Negru Denisa Claudia, Tit Delia Mirela, Negru Paul Andrei, Bungau Gabriela, Marin Ruxandra Cristina
Doctoral School of Biological and Biomedical Sciences, University of Oradea, 410087 Oradea, Romania.
Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania.
Medicina (Kaunas). 2025 May 11;61(5):877. doi: 10.3390/medicina61050877.
: Alzheimer's disease (AD) is a progressive neurodegenerative condition that significantly affects cognitive, emotional, and functional abilities in older adults. This study aimed to explore how demographic, clinical, and psychological factors influence the progression of cognitive decline in patients diagnosed with AD. A total of 101 patients were evaluated retrospectively and followed longitudinally at three different time points, using standardized instruments, including the MMSE, Reisberg's GDS, clock-drawing test, MADRS, and Hamilton depression scale. Statistical methods included non-parametric tests, mixed-effect modeling, and Bayesian analysis. Most patients were older women from rural areas, predominantly in moderate-to-severe stages of AD. Age showed a significant association with cognitive decline ( < 0.05), and depression-particularly in moderate and severe forms-was strongly linked to lower MMSE scores ( < 0.001). Over 70% of the participants had some degree of depression. The clock-drawing test highlighted visuospatial impairments, consistent with everyday functional loss. Although donepezil and memantine combinations appeared to be more frequently prescribed, no treatment showed a statistically significant advantage, and confidence interval overlaps suggest caution in interpreting differences between therapies. Longitudinal models confirmed a progressive and accelerated decline, with inter-individual variability becoming more pronounced in later stages. Although comorbidities, such as hypertension and diabetes, were frequent, they did not show a statistically significant effect on MMSE scores in this cohort. Age and depression appear to play central roles in the pace of cognitive deterioration in AD. Given the limited efficacy of most current therapies, these findings highlight the need for earlier intervention and a more personalized, integrated approach-combining cognitive care, psychiatric support, and comorbidity management-to better meet the needs of patients with AD.
阿尔茨海默病(AD)是一种进行性神经退行性疾病,严重影响老年人的认知、情感和功能能力。本研究旨在探讨人口统计学、临床和心理因素如何影响被诊断为AD的患者认知衰退的进展。使用标准化工具,包括简易精神状态检查表(MMSE)、雷斯伯格总体衰退量表(GDS)、画钟试验、蒙哥马利-艾森伯格抑郁量表(MADRS)和汉密尔顿抑郁量表,对101例患者进行了回顾性评估,并在三个不同时间点进行纵向随访。统计方法包括非参数检验、混合效应建模和贝叶斯分析。大多数患者是来自农村地区的老年女性,主要处于AD的中度至重度阶段。年龄与认知衰退显著相关(P<0.05),抑郁——尤其是中度和重度形式——与较低的MMSE评分密切相关(P<0.001)。超过70%的参与者有一定程度的抑郁。画钟试验突出了视觉空间障碍,这与日常功能丧失一致。尽管多奈哌齐和美金刚联合用药似乎更常被处方,但没有一种治疗方法显示出统计学上的显著优势,置信区间重叠表明在解释不同治疗方法之间的差异时需谨慎。纵向模型证实了认知衰退的进行性和加速性,个体间差异在后期变得更加明显。尽管高血压和糖尿病等合并症很常见,但在该队列中它们对MMSE评分没有显示出统计学上的显著影响。年龄和抑郁似乎在AD认知恶化的速度中起核心作用。鉴于目前大多数治疗方法的疗效有限,这些发现凸显了早期干预以及更个性化、综合化方法的必要性——结合认知护理、精神支持和合并症管理——以更好地满足AD患者的需求。