Short-term response to cholinesterase inhibitors in Alzheimer’s disease delays time to nursing home placement
(2018) In Current Alzheimer Research 15(10). p.905-916- Abstract
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.... (More)
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.
(Less)
- author
- Wattmo, Carina LU ; Londos, Elisabet LU and Minthon, Lennart LU
- organization
- publishing date
- 2018-01-01
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Activities of daily living, Alzheimer’s disease, Cholinesterase inhibitors, Cognition, Nursing home placement, Predictors, Statistical models, Treatment effect
- in
- Current Alzheimer Research
- volume
- 15
- issue
- 10
- pages
- 12 pages
- publisher
- Bentham Science Publishers
- external identifiers
-
- pmid:29732972
- scopus:85051843996
- ISSN
- 1567-2050
- DOI
- 10.2174/1567205015666180507105326
- language
- English
- LU publication?
- yes
- id
- 17692ad3-555a-468c-89e1-5900a00f2ae8
- date added to LUP
- 2018-09-12 09:00:22
- date last changed
- 2024-09-18 01:31:44
@article{17692ad3-555a-468c-89e1-5900a00f2ae8, abstract = {{<p>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.</p>}}, author = {{Wattmo, Carina and Londos, Elisabet and Minthon, Lennart}}, issn = {{1567-2050}}, keywords = {{Activities of daily living; Alzheimer’s disease; Cholinesterase inhibitors; Cognition; Nursing home placement; Predictors; Statistical models; Treatment effect}}, language = {{eng}}, month = {{01}}, number = {{10}}, pages = {{905--916}}, publisher = {{Bentham Science Publishers}}, series = {{Current Alzheimer Research}}, title = {{Short-term response to cholinesterase inhibitors in Alzheimer’s disease delays time to nursing home placement}}, url = {{http://dx.doi.org/10.2174/1567205015666180507105326}}, doi = {{10.2174/1567205015666180507105326}}, volume = {{15}}, year = {{2018}}, }