Long Term Outcome and Prediction Models of Cognition, Activities of Daily Living and Nursing Home Placement in Alzheimer’s Disease with Cholinesterase Inhibitor Treatment
type: CreativeWork
description: Background Prospective longitudinal studies in Alzheimer's disease (AD) that include cholinesterase inhibitor (ChEI) treatment in routine clinical settings are scarce. The patients vary in severity of the disease, clinical course, rate of progression and response to treatment. Knowledge about the predicted course of the disease, sociodemographic and clinical factors affecting the outcome and the impact of ChEI therapy, could be valuable for clinicians and the social services. This information is also essential for clinical research and for evaluating new therapies. Aims Study aims are to investigate potential predictors of change, differences in long-term outcome and rates of decline, and the time to nursing home placement for ChEI-treated AD patients in clinical practice. Material Swedish Alzheimer Treatment Study - outpatients with a clinical dementia diagnosis, and probable or possible AD, were recruited from memory clinics across Sweden. Cognitive, global and Activities of Daily Living (ADL) assessments were performed at the start of ChEI treatment and every 6 months during the following 3 years. I. 435 donepezil-treated patients II. 843 patients treated with donepezil, rivastigmine or galantamine III. 790 patients treated with donepezil, rivastigmine or galantamine IV. 880 patients treated with donepezil, rivastigmine or galantamine Results I. Regression models predicted 3-year cognitive outcome in ChEI-treated patients with high accuracy at the group level, but not individual patient responses. II. A higher dose of ChEI, male gender, older age, absence of the APOE ε4 allele or usage of NSAIDs/acetylsalicylic acid were predictors of improved cognitive response to ChEI treatment after 6 months, and of a more positive long-term outcome. III. Lower cognitive status at baseline, older age, higher education level, and solitary living were identified as risk factors for faster decline in functional ability, whereas a higher dose of ChEI, regardless of drug agent, was…
abstract: Background Prospective longitudinal studies in Alzheimer's disease (AD) that include cholinesterase inhibitor (ChEI) treatment in routine clinical settings are scarce. The patients vary in severity of the disease, clinical course, rate of progression and response to treatment. Knowledge about the predicted course of the disease, sociodemographic and clinical factors affecting the outcome and the impact of ChEI therapy, could be valuable for clinicians and the social services. This information is also essential for clinical research and for evaluating new therapies. Aims Study aims are to investigate potential predictors of change, differences in long-term outcome and rates of decline, and the time to nursing home placement for ChEI-treated AD patients in clinical practice. Material Swedish Alzheimer Treatment Study - outpatients with a clinical dementia diagnosis, and probable or possible AD, were recruited from memory clinics across Sweden. Cognitive, global and Activities of Daily Living (ADL) assessments were performed at the start of ChEI treatment and every 6 months during the following 3 years. I. 435 donepezil-treated patients II. 843 patients treated with donepezil, rivastigmine or galantamine III. 790 patients treated with donepezil, rivastigmine or galantamine IV. 880 patients treated with donepezil, rivastigmine or galantamine Results I. Regression models predicted 3-year cognitive outcome in ChEI-treated patients with high accuracy at the group level, but not individual patient responses. II. A higher dose of ChEI, male gender, older age, absence of the APOE ε4 allele or usage of NSAIDs/acetylsalicylic acid were predictors of improved cognitive response to ChEI treatment after 6 months, and of a more positive long-term outcome. III. Lower cognitive status at baseline, older age, higher education level, and solitary living were identified as risk factors for faster decline in functional ability, whereas a higher dose of ChEI, regardless of drug agent, was…
author: Wattmo, Carina
language: eng
keywords: Neurology, Medical and Health Sciences, Clinical Medicine, longitudinal studies, nursing home placement, activities of daily living, cognition, Alzheimer's disease, cholinesterase inhibitors, disease progression, predictors, statistical models.
date published: 2011
date modified: 2026-07-24T02:59:36Z
provider: University of Lund
publisher: Networked Digital Library of Theses and Dissertations
type: WebPage
source organization: Lund University