Cognitive deterioration in Alzheimer's disease:behavioral and health factors.
Hughes JP
Bok Engelsk
| Utgitt | Department of Psychiatry and Behavioral Sciences,U
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| Omfang | 6 s.
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| Utgave | Kopi
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| Opplysninger | Alzheimer's disease is characterized by progressivecognitive decline. However, little is known about the "typical" rate ofdecline, the degree of individual heterogeneity evident in decline, or thetypes of factors that influence such decline. This study investigatedthese questions in a sample of 106 patients with Alzheimer's disease,assessed at 1-5 points in time, spanning up to three years. At each time point,the Mini-Mental State Exam, a measure of global cognitive function, wasadministered to all patients. Measures of behavioral disturbance(including the presence/absence of hallucinations, depression,incontinence, wandering, and agitation), health status (includingpresence/absence of neurological, cardiovascular, and other diseases), anddescriptive information (such as gender, age at time of onset, andduration of deficits) were obtained at entry into the study. Atwo-stage random effects regression model was fit to the data and thenused to assess the effect of these behavioral, health, and descriptivemeasures on the rate of decline. Results indicate that the rate of cognitivedecline in Alzheimer's disease is quite variable. Patients withvarious health and behavioral problems declined at a rate between 1.4 and 5times faster than patients without such problems. Alcohol abuse,additional neurological disease, and agitation were significantlyrelated to rate of decline. Overall number of problems was not. Theassociation of these problems with accelerated decline may have prognostic and treatment implications.
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| Emner |
