摘要
背景:阿尔茨海默病(AD)患者对胆碱酯酶抑制剂(CHI)治疗的反应不同,个体特异性反应是否直接影响到疗养院安置时间(NHP)。 目的:探讨6个月对CHI的反应与住院治疗的关系。 方法:采用前瞻性、观察性、多中心研究的方法,对881例门诊患者在CHI治疗开始时(基线)进行临床诊断和简易精神状态评分(10-26分),采用认知、整体和日常生活活动能力量表(ADL)进行评定,每半年一次,记录进NHP的日期。 结果:在本研究中,213例(24%)患者入院,从基线(AD诊断)到NHP的平均±标准差时间(AD)为20.8±9.3个月,经过6个月的CHI治疗后,改善或未改变的患者对NHP的治疗时间比恶化的患者长,认知反应延长3个月(p=0.022),整体反应延长4个月(p=0.004),基础不良反应6个月。3个量表均有反应(p<0.001)和8个月(p<0.001),改善组与未变化组在任何量表上均无显着性差异(P>0.05)。 结论:对CHI有阳性短期反应的患者可期望在家中待3~8个月,这些发现强调了综合临床检查的重要性,包括各种评估量表,以评估治疗效果并提供更准确的预后。
关键词: 阿尔茨海默病,胆碱酯酶抑制剂,治疗效果,日常生活能力,认知,养老院安置,预测因子,统计模型。
Current Alzheimer Research
Title:Short-Term Response to Cholinesterase Inhibitors in Alzheimer’s Disease Delays Time to Nursing Home Placement
Volume: 15 Issue: 10
关键词: 阿尔茨海默病,胆碱酯酶抑制剂,治疗效果,日常生活能力,认知,养老院安置,预测因子,统计模型。
摘要: Background: A varying response to cholinesterase inhibitor (ChEI) treatment has been reported among patients with Alzheimer’s disease (AD). Whether the individual-specific response directly affects time to nursing home placement (NHP) was not investigated.
Objective: We examined the relationship between the 6-month response to ChEI and institutionalization.
Methods: In a prospective, observational, multicenter study, 881 outpatients with a clinical AD diagnosis and a Mini-Mental State Examination score of 10-26 at the start of ChEI therapy (baseline) were included. The participants were evaluated using cognitive, global, and activities of daily living (ADL) scales at baseline and semiannually over 3 years. The date of NHP was recorded.
Results: During the study, 213 patients (24%) were admitted to nursing homes. The mean ± standard deviation time from baseline (AD diagnosis) to NHP was 20.8 ± 9.3 months. After 6 months of ChEI treatment, the improved/unchanged individuals had longer time to NHP than those who worsened. The prolonged time to NHP was 3 months for cognitive response (P=0.022), 4 months for global response (P=0.004), 6 months for basic ADL response (P<0.001), and 8 months for response in all three scales (P<0.001). No differences were detected between the improved and unchanged groups in any scales.
Conclusion: Patients who exhibit a positive short-term response to ChEI can expect to stay in their own home for 3-8 months longer. These findings underline the importance of a comprehensive clinical examination including various assessment scales to evaluate treatment response and provide a more accurate prognosis.
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Cite this article as:
Short-Term Response to Cholinesterase Inhibitors in Alzheimer’s Disease Delays Time to Nursing Home Placement, Current Alzheimer Research 2018; 15 (10) . https://dx.doi.org/10.2174/1567205015666180507105326
DOI https://dx.doi.org/10.2174/1567205015666180507105326 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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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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