Determinants of global clinical change assessment in patients withearly Alzheimer's disease
J.J. Claus
Bok Engelsk 1998
| Utgitt | 1998
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| Omfang | Side 157- 163
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| Opplysninger | Global clinical impression (GCI) of change is assumed to integrateaspects of both cognitive and noncognitive functioning. We evaluated140 consecutive patients with probable (n = 90) and possible (n = 50)early Alzheimer's disease at baseline and after 6 months withmeasurements of global cognitive function (CAMCOG), behavior,activities of daily living, and burden of the caregiver. After 6months, both the clinician (GCI-clin) and the caregiver (GCI-care)rated clinical change on a 3-point scale (worse, no change,improved). Data were analyzed with multiple polychotomous logisticregression, adjusted for age and sex. Change in global cognitivefunction and GCI-care were significantly and independently related toGCI-clin, while changes in activities of daily living and in behaviorwere significantly and independently associated with GCI-care. Thefindings suggest a double dissociation. Change in cognition appearsto be the major determinant of the clinician's global impression butnot change in behavioral and functional parameters, while globalimpression of the caregiver is primarily based on change inbehavioral and functional measures but not on change in cognition.
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