Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.
Norwegian National Advisory Unit on Ageing and Health, Vestfold Hospital Trust, Tønsberg, Norway.
J Alzheimers Dis. 2018;61(3):1221-1232. doi: 10.3233/JAD-170436.
The course of Alzheimer's disease (AD) varies considerably between individuals. There is limited evidence on factors important for disease progression.
The primary aim was to study the progression of AD, as measured by the Clinical Dementia Rating Scale Sum of Boxes (CDR-SB). Secondary aims were to investigate whether baseline characteristics are important for differences in progression, and to examine the correlation between progression assessed using three different instruments: CDR-SB (0-18), the cognitive test Mini-Mental State Examination (MMSE, 0-30), and the functional measure Instrumental Activities of Daily Living (IADL, 0-1).
The Progression of AD and Resource use (PADR) study is a longitudinal observational study in three Norwegian memory clinics.
In total, 282 AD patients (mean age 73.3 years, 54% female) were followed for mean 24 (16-37) months. The mean annual increase in CDR-SB was 1.6 (SD 1.8), the mean decrease in MMSE score 1.9 (SD 2.6), and the mean decrease in IADL score 0.13 (SD 0.14). Of the 282 patients, 132 (46.8%) progressed slowly, with less than 1 point yearly increase in CDR-SB. Cognitive test results at baseline predicted progression rate, and together with age, ApoE, history of hypertension, and drug use could explain 17% of the variance in progression rate. The strongest correlation of change was found between CDR-SB and IADL scores, the weakest between MMSE and IADL scores.
Progression rate varied considerably among AD patients; about half of the patients progressed slowly. Cognitive test results at baseline were predictors of progression rate.
阿尔茨海默病（AD）的病程在个体之间差异很大。目前关于对疾病进展有重要影响的因素的证据有限。
本研究的主要目的是使用临床痴呆评定量表总和分（CDR-SB）来评估 AD 的进展情况。次要目的是探讨基线特征是否对进展差异有重要意义，并检查使用三种不同仪器评估的进展之间的相关性：CDR-SB（0-18）、认知测试简易精神状态检查（MMSE，0-30）和功能测量工具日常生活活动能力（IADL，0-1）。
AD 进展和资源使用（PADR）研究是一项在挪威三家记忆诊所进行的纵向观察性研究。
共纳入 282 名 AD 患者（平均年龄 73.3 岁，54%为女性），平均随访 24（16-37）个月。CDR-SB 的平均年增长率为 1.6（SD 1.8），MMSE 评分的平均下降率为 1.9（SD 2.6），IADL 评分的平均下降率为 0.13（SD 0.14）。在 282 名患者中，132 名（46.8%）进展缓慢，每年 CDR-SB 增加不到 1 分。基线认知测试结果预测了进展速度，与年龄、ApoE、高血压病史和药物使用一起，可以解释进展速度差异的 17%。CDR-SB 和 IADL 评分之间的变化相关性最强，MMSE 和 IADL 评分之间的相关性最弱。
AD 患者的进展速度差异很大；约一半患者进展缓慢。基线认知测试结果是进展速度的预测因素。
