Diagnosis of Alzheimer’s disease patients with rapid cognitive decline in clinical practice: Interest of the Deco questionnaire
Background Patients with Alzheimer’s disease (AD) who deteriorate rapidly are likely to have a poorer prognosis. There is a clear need for a clinical assessment fool to defect, such a decline in newly diagnosed patients. Objective To identify die predictive factors of rapid cognitive decline (RCD) i...
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| Veröffentlicht in: | The Journal of nutrition, health & aging health & aging, 2011-05, Vol.15 (5), p.361-366 |
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| creator | Carcaillon, Laure Berrutp, G. Sellalm, F. Dartigues, J. F. Gillette, S. Pere, J. J. Bourdeix, I. |
| description | Background
Patients with Alzheimer’s disease (AD) who deteriorate rapidly are likely to have a poorer prognosis. There is a clear need for a clinical assessment fool to defect, such a decline in newly diagnosed patients.
Objective
To identify die predictive factors of rapid cognitive decline (RCD) in a cohort of patients with mild to moderate AD; and to validate a self-questionnaire for caregivers as a diagnostic tool for rapid decline.
Design and analysis
An open-label, observational, 12-month, multicenter, French study. Physicians were asked to record data of three eligible rivastigmine naïve (or on rivastigmine for < 1 year) AD patients. Risk factors of RCD and the detection power of the Détérioration Cognitive Observée scale (Deco), a 19 item self-questionnaire for caregivers, were assessed at endpoint using regression analyses.
Results
Out of the 361 patients enrolled in the study, 91 (25.2%) were excluded due to loss of follow-up. Among subjects using cholinesterase inhibitors or memantine, 161 (59.6%) experienced a stabilization (29.2%) or an improvement (30.4%) in global functioning as measured by the CGI-C. Sixty of the remaining 204 patients retained for analysis (29.6%, CI 95% [23.4; 35.8]) lost three or more points on the MMSH score between the inclusion and one of the follow-up visit. In the multivariate logistic regression analysis, institutionalization, higher level of education and the loss of 3 points or more on the MMSE were found to be significant predictors of a rapid cognitive loss in this population. The threshold which maximizes the predictive values of the Deco score as a diagnostic tool of rapid cognitive decline was significantly different according to the age of the patient (below or over 75 years old). A score below 16 for patients < 75 years old and below 14 for patients ≥ 75 years old consistently predicted a RCD within die next year.
Conclusion
The Deco test appears to be a simple tool to alert the physician to the possibility of an aggressive course of the disease which warrants particular management. |
| doi_str_mv | 10.1007/s12603-011-0047-z |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_inserm_00590465v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2363150221</sourcerecordid><originalsourceid>FETCH-LOGICAL-c480t-b16a57ff5eae29b4fd9635458a01585eb2882f52a5a5dc9f936532d9cf01e0b93</originalsourceid><addsrcrecordid>eNp1kc1u1DAUhSMEoqXwAGyQhYTYELCd-I_dqAVaaSQ2sLYc53rGVWIPdqaIWcFj8Ho8CQ4ZWgmJla_s7x6fe09VPSX4NcFYvMmEctzUmJAa41bUh3vVKREc162Q8n6pqVC1EFicVI9yvi4MU5I_rE4oYVQSTk-rHxfebELMPqPo0Go4bMGPkH59_5lR7zOYDGhnJg9hyuirn7YomZ3vkY2b4Cd_A6gHO_gAyAc0F96aAe2SsZO38BZdhQkS5GlWn7aALsBG9GVfbnwMwfgEj6sHzgwZnhzPs-rz-3efzi_r9ccPV-erdW1biae6I9ww4RwDA1R1resVb1jLpMGESQYdlZI6Rg0zrLfKqYazhvbKOkwAd6o5q14tulsz6F3yo0nfdDReX67W2ocMadQYM4Vbzm5IwV8u-C7FP3716LOFYTAB4j5ryVuiWqpYIZ__Q17HfQpllgIpRjlXsxxZIJtizgncrQWC9RymXsLUJUw9h6kPpefZUXjfjdDfdvxNrwAvjoDJZe0umWB9vuNaQgTjonB04XJ5ChtIdw7___tvVVe5Hw</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>869526691</pqid></control><display><type>article</type><title>Diagnosis of Alzheimer’s disease patients with rapid cognitive decline in clinical practice: Interest of the Deco questionnaire</title><source>MEDLINE</source><source>SpringerNature Complete Journals</source><source>Alma/SFX Local Collection</source><creator>Carcaillon, Laure ; Berrutp, G. ; Sellalm, F. ; Dartigues, J. F. ; Gillette, S. ; Pere, J. J. ; Bourdeix, I.</creator><creatorcontrib>Carcaillon, Laure ; Berrutp, G. ; Sellalm, F. ; Dartigues, J. F. ; Gillette, S. ; Pere, J. J. ; Bourdeix, I.</creatorcontrib><description>Background
Patients with Alzheimer’s disease (AD) who deteriorate rapidly are likely to have a poorer prognosis. There is a clear need for a clinical assessment fool to defect, such a decline in newly diagnosed patients.
