale. We analyzed the data using general linear models. Results: Patients with AD or multiple-domain aMCI had slower motor responses when compared to controls. AD patients were slower than those with single-domain aMCI. We found associations between cognition and instrumental ADLs, and between fine motor dexterity and self-care ADLs. Conclusion: We observed progressive slowing of fine motor dexterity along the normal aging-MCI-AD spectrum, which was associated with autonomy in self-care ADLs.

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Quality of Life in relation to neuropsychiatric symptoms in Alzheimer's disease: 5‐year prospective ALSOVA cohort study

Hongisto

Hallikainen

Selander

et al. 2017

Int J Geriat Psychiatry

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Objective: To examine the association between neuropsychiatric symptoms (NPS) with self-and caregiver-rated Quality of Life (QoL) for patients with Alzheimer's disease (AD) during a 5-year follow-up. Methods: The ALSOVA 5-year follow-up study included, at baseline, 236 patients with either very mild (Clinical Dementia Rating Scale (CDR) 0.5), or mild (CDR 1) AD, together with their caregivers from three Finnish hospital districts. QoL was evaluated using patient self-reported, and caregiver-rated, QoL in AD (QoL-AD) scores. NPS were assessed using the Neuropsychiatric Inventory (NPI), and AD severity was evaluated using the CDR, with cognition tested by the mini-mental state examination. The performance of daily activities was assessed using the Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory. Results: Over the 5-year follow-up period, patient self-reported QoL-AD scores did not change significantly (p = 0.245), despite increases in their NPS. However, caregiver-rated patient QoL-AD scores declined significantly (p ≤ 0.001), as total NPI scores increased during follow-up. No NPS at baseline, and only apathy at follow-up, correlated significantly (p = 0.007) with patient self-rated QoL-AD scores. Caregiver-rated patient QoL-AD scores correlated significantly with most NPS, especially (p ≤ 0.001) apathy, agitation, anxiety, irritability, depression, and delusions at baseline, and delusions, hallucinations, apathy, appetite disturbances, and anxiety during follow-up. Conclusions: Patient rated QoL-AD scores are an unreliable tool with which to evaluate the success of therapy for NPS. Instead, caregiver-rated scores for patients correlated well with NPI scores, and health care professionals in the clinic should preferentially use these.

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Progression of Alzheimer's disease during a three-year follow-up using the CERAD-NB total score: Kuopio ALSOVA study

Cited by 27 publications

References 27 publications

Progression of Alzheimer’s Disease: A Longitudinal Study in Norwegian Memory Clinics

Progression of Alzheimer’s Disease: A Longitudinal Study in Norwegian Memory Clinics

Impairment of fine motor dexterity in mild cognitive impairment and Alzheimer’s disease dementia: association with activities of daily living

Quality of Life in relation to neuropsychiatric symptoms in Alzheimer's disease: 5‐year prospective ALSOVA cohort study

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