Campbell Joanna, Lavoie Louis, Farraia Mariana, Huelin Rachel, Zhang Quanwu, Tahami Monfared Amir Abbas
Evidence Synthesis, Modelling and Communications, PPD Evidera, 201 Talgarth Road, Hammersmith, London, W6 8BJ, UK.
Evidence Synthesis, Modelling and Communications, PPD Evidera, 7575 Trans-Canada Highway, Suite 404, St-Laurent, Quebec, H4T 1V6, Canada.
Neurol Ther. 2025 Feb;14(1):7-26. doi: 10.1007/s40120-024-00676-9. Epub 2024 Nov 3.
Mild cognitive impairment (MCI) and Alzheimer's disease (AD) have a profound impact on patients' quality of life (QoL), with progressive declines occurring as the disease advances. This systematic review aims to summarize the published evidence on patient-reported outcomes (PROs) in individuals with MCI due to AD and mild AD dementia. Comprehensive searches were conducted across five major databases to identify studies reporting on utility values, disutilities, and QoL measures in these patient populations. A total of 23 studies were included that utilized various QoL assessment tools, including EQ-5D (n = 14), SF-36/SF-12 (n = 4), and QOL-AD (n = 11). Reported EQ-5D scores ranged from 0.81 to 0.92 for patients with MCI and from 0.67 to 0.85 for those with mild AD, indicating a noticeable decline in QoL as the disease progresses. QOL-AD scores ranged from 33.8 to 42.5 for MCI and from 32.4 to 38.1 for mild AD, equally reflecting the greater impairment in QoL with disease advancement. Interventions were generally associated with smaller declines in PROs compared to placebo, suggesting a positive impact of treatment in mitigating QoL deterioration. The findings underscore the significant QoL differences between MCI and mild AD, emphasizing the potential benefit of early intervention to preserve QoL and delay disease progression. This review highlights the importance of continued research to better understand QoL in patients with MCI and mild AD dementia, particularly in terms of capturing comprehensive patient-reported outcomes and evaluating the effectiveness of interventions over time. These findings can contribute to a more informed approach in clinical practice and support decision-making in the management of early-stage AD.
轻度认知障碍(MCI)和阿尔茨海默病(AD)对患者的生活质量(QoL)有深远影响,随着疾病进展,患者的生活质量会逐渐下降。本系统评价旨在总结已发表的关于AD所致MCI患者和轻度AD痴呆患者报告结局(PROs)的证据。我们在五个主要数据库中进行了全面检索,以识别报告这些患者群体效用值、负效用和生活质量测量的研究。共纳入23项研究,这些研究使用了各种生活质量评估工具,包括EQ-5D(n = 14)、SF-36/SF-12(n = 4)和QOL-AD(n = 11)。报告的MCI患者EQ-5D评分范围为0.81至0.92,轻度AD患者为0.67至0.85,这表明随着疾病进展,生活质量有明显下降。MCI患者的QOL-AD评分范围为33.8至42.5,轻度AD患者为32.4至38.1,同样反映出随着疾病进展生活质量损害更大。与安慰剂相比,干预措施通常与PROs的较小下降相关,这表明治疗对减轻生活质量恶化有积极影响。研究结果强调了MCI和轻度AD之间显著的生活质量差异,强调了早期干预对维持生活质量和延缓疾病进展的潜在益处。本综述强调了持续研究的重要性,以便更好地了解MCI和轻度AD痴呆患者的生活质量,特别是在获取全面的患者报告结局以及评估干预措施随时间推移的有效性方面。这些发现有助于在临床实践中采取更明智的方法,并为早期AD管理中的决策提供支持。