Objective
To identify die predictive factors of rapid cognitive decline (RCD) in a cohort of patients with mild to moderate AD; and to validate a self-questionnaire for caregivers as a diagnostic tool for rapid decline.
Design and analysis
An open-label, observational, 12-month, multicenter, French study. Physicians were asked to record data of three eligible rivastigmine naïve (or on rivastigmine for < 1 year) AD patients. Risk factors of RCD and the detection power of the Détérioration Cognitive Observée scale (Deco), a 19 item self-questionnaire for caregivers, were assessed at endpoint using regression analyses.
Results
Out of the 361 patients enrolled in the study, 91 (25.2%) were excluded due to loss of follow-up. Among subjects using cholinesterase inhibitors or memantine, 161 (59.6%) experienced a stabilization (29.2%) or an improvement (30.4%) in global functioning as measured by the CGI-C. Sixty of the remaining 204 patients retained for analysis (29.6%, CI 95% [23.4; 35.8]) lost three or more points on the MMSH score between the inclusion and one of the follow-up visit. In the multivariate logistic regression analysis, institutionalization, higher level of education and the loss of 3 points or more on the MMSE were found to be significant predictors of a rapid cognitive loss in this population. The threshold which maximizes the predictive values of the Deco score as a diagnostic tool of rapid cognitive decline was significantly different according to the age of the patient (below or over 75 years old). A score below 16 for patients < 75 years old and below 14 for patients ≥ 75 years old consistently predicted a RCD within die next year.
Conclusion
The Deco test appears to be a simple tool to alert the physician to the possibility of an aggressive course of the disease which warrants particular management.</description><identifier>ISSN: 1279-7707</identifier><identifier>EISSN: 1760-4788</identifier><identifier>DOI: 10.1007/s12603-011-0047-z</identifier><identifier>PMID: 21528162</identifier><language>eng</language><publisher>Paris: Springer-Verlag</publisher><subject>Adult and adolescent clinical studies ; Age Factors ; Aged ; Aged, 80 and over ; Aging ; Alzheimer Disease - complications ; Alzheimer Disease - diagnosis ; Alzheimer Disease - drug therapy ; Biological and medical sciences ; Cholinesterase Inhibitors - therapeutic use ; Cognition Disorders - diagnosis ; Cognition Disorders - etiology ; Cohort Studies ; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases ; Disease Progression ; Educational Status ; Feeding. Feeding behavior ; Female ; Fundamental and applied biological sciences. Psychology ; Geriatric Assessment - methods ; Geriatrics/Gerontology ; Humans ; Institutionalization ; JNHA: Clinical Neurosciences ; Life Sciences ; Logistic Models ; Male ; Medical sciences ; Medicine ; Medicine & Public Health ; Memantine - therapeutic use ; Middle Aged ; Neurology ; Neurosciences ; Nutrition ; Observation ; Organic mental disorders. Neuropsychology ; Phenylcarbamates - therapeutic use ; Primary Care Medicine ; Psychology. Psychoanalysis. Psychiatry ; Psychopathology. Psychiatry ; Qualitative Research ; Quality of Life Research ; Risk Factors ; Rivastigmine ; Santé publique et épidémiologie ; Surveys and Questionnaires - standards ; Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><ispartof>The Journal of nutrition, health & aging, 2011-05, Vol.15 (5), p.361-366</ispartof><rights>Serdi and Springer Verlag France 2011</rights><rights>2015 INIST-CNRS</rights><rights>Copyright Springer Science & Business Media May 2011</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c480t-b16a57ff5eae29b4fd9635458a01585eb2882f52a5a5dc9f936532d9cf01e0b93</citedby><cites>FETCH-LOGICAL-c480t-b16a57ff5eae29b4fd9635458a01585eb2882f52a5a5dc9f936532d9cf01e0b93</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s12603-011-0047-z$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s12603-011-0047-z$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,780,784,885,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=24117567$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/21528162$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://inserm.hal.science/inserm-00590465$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Carcaillon, Laure</creatorcontrib><creatorcontrib>Berrutp, G.</creatorcontrib><creatorcontrib>Sellalm, F.</creatorcontrib><creatorcontrib>Dartigues, J. F.</creatorcontrib><creatorcontrib>Gillette, S.</creatorcontrib><creatorcontrib>Pere, J. J.</creatorcontrib><creatorcontrib>Bourdeix, I.</creatorcontrib><title>Diagnosis of Alzheimer’s disease patients with rapid cognitive decline in clinical practice: Interest of the Deco questionnaire</title><title>The Journal of nutrition, health & aging</title><addtitle>J Nutr Health Aging</addtitle><addtitle>J Nutr Health Aging</addtitle><description>Background
Patients with Alzheimer’s disease (AD) who deteriorate rapidly are likely to have a poorer prognosis. There is a clear need for a clinical assessment fool to defect, such a decline in newly diagnosed patients.
