Patterns of Loss of Abilities in Instrumental Activities of Daily Living in Alzheimer’s Disease: The REAL Cohort Study

2007 ◽  
Vol 25 (1) ◽  
pp. 46-53 ◽  
Author(s):  
Laurent Lechowski ◽  
Matthieu de Stampa ◽  
Bertrand Denis ◽  
Danièle Tortrat ◽  
Philippe Chassagne ◽  
...  
2013 ◽  
Vol 14 (2) ◽  
pp. 259-266 ◽  
Author(s):  
Carla Manuela Crispim Nascimento ◽  
Carlos Ayan ◽  
Jose Maria Cancela ◽  
Lilian Teresa Bucken Gobbi ◽  
Sebastião Gobbi ◽  
...  

2011 ◽  
Vol 7 (3) ◽  
pp. 300-308 ◽  
Author(s):  
Gad A. Marshall ◽  
Dorene M. Rentz ◽  
Meghan T. Frey ◽  
Joseph J. Locascio ◽  
Keith A. Johnson ◽  
...  

2020 ◽  
Author(s):  
Jin Wang ◽  
Xiaojuan Guo ◽  
Wenhui Lu ◽  
Jie Liu ◽  
Hong Zhang ◽  
...  

Abstract Background:Vascular factors and mitochondria dysfunction contributeto thepathogenesis of Alzheimer’s Disease (AD).DL-3-n-butylphthalide (NBP)has an effect in protecting mitochondria and improving microcirculation. We investigated the effect of NBP in patients with mild-moderate AD already receiving donepezil.Methods: It was a prospective cohort study. 92 mild-moderate AD patients were classified into the donepezil alone group (n=43) or the donepezil combined NBP group (n=49) for 48 weeks. The primary outcome was change of Alzheimer’s disease assessment scale-cognitive subscale (ADAS-cog) from baseline after treatment 48 weeks. All patients were also evaluated with clinician’s interview-based impression of change plus caregiver input (CIBIC-plus), Alzheimer's disease cooperative study-activities of daily living (ADCS-ADL) and neuropsychiatric inventory (NPI) every 12 weeks. All patients were monitored for adverse events (AEs). The efficacy was analyzed using logistic regression analysis.Results:The univariate analysis showed that age wasolder in donepezil alone group(P=0.005), prevalence of hypertension was higher in donepezil alone group(P=0.026).The ADAS-cog score change from baseline in thedonepezil alone group was significant than that in the donepezil combined NBP group at 48 weeks(1.82±5.20 vs -0.38±4.46, P=0.048). The multivariate logistic regression analysis showed that between the 2 groups, there were significant differencesin changes on the ADAS-cog(OR=0.879,95% CI:[0.785,0.984],P=0.026),MMSE(OR=1.270,95% CI:[1.036,1.557],P=0.021), and ADCS-ADL(OR=1.067,95% CI:[1.002,1.136],P=0.042) but no significant differences for changes on the NPI(OR=0.955,95% CI:[0.901,1.013],P=0.125)and CIBIC-plus (OR=0.356,95% CI:[0.093,1.364],P=0.132). The occurrence of AEs was similar in the 2 groups.Conclusions:Over the 48-week treatment period, donepezil combined NBP group had slower cognitive decline and better activities of daily living in patients with mild to moderate AD. These indicated that the multi-target therapeutic effect of NBP may be a new choice for AD treatment.Trial registration:Clinical trial registration URL:https://clinicaltrials.gov/ct2/show/NCT02711683?term=NCT02711683&draw=2&rank=1ClinicalTrials.gov Identifier: NCT02711683. Date of registration: March 14,2016.


2019 ◽  
Vol 34 (6) ◽  
pp. 855-855
Author(s):  
E Smith ◽  
J Schaffert ◽  
C LoBue ◽  
J Hart ◽  
H Rossetti ◽  
...  

Abstract Objective Research examining the course of Alzheimer’s disease (AD) in Hispanics is lacking. This study examined demographic, psychiatric, cognitive, and genetic predictors of longitudinal functional change in Hispanics and non-Hispanics with AD. Method Longitudinal change in instrumental activities of daily living (IADL) was examined over 10 years (M = 4.15 years) in 292 subjects (Hispanic = 67, non-Hispanic = 225). All were part of the Texas Alzheimer’s Research & Care Consortium and included those with AD (n = 217) and those with mild cognitive impairment at baseline who progressed to AD at follow-up (n = 75). Baseline comparisons were conducted between ethnic groups for demographics, Geriatric Depression Scale (GDS-30) score, Mini Mental State Examination (MMSE) score, presence of apolipoprotein ɛ4 alleles (APOE4), and annualized IADL change scores and then entered into a multiple linear regression model as predictors of annualized IADL change. Results The Hispanic group had significantly more females (χ2 = 5.71, p = .017), lower education [MH = 9.96(4.39), MNH = 15.26(2.70)], higher depression scores [GDS-30; MH = 9.45(5.89), MNH = 5.51(4.29)], lower MMSE scores [MH = 23.31(4.33), MNH = 24.65(3.21)], and slower annualized IADL change [MH = 1.19(1.42), MNH = 2.02(1.60)]. Regression results were significant (F = 3.66, p = .001, R2 = .08 ), with higher baseline MMSE (p = .007) and Hispanic origin (p = .010) predicting slower annualized IADL change. Demographics, APOE4 status, and depression did not significantly predict IADL change. Conclusions Higher cognitive functioning at baseline and Hispanic origin was associated with slower functional decline over an average 4-year period of time. Despite having lower MMSE scores at baseline, greater depression, and less education, the Hispanic group had a slower decline in IADLs compared to non-Hispanics. Further research is needed to better understand how/why Hispanic origin is associated with slower functional decline.


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