Department of Memory Clinic, Miniren-daini-chou Hospital, Kyoto, Japan.
Department of Memory Clinic, Biwako-Yoikuin Hospital, Otsu, Japan.
Geriatr Gerontol Int. 2020 Apr;20(4):324-328. doi: 10.1111/ggi.13883. Epub 2020 Feb 10.
Alzheimer's disease (AD) is the most common neurodegenerative disease. In 2000, Mendiondo et al. reported on a model predicting that AD progresses at an accelerating rate and cognitive function worsens rapidly. Recently, anti-AD drugs and non-pharmacological intervention have been established, but the effect of intervention is unclear and might depend on the stage of AD progression. Here, we examined the prediction of Mendiondo's model in patients with different severities of AD.
A total of 163 new outpatients with AD at four memory clinics were retrospectively analyzed. The Revised Hasegawa Dementia Scale (HDS-R) and Mini-Mental State Examination (MMSE) were administered to all AD patients at the first visit and after approximately 12 months. We divided the patients into three groups according to scores at the first visit: mild, moderate and moderate-to-severe. We compared the scores at the first visit with those obtained after 12 months of anti-AD drug and non-pharmacological interventions.
The HDS-R score improved from 14.5 to 15.0, and the MMSE score improved from 18.8 to 19.1 after 12 months of intervention. Also, the HDS-R and MMSE scores at the first visit were significantly associated with the annual change in the scores. Among the three groups, lower HDS-R and MMSE scores at the first visit were associated with significantly greater annual improvement in the scores after 12 months of intervention.
Contrary to the prediction of Mendiondo's model, mild or moderate AD progressed more rapidly than moderate-to-severe AD under pharmacological and non-pharmacological interventions. Geriatr Gerontol Int 2020; 20: 324-328.
阿尔茨海默病（AD）是最常见的神经退行性疾病。2000 年，Mendiondo 等人报告了一个模型，该模型预测 AD 以加速的速度进展，认知功能迅速恶化。最近，已经建立了抗 AD 药物和非药物干预措施，但干预的效果尚不清楚，可能取决于 AD 进展的阶段。在这里，我们检查了 Mendiondo 模型在不同严重程度的 AD 患者中的预测。
回顾性分析了来自四个记忆诊所的 163 名新的 AD 门诊患者。所有 AD 患者在首次就诊时和大约 12 个月后均进行了修订版 Hasegawa 痴呆量表（HDS-R）和简易精神状态检查（MMSE）。我们根据首次就诊时的分数将患者分为三组：轻度、中度和中重度。我们比较了首次就诊时的分数与抗 AD 药物和非药物干预 12 个月后的分数。
HDS-R 评分从 14.5 提高到 15.0，MMSE 评分从 18.8 提高到 19.1。此外，首次就诊时的 HDS-R 和 MMSE 评分与分数的年度变化显著相关。在三组中，首次就诊时的 HDS-R 和 MMSE 评分较低与干预后 12 个月内评分的显著年度改善相关。
与 Mendiondo 模型的预测相反，在药物和非药物干预下，轻度或中度 AD 的进展速度快于中重度 AD。老年医学与老年病学国际 2020；20:324-328。