Objective
To identify die predictive factors of rapid cognitive decline (RCD) in a cohort of patients with mild to moderate AD; and to validate a self-questionnaire for caregivers as a diagnostic tool for rapid decline.
Design and analysis
An open-label, observational, 12-month, multicenter, French study. Physicians were asked to record data of three eligible rivastigmine naïve (or on rivastigmine for < 1 year) AD patients. Risk factors of RCD and the detection power of the Détérioration Cognitive Observée scale (Deco), a 19 item self-questionnaire for caregivers, were assessed at endpoint using regression analyses.
Results
Out of the 361 patients enrolled in the study, 91 (25.2%) were excluded due to loss of follow-up. Among subjects using cholinesterase inhibitors or memantine, 161 (59.6%) experienced a stabilization (29.2%) or an improvement (30.4%) in global functioning as measured by the CGI-C. Sixty of the remaining 204 patients retained for analysis (29.6%, CI 95% [23.4; 35.8]) lost three or more points on the MMSH score between the inclusion and one of the follow-up visit. In the multivariate logistic regression analysis, institutionalization, higher level of education and the loss of 3 points or more on the MMSE were found to be significant predictors of a rapid cognitive loss in this population. The threshold which maximizes the predictive values of the Deco score as a diagnostic tool of rapid cognitive decline was significantly different according to the age of the patient (below or over 75 years old). A score below 16 for patients < 75 years old and below 14 for patients ≥ 75 years old consistently predicted a RCD within die next year.
Conclusion
The Deco test appears to be a simple tool to alert the physician to the possibility of an aggressive course of the disease which warrants particular management.</description><subject>Adult and adolescent clinical studies</subject><subject>Age Factors</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Aging</subject><subject>Alzheimer Disease - complications</subject><subject>Alzheimer Disease - diagnosis</subject><subject>Alzheimer Disease - drug therapy</subject><subject>Biological and medical sciences</subject><subject>Cholinesterase Inhibitors - therapeutic use</subject><subject>Cognition Disorders - diagnosis</subject><subject>Cognition Disorders - etiology</subject><subject>Cohort Studies</subject><subject>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</subject><subject>Disease Progression</subject><subject>Educational Status</subject><subject>Feeding. Feeding behavior</subject><subject>Female</subject><subject>Fundamental and applied biological sciences. Psychology</subject><subject>Geriatric Assessment - methods</subject><subject>Geriatrics/Gerontology</subject><subject>Humans</subject><subject>Institutionalization</subject><subject>JNHA: Clinical Neurosciences</subject><subject>Life Sciences</subject><subject>Logistic Models</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Memantine - therapeutic use</subject><subject>Middle Aged</subject><subject>Neurology</subject><subject>Neurosciences</subject><subject>Nutrition</subject><subject>Observation</subject><subject>Organic mental disorders. Neuropsychology</subject><subject>Phenylcarbamates - therapeutic use</subject><subject>Primary Care Medicine</subject><subject>Psychology. Psychoanalysis. Psychiatry</subject><subject>Psychopathology. Psychiatry</subject><subject>Qualitative Research</subject><subject>Quality of Life Research</subject><subject>Risk Factors</subject><subject>Rivastigmine</subject><subject>Santé publique et épidémiologie</subject><subject>Surveys and Questionnaires - standards</subject><subject>Vertebrates: anatomy and physiology, studies on body, several organs or systems</subject><issn>1279-7707</issn><issn>1760-4788</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2011</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNp1kc1u1DAUhSMEoqXwAGyQhYTYELCd-I_dqAVaaSQ2sLYc53rGVWIPdqaIWcFj8Ho8CQ4ZWgmJla_s7x6fe09VPSX4NcFYvMmEctzUmJAa41bUh3vVKREc162Q8n6pqVC1EFicVI9yvi4MU5I_rE4oYVQSTk-rHxfebELMPqPo0Go4bMGPkH59_5lR7zOYDGhnJg9hyuirn7YomZ3vkY2b4Cd_A6gHO_gAyAc0F96aAe2SsZO38BZdhQkS5GlWn7aALsBG9GVfbnwMwfgEj6sHzgwZnhzPs-rz-3efzi_r9ccPV-erdW1biae6I9ww4RwDA1R1resVb1jLpMGESQYdlZI6Rg0zrLfKqYazhvbKOkwAd6o5q14tulsz6F3yo0nfdDReX67W2ocMadQYM4Vbzm5IwV8u-C7FP3716LOFYTAB4j5ryVuiWqpYIZ__Q17HfQpllgIpRjlXsxxZIJtizgncrQWC9RymXsLUJUw9h6kPpefZUXjfjdDfdvxNrwAvjoDJZe0umWB9vuNaQgTjonB04XJ5ChtIdw7___tvVVe5Hw</recordid><startdate>20110501</startdate><enddate>20110501</enddate><creator>Carcaillon, Laure</creator><creator>Berrutp, G.