Center for Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany.
Department of Psychotherapy, Alexianer Psychiatric Hospital Köln-Porz, Köln, Germany.
Eur J Neurosci. 2022 Nov;56(9):5587-5600. doi: 10.1111/ejn.15446. Epub 2021 Sep 15.
Dementia, including Alzheimer's disease, is a growing problem worldwide. Prevention or early detection of the disease or a prodromal cognitive decline is necessary. By means of our long-term follow-up 'Vogel study', we aim to predict the pathological cognitive decline of a German cohort (mean age was 73.9 ± 1.55 years at first visit) with three measurement time points within 6 years per participant. Especially in samples of the elderly and subjects with chronic or co-morbid diseases, dropouts are one of the biggest problems of long-term studies. In contrast to the large number of research articles conducted on the course of dementia, little research has been done on the completion of treatment. To ensure unbiased and reliable predictors of cognitive decline from study completers, our objective was to determine predictors of dropout. We conducted multivariate analyses of covariance and multinomial logistic regression analyses to compare and predict the subject's dropout behaviour at the second visit 3 years after baseline (full participation, partial participation and no participation/dropout) with neuropsychiatric, cognitive, blood and lifestyle variables. Lower performance in declarative memory, attention and visual-spatial processing predicted dropout rather than full participation. Lower performance in visual-spatial processing predicted partial participation as opposed to full participation. Furthermore, lower performance in mini-mental status examination predicted whether subjects dropped out or participated partially instead of full participation. Baseline cognitive parameters are associated with dropouts at follow-up with a loss of impaired participants. We expect a bias into a healthier sample over time.
痴呆症，包括阿尔茨海默病，是全球日益严重的问题。有必要预防或早期发现这种疾病或前驱认知能力下降。通过我们的长期随访“Vogel 研究”，我们旨在预测一个德国队列（第一次就诊时的平均年龄为 73.9±1.55 岁）的病理性认知下降，每个参与者在 6 年内有三个测量时间点。特别是在老年人样本和患有慢性或合并症的受试者中，脱落是长期研究的最大问题之一。与大量关于痴呆症病程的研究文章相比，对治疗完成情况的研究较少。为了确保从完成治疗的研究参与者中得出无偏且可靠的认知能力下降预测因素，我们的目的是确定脱落的预测因素。我们进行了协方差多元分析和多项逻辑回归分析，以比较和预测基线后 3 年（第二次就诊）的脱落行为（完全参与、部分参与和不参与/脱落）与神经精神、认知、血液和生活方式变量之间的关系。在陈述性记忆、注意力和视觉空间处理方面表现较差预测会导致脱落而不是完全参与。在视觉空间处理方面表现较差预测部分参与而不是完全参与。此外，在简易精神状态检查中的表现较差预测受试者是否会脱落或部分参与而不是完全参与。基线认知参数与随访时的脱落有关，受损参与者的数量减少。我们预计随着时间的推移，会出现偏向更健康样本的情况。
