Dementia Research Centre, Department of Neurodegenerative Disease, UCL Institute of Neurology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
StatisticalInnovation Group, AstraZeneca, Cambridge, UK.
J Alzheimers Dis. 2018;64(2):631-642. doi: 10.3233/JAD-170841.
Health-care professionals, patients, and families seek as much information as possible about prognosis for patients with Alzheimer's disease (AD); however, we do not yet have a robust understanding of how demographic factors predict prognosis. We evaluated associations between age at presentation, age of onset, and symptom length with cognitive decline as measured using the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating sum-of-boxes (CDR-SOB) in a large dataset of AD patients. Age at presentation was associated with post-presentation decline in MMSE (p < 0.001), with younger patients showing faster decline. There was little evidence of an association with change in CDR-SOB. Symptom length, rather than age, was the strongest predictor of MMSE and CDR-SOB at presentation, with increasing symptom length associated with worse outcomes. The evidence that younger AD patients have a more aggressive disease course implies that early diagnosis is essential.
医疗保健专业人员、患者和家属都希望尽可能多地了解阿尔茨海默病（AD）患者的预后信息；然而，我们对于人口统计学因素如何预测预后还没有深入的了解。我们评估了在 AD 患者的大型数据集，中，发病年龄、起病年龄和症状持续时间与使用 Mini-Mental State Examination (MMSE) 和 Clinical Dementia Rating sum-of-boxes (CDR-SOB) 测量的认知能力下降之间的关系。发病年龄与 MMSE 后的下降呈正相关（p<0.001），年轻患者的下降速度更快。几乎没有证据表明与 CDR-SOB 的变化有关。症状持续时间，而不是年龄，是 MMSE 和 CDR-SOB 发病时的最强预测指标，症状持续时间的增加与预后较差有关。年龄较小的 AD 患者疾病进程更具侵袭性的证据表明早期诊断至关重要。
