Neuroscience
Measuring Alzheimer disease progression with transition probabilities: Estimates from NACC-UDS
Curr Alzheimer Res. 2011 Nov 28;
Spackman DE, Kadiyala S, Neumann PJ, Veenstra DL, Sullivan SD
Abstract
Objectives: Estimate the probabilities, for Alzheimer's disease (AD) patients, of transitioning between stages of disease severity (mild, moderate, severe, dead) and care settings (community, institutional). Methods: Data were compiled by the National Alzheimer Coordinating Center. The main analyses were limited to 3,852 patients who were >50 years old, diagnosed with possible/probable AD and had at least two center visits. A multinomial logistic model accounting for patient and center level correlation was used to calculate transition probabilities between stages of the Clinical Dementia Rating (CDR). Separately we calculated the probabilities of being institutionalized based on CDR stage. Both analyses controlled for baseline age, time between visits, sex, marital status, whether white, whether Hispanic and number of years of education. Results: The annual probabilities of dying for patients in mild, moderate and severe health states were 5.5%, 21.5% and 48.0%, respectively, while the annual probabilities for institutionalization were 1.2%, 3.4% and 6.6%, respectively. The majority of mild and moderate patients remain in the same health state after one year, 77.4% and 50.1% respectively. Progressing patients are most likely to transition one stage, but 1.3% of mild patients become severe in one year. Some patients revert to lower severity stages, 7% from moderate to mild. Conclusions: Transition probabilities to higher CDR stages and to institutionalization are lower than those published previously, but the probability of death is higher. These results are useful for understanding AD progression and can be used in simulation models to evaluate costs and compare new treatments or policies.
PMID: 22175655 [PubMed - as supplied by publisher]
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Neuroscience
Neuropsychology Abstract of the Day: Alzheimer's Disease Progression
Measuring Alzheimer disease progression with transition probabilities: Estimates from NACC-UDS
Curr Alzheimer Res. 2011 Nov 28;
Spackman DE, Kadiyala S, Neumann PJ, Veenstra DL, Sullivan SD
Abstract
Objectives: Estimate the probabilities, for Alzheimer's disease (AD) patients, of transitioning between stages of disease severity (mild, moderate, severe, dead) and care settings (community, institutional). Methods: Data were compiled by the National Alzheimer Coordinating Center. The main analyses were limited to 3,852 patients who were >50 years old, diagnosed with possible/probable AD and had at least two center visits. A multinomial logistic model accounting for patient and center level correlation was used to calculate transition probabilities between stages of the Clinical Dementia Rating (CDR). Separately we calculated the probabilities of being institutionalized based on CDR stage. Both analyses controlled for baseline age, time between visits, sex, marital status, whether white, whether Hispanic and number of years of education. Results: The annual probabilities of dying for patients in mild, moderate and severe health states were 5.5%, 21.5% and 48.0%, respectively, while the annual probabilities for institutionalization were 1.2%, 3.4% and 6.6%, respectively. The majority of mild and moderate patients remain in the same health state after one year, 77.4% and 50.1% respectively. Progressing patients are most likely to transition one stage, but 1.3% of mild patients become severe in one year. Some patients revert to lower severity stages, 7% from moderate to mild. Conclusions: Transition probabilities to higher CDR stages and to institutionalization are lower than those published previously, but the probability of death is higher. These results are useful for understanding AD progression and can be used in simulation models to evaluate costs and compare new treatments or policies.
PMID: 22175655 [PubMed - as supplied by publisher]
- Alzheimer's Disease: Gammagard Fails
From the company press release: Baxter Announces Topline Results of Phase III Study of Immunoglobulin for Alzheimer's Disease DEERFIELD, Ill., May 7, 2013 - Baxter International Inc. (NYSE:BAX) today announced that its Phase III clinical study of...
- Neuropsychology Abstract Of The Day: Donepezil, Mci, And Ad
Lu PH, Edland SD, Teng E, Tingus K, Petersen RC, Cummings JL & Alzheimer's Disease Cooperative Study Group. (2009) Donepezil delays progression to AD in MCI subjects with depressive symptoms. Neurology, 72(24):, 2115-2121. Departments of Neurology,...
- Neuropsychology Abstract Of The Day: Alzheimer Drug Regimens & Delivery Systems
Bassil, N & Grossberg, GT. (2009). Novel regimens and delivery systems in the pharmacological treatment of Alzheimer's disease. CNS Drugs, 23(4), 293-307. The mainstay of current management of patients with Alzheimer's disease involves drugs that...
- Neuropsychology Abstract Of The Day: Mild Cognitive Impairment (mci)
Fleisher AS, Sun S, Taylor C, Ward CP, Gamst AC, Petersen RC, Jack CR, Aisen PS, & Thal LJ. Volumetric MRI vs clinical predictors of Alzheimer disease in mild cognitive impairment. Neurology. 2008 Jan 15; 70(3): 191-199. OBJECTIVE: To compare volumetric...
- Donepezil, Vitamin E, And Mild Cognitive Impairment In Aging
The New England Journal of Medicine has made available on its website prepublication versions of the results of a large study relevant to aging, neuropsychological changes in aging, and the onset of dementia. It has also made available in the same format...