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Long-term Outcome and Prediction Models of Activities of Daily Living in Alzheimer Disease With Cholinesterase Inhibitor Treatment.

Wattmo, Carina LU ; Wallin, Åsa LU ; Londos, Elisabet LU and Minthon, Lennart LU (2011) In Alzheimer disease and associated disorders 25(1). p.63-72
Abstract
In untreated patients with Alzheimer disease (AD) the functional ability is gradually lost. What happens to the patients after continuous long-term cholinesterase inhibitor (ChEI) treatment is less investigated. The objective of this study was to describe the longitudinal functional outcome and analyze factors affecting the outcome in ChEI-treated patients. In an open, 3-year, nonrandomized, prospective, multicenter study in a routine clinical setting, 790 patients were treated with either donepezil, rivastigmine, or galantamine. At baseline and every 6 months, they were assessed with several rating scales including Instrumental Activities of Daily Living (IADL), Physical Self-Maintenance Scale (PSMS), and Mini-Mental State Examination... (More)
In untreated patients with Alzheimer disease (AD) the functional ability is gradually lost. What happens to the patients after continuous long-term cholinesterase inhibitor (ChEI) treatment is less investigated. The objective of this study was to describe the longitudinal functional outcome and analyze factors affecting the outcome in ChEI-treated patients. In an open, 3-year, nonrandomized, prospective, multicenter study in a routine clinical setting, 790 patients were treated with either donepezil, rivastigmine, or galantamine. At baseline and every 6 months, they were assessed with several rating scales including Instrumental Activities of Daily Living (IADL), Physical Self-Maintenance Scale (PSMS), and Mini-Mental State Examination (MMSE). A faster functional decline was associated with lower cognitive ability at baseline, older age, and the interaction of higher education and longer time in the study. The patients residing with a spouse or relative showed slower deterioration in IADL score. A higher mean dose of ChEI, regardless of drug agent, was also related to slower instrumental ADL decline. Prediction models for longitudinal functional outcome were provided. AD severity at baseline is a key factor in obtaining reliable clinical prognoses of the long-term ADL ability. The dosage of ChEI treatment could possibly lead to a different functional outcome. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Alzheimer's disease, activities of daily living, cholinesterase inhibitors, longitudinal study, statistical models, disease progression.
in
Alzheimer disease and associated disorders
volume
25
issue
1
pages
63 - 72
publisher
Lippincott Williams & Wilkins
external identifiers
  • wos:000287472000010
  • pmid:20847636
  • scopus:79952192664
ISSN
1546-4156
DOI
10.1097/WAD.0b013e3181f5dd97
language
English
LU publication?
yes
id
4ae23304-9272-4f58-bbb3-d5cb587b34f3 (old id 1688125)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/20847636?dopt=Abstract
date added to LUP
2010-10-05 10:39:07
date last changed
2017-09-17 05:48:08
@article{4ae23304-9272-4f58-bbb3-d5cb587b34f3,
  abstract     = {In untreated patients with Alzheimer disease (AD) the functional ability is gradually lost. What happens to the patients after continuous long-term cholinesterase inhibitor (ChEI) treatment is less investigated. The objective of this study was to describe the longitudinal functional outcome and analyze factors affecting the outcome in ChEI-treated patients. In an open, 3-year, nonrandomized, prospective, multicenter study in a routine clinical setting, 790 patients were treated with either donepezil, rivastigmine, or galantamine. At baseline and every 6 months, they were assessed with several rating scales including Instrumental Activities of Daily Living (IADL), Physical Self-Maintenance Scale (PSMS), and Mini-Mental State Examination (MMSE). A faster functional decline was associated with lower cognitive ability at baseline, older age, and the interaction of higher education and longer time in the study. The patients residing with a spouse or relative showed slower deterioration in IADL score. A higher mean dose of ChEI, regardless of drug agent, was also related to slower instrumental ADL decline. Prediction models for longitudinal functional outcome were provided. AD severity at baseline is a key factor in obtaining reliable clinical prognoses of the long-term ADL ability. The dosage of ChEI treatment could possibly lead to a different functional outcome.},
  author       = {Wattmo, Carina and Wallin, Åsa and Londos, Elisabet and Minthon, Lennart},
  issn         = {1546-4156},
  keyword      = {Alzheimer's disease,activities of daily living,cholinesterase inhibitors,longitudinal study,statistical models,disease progression.},
  language     = {eng},
  number       = {1},
  pages        = {63--72},
  publisher    = {Lippincott Williams & Wilkins},
  series       = {Alzheimer disease and associated disorders},
  title        = {Long-term Outcome and Prediction Models of Activities of Daily Living in Alzheimer Disease With Cholinesterase Inhibitor Treatment.},
  url          = {http://dx.doi.org/10.1097/WAD.0b013e3181f5dd97},
  volume       = {25},
  year         = {2011},
}