Long-term Course of Alzheimer Disease in Patients Treated According to the Dutch Dementia Guideline at a Memory Clinic A "Real-Life" Study

Erika Droogsma*, Dieneke van Asselt, Jolanda van Steijn, Marjolein Diekhuis, Nic Veeger, Peter P. De Deyn

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

4 Citations (Scopus)

Abstract

Introduction:There is little knowledge of the long-term course of Alzheimer disease (AD) in light of current pharmacological and nonpharmacological interventions provided in a real-life setting.Methods:The Frisian Alzheimer's Disease Cohort study is a real-life study of the course of AD in patients (n=576) treated with pharmacological (ie, cholinesterase inhibitors) and nonpharmacological (ie, case management, respite care) interventions. Disease course was described by changes in cognition (Mini Mental State Examination, clock-drawing test) and number of types of professional care applying a repeated-measures analysis using a marginal model (population-based average model). In addition, behavioral and psychological symptoms, and proportions of nursing home admissions and deaths were investigated.Results:During 3.5 years, the average Mini Mental State Examination decreased from 22.24 to 18.91, the clock-drawing test score increased from 3.38 to 4.05, the number of types of professional care increased from 0.85 to 2.64, and the patients with behavioral and psychological symptoms increased from 29.0% to 70.2%. The proportion of patients admitted to a nursing home was 40.8% and 41.0% died.Conclusions:Cognition and behaviour of AD patients deteriorated accompanied with an increase in care-dependency during 3.5 years. Nevertheless, compared with the precholinesterase inhibitor era, current pharmacological and nonpharmacological interventions appear to slow cognitive decline, which emphasizes that they seem to have a favorable effect.

Original languageEnglish
Pages (from-to)53-59
Number of pages7
JournalAlzheimer disease & associated disorders
Volume30
Issue number1
DOIs
Publication statusPublished - 2016

Keywords

  • Alzheimer disease
  • community-dwelling
  • "real-life" setting
  • memory clinic
  • cholinesterase inhibitors
  • disease course
  • RANDOMIZED CONTROLLED-TRIALS
  • NURSING-HOME PLACEMENT
  • MINI-MENTAL-STATE
  • EXTERNAL VALIDITY
  • GALANTAMINE
  • PROGRESSION
  • VALIDATION
  • DONEPEZIL
  • DECLINE
  • SCALE

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