Aubert Lauren, Pichierri Sophie, Hommet Caroline, Camus Vincent, Berrut Gilles, de Decker Laure
Department of Geriatrics, Nantes University Hospital, Nantes, France.
J Am Geriatr Soc. 2015 Mar;63(3):543-7. doi: 10.1111/jgs.13314. Epub 2015 Mar 6.
To determine the association between rapid cognitive decline and burden of comorbidities as assessed using the Charlson Comorbidity Index in individuals aged 65 and older with Alzheimer's disease (AD).
Retrospective cohort study.
Memory clinic at the University Hospital of Nantes.
Individuals aged 65 and older with AD (n=170).
Subjects were followed for 1 year. Rapid cognitive decline was defined as a decrease of 3 or more points on the Mini-Mental State Examination per 12-month period. Variables studied were the Charlson Comorbidity Index (measure of comorbidity burden), age, sex, AD stage, type of residence (living at home or not), presence of caregiver, functional abilities (Lawton and Katz scales), risk of malnutrition or depression, and intercurrent events (hospitalization or initiating home care).
Rapid cognitive decline at 1-year follow-up occurred in 65 subjects (38.2%). In fully adjusted logistic regression analysis, Charlson Comorbidity Index was significantly associated with rapid cognitive decline (odds ratio (OR)=1.30, P=.03). Moderate stage of AD (OR=2.07, P=.04) and living at home (OR=4.17, P=.04) were also associated with rapid cognitive decline.
Comorbidity burden was associated with rapid cognitive decline in subjects with AD.
使用查尔森合并症指数评估65岁及以上阿尔茨海默病（AD）患者的快速认知衰退与合并症负担之间的关联。
回顾性队列研究。
南特大学医院记忆门诊。
65岁及以上的AD患者（n = 170）。
对受试者进行1年的随访。快速认知衰退定义为每12个月简易精神状态检查表得分下降3分或更多。研究的变量包括查尔森合并症指数（合并症负担的测量指标）、年龄、性别、AD阶段、居住类型（是否在家居住）、是否有照顾者、功能能力（劳顿和卡茨量表）、营养不良或抑郁风险以及并发事件（住院或开始接受家庭护理）。
1年随访时，65名受试者（38.2%）出现快速认知衰退。在完全调整的逻辑回归分析中，查尔森合并症指数与快速认知衰退显著相关（比值比（OR）= 1.30，P = .03）。AD中度阶段（OR = 2.07，P = .04）和在家居住（OR = 4.17，P = .04）也与快速认知衰退相关。
AD患者的合并症负担与快速认知衰退相关。
