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Longitudinal Associations between Survival in Alzheimer's Disease and Cholinesterase Inhibitor Use, Progression, and Community-Based Services.

Wattmo, Carina LU ; Londos, Elisabet LU and Minthon, Lennart LU (2015) In Dementia and Geriatric Cognitive Disorders 40(5-6). p.297-310
Abstract
Background/Aims: Factors including rate of disease progression, different aspects of cholinesterase inhibitor (ChEI) treatment, and use of community-based services might affect the longitudinal outcome of Alzheimer’s disease (AD). Whether these factors alter life expectancy in AD is unclear. We therefore examined the association between long-term ChEI therapy and survival.

Methods: The present study included 1,021 patients with a clinical diagnosis of AD and a Mini-Mental State Examination score of 10–26 at baseline from a 3-year, prospective, multicenter study of ChEI therapy in clinical practice. The relationship of potential predictors with mortality was analyzed using Cox regression models.

Results: After up to 16... (More)
Background/Aims: Factors including rate of disease progression, different aspects of cholinesterase inhibitor (ChEI) treatment, and use of community-based services might affect the longitudinal outcome of Alzheimer’s disease (AD). Whether these factors alter life expectancy in AD is unclear. We therefore examined the association between long-term ChEI therapy and survival.

Methods: The present study included 1,021 patients with a clinical diagnosis of AD and a Mini-Mental State Examination score of 10–26 at baseline from a 3-year, prospective, multicenter study of ChEI therapy in clinical practice. The relationship of potential predictors with mortality was analyzed using Cox regression models.

Results: After up to 16 years of follow-up, 841 (82%) of the participants had died. In the Alzheimer’s Disease Assessment Scale-cognitive subscale, a mean decline of >= 4 points/year or >= 2 points/year on the Physical Self-Maintenance Scale was a risk factor for an earlier death. In the multivariate models, longer survival was associated with higher ChEI dose and longer duration of treatment. Users of community-based services at baseline exhibited a 1 year shorter mean life expectancy than nonusers.

Conclusion: A longer survival time can be anticipated for AD patients with slower deterioration, who receive and tolerate higher ChEI doses and a longer duration of treatment. (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
Cognition, Activities of daily living, Home help services, Adult day care, Mortality, Statistical models
in
Dementia and Geriatric Cognitive Disorders
volume
40
issue
5-6
pages
297 - 310
publisher
Karger
external identifiers
  • pmid:26335053
  • wos:000363429400006
  • scopus:84941249271
ISSN
1420-8008
DOI
10.1159/000437050
language
English
LU publication?
yes
id
6ad7dc27-f5e2-4f1b-a5f8-aaaaafdfcdca (old id 8043307)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/26335053?dopt=Abstract
date added to LUP
2015-10-04 18:34:38
date last changed
2017-02-26 03:12:09
@article{6ad7dc27-f5e2-4f1b-a5f8-aaaaafdfcdca,
  abstract     = {Background/Aims: Factors including rate of disease progression, different aspects of cholinesterase inhibitor (ChEI) treatment, and use of community-based services might affect the longitudinal outcome of Alzheimer’s disease (AD). Whether these factors alter life expectancy in AD is unclear. We therefore examined the association between long-term ChEI therapy and survival.<br/><br>
Methods: The present study included 1,021 patients with a clinical diagnosis of AD and a Mini-Mental State Examination score of 10–26 at baseline from a 3-year, prospective, multicenter study of ChEI therapy in clinical practice. The relationship of potential predictors with mortality was analyzed using Cox regression models.<br/><br>
Results: After up to 16 years of follow-up, 841 (82%) of the participants had died. In the Alzheimer’s Disease Assessment Scale-cognitive subscale, a mean decline of &gt;= 4 points/year or &gt;= 2 points/year on the Physical Self-Maintenance Scale was a risk factor for an earlier death. In the multivariate models, longer survival was associated with higher ChEI dose and longer duration of treatment. Users of community-based services at baseline exhibited a 1 year shorter mean life expectancy than nonusers.<br/><br>
Conclusion: A longer survival time can be anticipated for AD patients with slower deterioration, who receive and tolerate higher ChEI doses and a longer duration of treatment.},
  author       = {Wattmo, Carina and Londos, Elisabet and Minthon, Lennart},
  issn         = {1420-8008},
  keyword      = {Cognition,Activities of daily living,Home help services,Adult day care,Mortality,Statistical models},
  language     = {eng},
  number       = {5-6},
  pages        = {297--310},
  publisher    = {Karger},
  series       = {Dementia and Geriatric Cognitive Disorders},
  title        = {Longitudinal Associations between Survival in Alzheimer's Disease and Cholinesterase Inhibitor Use, Progression, and Community-Based Services.},
  url          = {http://dx.doi.org/10.1159/000437050},
  volume       = {40},
  year         = {2015},
}