摘要
背景:神经心理测试(NPTS)在阿尔茨海默病(AD)治疗中的纵向变化对于了解药物治疗反应和药物治疗反应之间的相互作用至关重要。ASE下降是由于退化过程。本研究的目的是研究AD患者的年认知进展情况,并评估其潜力。疾病进展的预测因子。 方法:2009年1月至12月20日,在台湾南部三所医院的记忆诊所,对455例AD患者进行胆碱酯酶抑制剂(ChEIS)或美金刚治疗。14人参加了这项前瞻性的注册研究。平均随访时间为3.2±0.9年。AD的严重程度为非常轻微(临床痴呆分级(CDR)=0。5)至中度(CDR=2.0)。在基线和每年的测试中,参与者通过临床实践中常用的多项NPT进行评估,包括最小精神状态检查(MMSE)、认知测试。能力筛选仪(CASI),CDR和CDR-和盒(CDR-SB).。所有登记的参与者在随访期间至少接受两年的评估.。我们用混合效应模型来检验年度。整个组的进展情况,并比较轻度AD和轻度至中度AD亚组之间的认知进展。疾病进展的潜在预测因素,包括年龄、性别NDER、ChEI分型、载脂蛋白E(APOE)基因型分析。 结果:研究组MMSE评分年变化率为-1.15分,CASI分为-4.27分,CDR-SB分年变化率为0.81分。ANN的斜率CDR 0.5组与CDR 1~2组的UAL变化有显着性差异(P<0.05)。最显著的预测因素是年龄的增长和早期CDR分期的升高。然而,不同类型的ChEI治疗(多奈哌齐与利瓦斯丁使用者)和APOE基因型与疾病进展率无关。 结论:该纵向资料显示AD患者MMSE、CASI、CDR和CDR-SB的年平均变化.。这些数据可以为临床医生提供有关认知方面的信息。AD患者在现实世界中接受批准的药物治疗时,每年的下降率。老年痴呆症患者在接受治疗时年龄和严重程度的增加是主要因素。与更快的恶化有关。
关键词: 阿尔茨海默病,认知能力筛查工具,临床痴呆评定量表,临床痴呆评定量表,简易精神状态检查,系列认知评估.
Current Alzheimer Research
Title:Longitudinal Neuropsychological Outcome in Taiwanese Alzheimer's Disease Patients Treated with Medication
Volume: 15 Issue: 5
关键词: 阿尔茨海默病,认知能力筛查工具,临床痴呆评定量表,临床痴呆评定量表,简易精神状态检查,系列认知评估.
摘要: Background: The longitudinal change of neuropsychological tests (NPTs) in treated Alzheimer's disease (AD) is essential to understand the interplay of a therapeutic response from medication and a disease decline due to degenerative processes. The aim of our study is to investigate the annual cognitive progression as measured by commonly used NPTs in treated AD patients and to assess the potential predictors of disease progression.
Methods: Participants (N=455) diagnosed with AD and treated with cholinesterase inhibitors (ChEIs) or memantine at memory clinics in three hospitals in southern Taiwan from January 2009 to December 2014 were enrolled in this prospectively registered study. The mean follow-up duration was 3.2 ± 0.9 years. The patients' severity of AD ranged from very mild (clinical dementia rating (CDR) scales = 0.5) to moderate (CDR = 2.0). At baseline and for each year, participants were assessed by various NPTs commonly used in clinical practice, including the Mini-Mental State Examination (MMSE), Cognitive Abilities Screening Instrument (CASI), CDR and CDR-sum of boxes (CDR-SB). All enrolled participants were assessed for at least two years during follow-up. We used mixed-effect models to examine annual progression in the whole group and to compare the cognitive progression between the subgroups with very mild AD and mild to moderate AD. Potential predictors of disease progression, including age, gender, the type of ChEI, and Apolipoprotein E (APOE) genotype, were also analyzed.
Results: Among the study population, the rate of change in MMSE scores were -1.15 points per year, CASI scores were -4.27 points per year, and CDR-SB scores were 0.81 points per year. The slope of annual changes of NPTs differed significantly between the CDR 0.5 group and the CDR 1 to 2 group. The most significant predictors of the faster progression were increasing age and higher CDR stage at entry; however, different types of ChEI therapy (donepezil vs. rivastigmine users), and APOE genotype were not associated with the rate of disease progression.
Conclusions: This longitudinal data shows the mean annual change of the MMSE, CASI, CDR, and CDR-SB in treated AD patients. The data may provide clinicians with information regarding to the cognitive decline rate in every year while their AD patients receive approved pharmacological therapy in real-world practice. Increasing age and severity of dementia when receiving therapy are the main factors that associated with faster deterioration.
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Cite this article as:
Longitudinal Neuropsychological Outcome in Taiwanese Alzheimer's Disease Patients Treated with Medication, Current Alzheimer Research 2018; 15 (5) . https://dx.doi.org/10.2174/1567205014666171010112518
DOI https://dx.doi.org/10.2174/1567205014666171010112518 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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Aims and Scope: Introduction: Alzheimer's disease (AD) poses a significant global health challenge, with an increasing prevalence that demands concerted efforts to advance our understanding and strategies for prevention, diagnosis, treatment, and rehabilitation. This thematic issue aims to bring together cutting-edge research and innovative approaches from multidisciplinary perspectives to address ...read more
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Deep Learning for Advancing Alzheimer's Disease Research
Alzheimer's disease (AD) poses a significant global health challenge, with an increasing number of individuals affected yearly. Deep learning, a subfield of artificial intelligence, has shown immense potential in various domains, including healthcare. This thematic issue of Current Alzheimer Research explores the application of deep learning techniques in advancing our ...read more
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Dementia affects 18 million people worldwide. Dementia is a syndrome of symptoms caused by brain disease, usually chronic or progressive, clinically characterized by multiple impairments of higher cortical functions such as memory, thinking, orientation, and learning. In addition, in the course of dementia, cognitive deficits are observed, which often hinder ...read more
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