</creator><creator>Sellalm, F.</creator><creator>Dartigues, J. F.</creator><creator>Gillette, S.</creator><creator>Pere, J. J.</creator><creator>Bourdeix, I.</creator><general>Springer-Verlag</general><general>Springer</general><general>Springer Nature B.V</general><general>Springer Verlag (Germany)</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88G</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>M2M</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>PSYQQ</scope><scope>Q9U</scope><scope>7X8</scope><scope>1XC</scope><scope>VOOES</scope></search><sort><creationdate>20110501</creationdate><title>Diagnosis of Alzheimer’s disease patients with rapid cognitive decline in clinical practice: Interest of the Deco questionnaire</title><author>Carcaillon, Laure ; Berrutp, G. ; Sellalm, F. ; Dartigues, J. F. ; Gillette, S. ; Pere, J. J. ; Bourdeix, I.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c480t-b16a57ff5eae29b4fd9635458a01585eb2882f52a5a5dc9f936532d9cf01e0b93</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2011</creationdate><topic>Adult and adolescent clinical studies</topic><topic>Age Factors</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Aging</topic><topic>Alzheimer Disease - complications</topic><topic>Alzheimer Disease - diagnosis</topic><topic>Alzheimer Disease - drug therapy</topic><topic>Biological and medical sciences</topic><topic>Cholinesterase Inhibitors - therapeutic use</topic><topic>Cognition Disorders - diagnosis</topic><topic>Cognition Disorders - etiology</topic><topic>Cohort Studies</topic><topic>Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases</topic><topic>Disease Progression</topic><topic>Educational Status</topic><topic>Feeding. Feeding behavior</topic><topic>Female</topic><topic>Fundamental and applied biological sciences. Psychology</topic><topic>Geriatric Assessment - methods</topic><topic>Geriatrics/Gerontology</topic><topic>Humans</topic><topic>Institutionalization</topic><topic>JNHA: Clinical Neurosciences</topic><topic>Life Sciences</topic><topic>Logistic Models</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Memantine - therapeutic use</topic><topic>Middle Aged</topic><topic>Neurology</topic><topic>Neurosciences</topic><topic>Nutrition</topic><topic>Observation</topic><topic>Organic mental disorders. Neuropsychology</topic><topic>Phenylcarbamates - therapeutic use</topic><topic>Primary Care Medicine</topic><topic>Psychology. Psychoanalysis. Psychiatry</topic><topic>Psychopathology. Psychiatry</topic><topic>Qualitative Research</topic><topic>Quality of Life Research</topic><topic>Risk Factors</topic><topic>Rivastigmine</topic><topic>Santé publique et épidémiologie</topic><topic>Surveys and Questionnaires - standards</topic><topic>Vertebrates: anatomy and physiology, studies on body, several organs or systems</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Carcaillon, Laure</creatorcontrib><creatorcontrib>Berrutp, G.</creatorcontrib><creatorcontrib>Sellalm, F.</creatorcontrib><creatorcontrib>Dartigues, J. F.</creatorcontrib><creatorcontrib>Gillette, S.</creatorcontrib><creatorcontrib>Pere, J. J.</creatorcontrib><creatorcontrib>Bourdeix, I.</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>ProQuest One Psychology</collection><collection>ProQuest Central Basic</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><collection>Hyper Article en Ligne (HAL) (Open Access)</collection><jtitle>The Journal of nutrition, health & aging</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Carcaillon, Laure</au><au>Berrutp, G.</au><au>Sellalm, F.</au><au>Dartigues, J. F.</au><au>Gillette, S.</au><au>Pere, J. J.</au><au>Bourdeix, I.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Diagnosis of Alzheimer’s disease patients with rapid cognitive decline in clinical practice: Interest of the Deco questionnaire</atitle><jtitle>The Journal of nutrition, health & aging</jtitle><stitle>J Nutr Health Aging</stitle><addtitle>J Nutr Health Aging</addtitle><date>2011-05-01</date><risdate>2011</risdate><volume>15</volume><issue>5</issue><spage>361</spage><epage>366</epage><pages>361-366</pages><issn>1279-7707</issn><eissn>1760-4788</eissn><abstract>Background
Patients with Alzheimer’s disease (AD) who deteriorate rapidly are likely to have a poorer prognosis. There is a clear need for a clinical assessment fool to defect, such a decline in newly diagnosed patients.
