Carcaillon_2011_J.Nutr.Health.Aging_15_361

Reference

Title : Diagnosis of Alzheimer's disease patients with rapid cognitive decline in clinical practice: interest of the deco questionnaire - Carcaillon_2011_J.Nutr.Health.Aging_15_361
Author(s) : Carcaillon L , Berrut G , Sellal F , Dartigues JF , Gillette S , Pere JJ , Bourdeix I
Ref : J Nutr Health Aging , 15 :361 , 2011
Abstract :

BACKGROUND: Patients with Alzheimer's disease (AD) who deteriorate rapidly are likely to have a poorer prognosis. There is a clear need for a clinical assessment tool to detect such a decline in newly diagnosed patients. OBJECTIVE: To identify the predictive factors of rapid cognitive decline (RCD) in a cohort of patients with mild to moderate AD ; and to validate a self-questionnaire for caregivers as a diagnostic tool for rapid decline. DESIGN AND ANALYSIS: An open-label, observational, 12-month, multicenter, French study. Physicians were asked to record data of three eligible rivastigmine nave (or on rivastigmine for < 1 year) AD patients. Risk factors of RCD and the detection power of the Dtrioration Cognitive Observe scale (Deco), a 19 item self-questionnaire for caregivers, were assessed at endpoint using regression analyses. RESULTS: Out of the 361 patients enrolled in the study, 91 (25.2%) were excluded due to loss of follow-up. Among subjects using cholinesterase inhibitors or memantine, 161 (59.6%) experienced a stabilization (29.2%) or an improvement (30.4%) in global functioning as measured by the CGI-C. Sixty of the remaining 204 patients retained for analysis (29.6%, CI 95% [23.4; 35.8]) lost three or more points on the MMSE score between the inclusion and one of the follow-up visit. In the multivariate logistic regression analysis, institutionalization, higher level of education and the loss of 3 points or more on the MMSE were found to be significant predictors of a rapid cognitive loss in this population. The threshold which maximizes the predictive values of the Deco score as a diagnostic tool of rapid cognitive decline was significantly different according to the age of the patient (below or over 75 years old). A score below 16 for patients < 75 years old and below 14 for patients > 75 years old consistently predicted a RCD within the next year. CONCLUSION: The Deco test appears to be a simple tool to alert the physician to the possibility of an aggressive course of the disease which warrants particular management..

PubMedSearch : Carcaillon_2011_J.Nutr.Health.Aging_15_361
PubMedID: 21528162

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Citations formats

Carcaillon L, Berrut G, Sellal F, Dartigues JF, Gillette S, Pere JJ, Bourdeix I (2011)
Diagnosis of Alzheimer's disease patients with rapid cognitive decline in clinical practice: interest of the deco questionnaire
J Nutr Health Aging 15 :361

Carcaillon L, Berrut G, Sellal F, Dartigues JF, Gillette S, Pere JJ, Bourdeix I (2011)
J Nutr Health Aging 15 :361