当前位置: X-MOL 学术J. Alzheimer’s Dis. › 论文详情
Our official English website, www.x-mol.net, welcomes your feedback! (Note: you will need to create a separate account there.)
Identification of a Cascade of Changes in Activities of Daily Living Preceding Short-Term Clinical Deterioration in Mild Alzheimer's Disease Dementia via Lead-Lag Analysis.
Journal of Alzheimer’s Disease ( IF 4 ) Pub Date : 2020-06-24 , DOI: 10.3233/jad-200230
Manuel Fuentes 1, 2 , Arne Klostermann 1 , Luca Kleineidam 3, 4 , Chris Bauer 5 , Johannes Schuchhardt 5 , Wolfgang Maier 6 , Frank Jessen 7 , Lutz Frölich 8 , Jens Wiltfang 9, 10, 11 , Johannes Kornhuber 12 , Stefan Klöppel 13, 14 , Vera Schieting 13 , Stefan J Teipel 15, 16 , Michael Wagner 3, 4 , Oliver Peters 1, 2
Affiliation  

Abstract

Background:

Cognitive functions and activities of daily living (ADL) become increasingly impaired with progressing Alzheimer’s disease. However, the temporal dynamics of this decline are inconsistent.

Objective:

To gain insight into the classical temporal cascade of specific cognitive and ADL changes, which may aid in improving detection of an impending clinical deterioration in patients, and to select ADL items and tests most sensitive to change in a specific disease stage.

Methods:

Patients with mild Alzheimer’s dementia (AD; MMSE = 23.9±2.88) were followed at 12 and 24 months. Lead-lag analysis of changes in cognitive and functional outcome measures (CDR-SOB, 12 neuropsychological subtest scores from the CERAD + test battery, 25 Bayer-ADL items) was applied to rank the temporal sequence of changes on an ordinal scale.

Results:

Of 164 patients with mild AD, moderatedisease progression was identified in 84 patients over 24 months (ΔMMSE 5.8±8.64; ΔCDR-SOB 4.32±4.03). Ten Bayer-ADL item measures were altered early in moderate progressors and included in a new ADL composite score. Accordingly, the new ADL score surpassed all neuropsychological measures in repeated lead-lag analysis. The Bayer-ADL total score, TMT-A, and MMSE were lagging variables in all lead-lag analyses.

Conclusion:

Short-term clinical deteriorationin mild AD is initially preceded by changes (i.e., decline) in a well-defined set of ADL and not in classical cognitive measures.



中文翻译:

通过铅滞后分析鉴定轻度阿尔茨海默氏病痴呆患者在短期临床恶化之前日常生活活动的一系列变化。

摘要

背景:

随着阿尔茨海默氏病的进展,人们的认知功能和日常生活活动(ADL)越来越受到损害。但是,这种下降的时间动态是不一致的。

目的:

为了深入了解特定认知和ADL变化的经典时间级联,这可能有助于改善对患者即将发生的临床恶化的检测,并选择对特定疾病阶段变化最敏感的ADL项目和测试。

方法:

轻度阿尔茨海默氏痴呆(AD; MMSE = 23.9±2.88)患者在12和24个月时接受随访。应用认知和功能结果量度(CDR-SOB,来自CERAD +测试电池的12个神经心理学子测验分数,25个Bayer-ADL项目)变化的超前滞分析来按顺序对变化的时间序列进行排序。

结果:

164例轻度AD的,moderatedisease进展84例被鉴定超过24个月(Δ MMSE 5.8±8.64; Δ CDR-SOB 4.32±4.03)。十项Bayer-ADL项目测度在中等进度指标的早期进行了更改,并包含在新的ADL综合评分中。因此,在重复的超前-滞后分析中,新的ADL得分超过了所有神经心理学指标。在所有超前-滞后分析中,Bayer-ADL总分,TMT-A和MMSE是滞后变量。

结论:

轻度AD的短期临床恶化最初是在一组定义明确的ADL中发生变化(即下降),而不是经典的认知指标。

更新日期:2020-06-30
down
wechat
bug