Understanding Alzheimer’s disease (AD) dynamics is essential in diagnosis and measuring progression for clinical decision-making; however, clinical instruments are imperfect at classifying true disease stages. This research evaluates sensitivity and determinants of AD stage changes longitudinally using current classifications of “mild,” “moderate,” and “severe” AD, using Mini-Mental State Examination (MMSE), Alzheimer’s Disease Assessment Scale–Cognitive subscale (ADAS-Cog), and the Clinical Dementia Rating–Sum of Boxes (CDR-SB) thresholds. Age and pre-progression rate were significant determinants of AD progression using MMSE alone to stage AD, and pre-progression was found to impact disease progression with CDR-SB. Sensitivity of these instruments for identifying clinical stages of AD to correctly staging a “moderate” level of disease severity for outcomes MMSE, CDR-SB, and ADAS-Cog was 92%, 78%, and 92%, respectively. This research derives longitudinal sensitivity of clinical instruments used to stage AD useful for clinical decision-making. The MMSE and ADAS-Cog provided adequate sensitivity to classify AD stages.

了解阿尔茨海默病 (AD) 动态对于临床决策的诊断和衡量进展至关重要；然而，临床仪器在对真正的疾病阶段进行分类方面并不完善。本研究使用当前的“轻度”、“中度”和“重度”AD 分类，使用简易精神状态检查 (MMSE)、阿尔茨海默病评估量表 - 认知分量表 (ADAS-Cog) 纵向评估 AD 阶段变化的敏感性和决定因素）和临床痴呆评级 - 框总和 (CDR-SB) 阈值。单独使用 MMSE 对 AD 进行分期时，年龄和进展前比率是 AD 进展的重要决定因素，并且发现进展前会影响 CDR-SB 的疾病进展。这些仪器用于识别 AD 临床分期，以正确对 MMSE、CDR-SB 和 ADAS-Cog 结果的“中等”疾病严重程度进行分期，其灵敏度分别为 92%、78% 和 92%。这项研究得出了用于 AD 分期的临床仪器的纵向敏感性，有助于临床决策。 MMSE 和 ADAS-Cog 提供了足够的灵敏度来对 AD 阶段进行分类。