Mortality and Temporal Course of Probable Alzheimer's Disease: A 5-Year Prospective Study

Alzheimer's disease (AD) is asociated with an increased mortality in comparison with aged control populations. The relationship between the clinical and the temporal course of AD has not been well studied over significant intervals. Community residing patients with probable AD (N = 103, 42 men,...

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Bibliographic Details
Published in:International psychogeriatrics 1996-06, Vol.8 (2), p.291-311
Main Authors: Reisberg, Barry, Ferris, Steven H., Franssen, Emile H., Shulman, Emma, Monteiro, Isabel, Sclan, Steven G., Steinberg, Gertrude, Kluger, Alan, Torossian, Carol, Leon, Mony J. de, Laska, Eugene
Format: Article
Language:English
Subjects:
Aged
Aged, 80 and over
Alzheimer Disease - diagnosis
Alzheimer Disease - mortality
Alzheimer's disease
Cohort Studies
Female
Follow-Up Studies
Geriatric Assessment - statistics & numerical data
Humans
Longitudinal Course
Longitudinal Studies
Male
Mental Status Schedule - statistics & numerical data
Mini-Mental State Examination
Mortality
New York - epidemiology
Prospective Studies
Psychometrics
Survival Analysis
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Summary:Alzheimer's disease (AD) is asociated with an increased mortality in comparison with aged control populations. The relationship between the clinical and the temporal course of AD has not been well studied over significant intervals. Community residing patients with probable AD (N = 103, 42 men, mean age = 70.2 ± 8.0 years) were studied at baseline on demographic and clinical variables, including measures of global deterioration (Global Deterioration Scale; GDS), mental status and cognition (e.g., Mini-Mental State Examination; MMSE), and functional impairment (Functional Assessment Staging; FAST). Baseline characteristics included a GDS range of Stage 4, 5, or 6 (38.8%, 39.8%, and 21.4% respectively) and a mean MMSE score of 15.4 ± 5.6. The mean follow-up interval was 4.6 ± 1.4 year. Follow-ups were done blind to baseline measures and when necessary were conducted in residential and nursing home settings. Of locatable subjects (n = 95, 92%), 30 (31.6%) were deceased. Survivors (n = 65) had a mean GDS stage of 6.2 ± 0.9 and a mean MMSE score of 5.1 ± 6.9; 51% had MMSE scores of 0. Increased age and male gender, but not baseline clinical dementia variables, increased the risk of death (ps < .01). Change in clinical variables correlated significantly with time elapsed (r = .32, p < .05, for MMSE change, to r = .48, p < .001, for GDS change). Significant variance in temporal change (i.e., time elapsed) was accounted for by change in two of the five clinical measures studied (i.e., GDS and FAST; multiple r = .53). The results support previous estimates of mean duration of the GDS and FAST stages. For subjects with probable AD followed over approximately 5 years, clinical variables changed significantly over time in survivors. However, the majority of temporal variance in the course of AD remains unexplained.
ISSN:1041-6102
1741-203X
DOI:10.1017/S1041610296002657