Objective
To identify die predictive factors of rapid cognitive decline (RCD) in a cohort of patients with mild to moderate AD; and to validate a self-questionnaire for caregivers as a diagnostic tool for rapid decline.
Design and analysis
An open-label, observational, 12-month, multicenter, French study. Physicians were asked to record data of three eligible rivastigmine naïve (or on rivastigmine for < 1 year) AD patients. Risk factors of RCD and the detection power of the Détérioration Cognitive Observée scale (Deco), a 19 item self-questionnaire for caregivers, were assessed at endpoint using regression analyses.
Results
Out of the 361 patients enrolled in the study, 91 (25.2%) were excluded due to loss of follow-up. Among subjects using cholinesterase inhibitors or memantine, 161 (59.6%) experienced a stabilization (29.2%) or an improvement (30.4%) in global functioning as measured by the CGI-C. Sixty of the remaining 204 patients retained for analysis (29.6%, CI 95% [23.4; 35.8]) lost three or more points on the MMSH score between the inclusion and one of the follow-up visit. In the multivariate logistic regression analysis, institutionalization, higher level of education and the loss of 3 points or more on the MMSE were found to be significant predictors of a rapid cognitive loss in this population. The threshold which maximizes the predictive values of the Deco score as a diagnostic tool of rapid cognitive decline was significantly different according to the age of the patient (below or over 75 years old). A score below 16 for patients < 75 years old and below 14 for patients ≥ 75 years old consistently predicted a RCD within die next year.
Conclusion
The Deco test appears to be a simple tool to alert the physician to the possibility of an aggressive course of the disease which warrants particular management.</abstract><cop>Paris</cop><pub>Springer-Verlag</pub><pmid>21528162</pmid><doi>10.1007/s12603-011-0047-z</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1279-7707 |
| ispartof | The Journal of nutrition, health & aging, 2011-05, Vol.15 (5), p.361-366 |
| issn | 1279-7707 1760-4788 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_inserm_00590465v1 |
| source | MEDLINE; SpringerNature Complete Journals; Alma/SFX Local Collection |
| subjects | Adult and adolescent clinical studies Age Factors Aged Aged, 80 and over Aging Alzheimer Disease - complications Alzheimer Disease - diagnosis Alzheimer Disease - drug therapy Biological and medical sciences Cholinesterase Inhibitors - therapeutic use Cognition Disorders - diagnosis Cognition Disorders - etiology Cohort Studies Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases Disease Progression Educational Status Feeding. Feeding behavior Female Fundamental and applied biological sciences. Psychology Geriatric Assessment - methods Geriatrics/Gerontology Humans Institutionalization JNHA: Clinical Neurosciences Life Sciences Logistic Models Male Medical sciences Medicine Medicine & Public Health Memantine - therapeutic use Middle Aged Neurology Neurosciences Nutrition Observation Organic mental disorders. Neuropsychology Phenylcarbamates - therapeutic use Primary Care Medicine Psychology. Psychoanalysis. Psychiatry Psychopathology. Psychiatry Qualitative Research Quality of Life Research Risk Factors Rivastigmine Santé publique et épidémiologie Surveys and Questionnaires - standards Vertebrates: anatomy and physiology, studies on body, several organs or systems |
| title | Diagnosis of Alzheimer’s disease patients with rapid cognitive decline in clinical practice: Interest of the Deco questionnaire |
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