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Predictors of long-term cognitive outcome in Alzheimer's disease.

Wattmo, Carina LU ; Wallin, Åsa LU ; Londos, Elisabet LU and Minthon, Lennart LU (2011) In Alzheimer’s Research & Therapy 3(4).
Abstract
Introduction: The objective of this study was to describe the longitudinal cognitive outcome in Alzheimer’s

disease (AD) and analyze factors that affect the outcome, including the impact of different cholinesterase inhibitors (ChEI).

Methods: In an open, three-year, nonrandomized, prospective, multicenter study, 843 patients were treated with

donepezil, rivastigmine, or galantamine in a routine clinical setting. At baseline and every six months, patients were assessed using several rating scales, including the Mini-Mental State Examination (MMSE) and the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) and the dose of ChEI was recorded. Sociodemographic and clinical characteristics were... (More)
Introduction: The objective of this study was to describe the longitudinal cognitive outcome in Alzheimer’s

disease (AD) and analyze factors that affect the outcome, including the impact of different cholinesterase inhibitors (ChEI).

Methods: In an open, three-year, nonrandomized, prospective, multicenter study, 843 patients were treated with

donepezil, rivastigmine, or galantamine in a routine clinical setting. At baseline and every six months, patients were assessed using several rating scales, including the Mini-Mental State Examination (MMSE) and the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) and the dose of ChEI was recorded. Sociodemographic and clinical characteristics were investigated. The relationships of these predictors with longitudinal cognitive ability were analyzed using mixed-effects models.

Results: Slower long-term cognitive decline was associated with a higher cognitive ability at baseline or a lower

level of education. The improvement in cognitive response after six months of ChEI therapy and a more positive

longitudinal outcome were related to a higher mean dose of ChEI, nonsteroidal anti-inflammatory drug (NSAID)/

acetylsalicylic acid usage, male gender, older age, and absence of the apolipoprotein E (APOE) ε4 allele. More

severe cognitive impairment at baseline also predicted an improved response to ChEI treatment after six months.

The type of ChEI agent did not influence the short-term response or the long-term outcome.

Conclusions: In this three-year AD study performed in a routine clinical practice, the response to ChEI treatment

and longitudinal cognitive outcome were better in males, older individuals, non-carriers of the APOE ε4 allele,

patients treated with NSAIDs/acetylsalicylic acid, and those receiving a higher dose of ChEI, regardless of the drug agent. (Less)
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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Alzheimer’s Research & Therapy
volume
3
issue
4
publisher
BioMed Central
external identifiers
  • wos:000310145600001
  • scopus:79960559514
DOI
10.1186/alzrt85
language
English
LU publication?
yes
id
df41602b-c85e-46bd-bb93-84fabf8f5aca (old id 3046698)
alternative location
http://alzres.com/content/3/4/23
date added to LUP
2013-02-07 12:00:21
date last changed
2017-09-17 08:57:27
@article{df41602b-c85e-46bd-bb93-84fabf8f5aca,
  abstract     = {Introduction: The objective of this study was to describe the longitudinal cognitive outcome in Alzheimer’s<br/><br>
disease (AD) and analyze factors that affect the outcome, including the impact of different cholinesterase inhibitors (ChEI).<br/><br>
Methods: In an open, three-year, nonrandomized, prospective, multicenter study, 843 patients were treated with<br/><br>
donepezil, rivastigmine, or galantamine in a routine clinical setting. At baseline and every six months, patients were assessed using several rating scales, including the Mini-Mental State Examination (MMSE) and the Alzheimer’s Disease Assessment Scale-cognitive subscale (ADAS-cog) and the dose of ChEI was recorded. Sociodemographic and clinical characteristics were investigated. The relationships of these predictors with longitudinal cognitive ability were analyzed using mixed-effects models.<br/><br>
Results: Slower long-term cognitive decline was associated with a higher cognitive ability at baseline or a lower<br/><br>
level of education. The improvement in cognitive response after six months of ChEI therapy and a more positive<br/><br>
longitudinal outcome were related to a higher mean dose of ChEI, nonsteroidal anti-inflammatory drug (NSAID)/<br/><br>
acetylsalicylic acid usage, male gender, older age, and absence of the apolipoprotein E (APOE) ε4 allele. More<br/><br>
severe cognitive impairment at baseline also predicted an improved response to ChEI treatment after six months.<br/><br>
The type of ChEI agent did not influence the short-term response or the long-term outcome.<br/><br>
Conclusions: In this three-year AD study performed in a routine clinical practice, the response to ChEI treatment<br/><br>
and longitudinal cognitive outcome were better in males, older individuals, non-carriers of the APOE ε4 allele,<br/><br>
patients treated with NSAIDs/acetylsalicylic acid, and those receiving a higher dose of ChEI, regardless of the drug agent.},
  articleno    = {23},
  author       = {Wattmo, Carina and Wallin, Åsa and Londos, Elisabet and Minthon, Lennart},
  language     = {eng},
  number       = {4},
  publisher    = {BioMed Central},
  series       = {Alzheimer’s Research & Therapy},
  title        = {Predictors of long-term cognitive outcome in Alzheimer's disease.},
  url          = {http://dx.doi.org/10.1186/alzrt85},
  volume       = {3},
  year         = {2011},
}