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• W2015955416 abstract "There is considerable variability in observed progression rates among Alzheimer's disease patients. It is not clear whether patients who start out progressing rapidly or slowly will remain consistently separate over time. To examine if preprogression rate, established at the initial assessment, predicts whether patients will progress as distinct groups over time. We classified 801 probable AD patients (NINCDS–ADRDA, DSM IV) at their initial visit into slow, intermediate, and rapid progressors based upon our previously published calculated preprogression rate (derived from the Mini–Mental Status Examination score and a standardized and published Physician's Estimate of Duration). We then performed a mixed effects regression analysis to determine whether the preprogression groups (slow, intermediate, rapid) remained distinct over follow up (3.60 ± 2.4 years) on multiple outcome measures including: Alzheimer's Disease Assessment Scale–cognitive subscale (ADAS–cog), Clinical Dementia Rating Scale (sum of the boxes), measures of attention (Verbal Sustained Attention Test– speed and accuracy) and activities of daily living (Lawton & Brody PSMS and IADL). We adjusted for covariates previously reported to influence progression in AD. In the unadjusted model with fast preprogressors as the reference group, both intermediate and slow preprogressors remained distinct on all outcomes with one exception (PSMS change did not differ for the intermediate preprogressors). After adjusting for age, sex, education, premorbid IQ, psychosis and extrapyramidal signs, the differences remained significant: e.g. group mean ADAS scores remained 3.5 points lower on the ADAScog for the intermediate and 10.3 points lower for slow progressors relative to fast progressors . Preprogression rate and premorbid IQ were the most important determinants of observed change. Slopes of decline in the three groups were not completely parallel for all measures, but the interaction terms did not suggest a specific pattern. Slow progressors were also less likely to die compared to intermediate (HR 0.65, p=0.01) or rapid (HR 0.52, p<0.001) progressors. A preprogression rate calculated at the initial visit is predictive of subsequent performance on multiple cognitive and functional measures over time. This has implications for clinical prognostication as well as for the design of clinical trials." @default.
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• W2015955416 date "2006-07-01" @default.
• W2015955416 modified "2023-09-27" @default.
• W2015955416 title "O4-04-06: Predicting progression and survival in Alzheimer's disease" @default.
• W2015955416 doi "https://doi.org/10.1016/j.jalz.2006.05.323" @default.
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