Mohs R C
Psychiatry Service, Veterans Affairs medical Center, Bronx, New York, USA.
Int Psychogeriatr. 1996 Summer;8(2):195-203. doi: 10.1017/s1041610296002578.
This article reviews longitudinal data collected from patients with Alzheimer's disease (AD) that are relevant to the design and interpretation of clinical treatment trials. Longitudinal data from patients tested with the Alzheimer's Disease Assessment Scale demonstrate that cognitive symptoms, including memory loss, dysphasia, and dyspraxia, worsen relentlessly over time with the rate of change depending upon baseline dementia severity. Noncognitive symptoms, such as agitation, depressed mood, and psychosis, are episodic, do not necessarily worsen over time, and tend not to be highly correlated with one another. The reliability of cognitive change measures increases with follow-up duration so that the likelihood of detecting drug effects on the rate of cognitive deterioration is greater with longer treatment trials. Functional measures of activities of daily living are difficult to standardize for AD patients but are important for determining the overall clinical and economic impact of AD treatments.
本文回顾了从阿尔茨海默病(AD)患者收集的纵向数据,这些数据与临床治疗试验的设计和解读相关。使用阿尔茨海默病评估量表对患者进行测试所得到的纵向数据表明,认知症状,包括记忆力丧失、言语困难和失用症,会随着时间无情地恶化,变化速率取决于基线痴呆严重程度。非认知症状,如激越、情绪低落和精神病症状,呈发作性,不一定会随着时间而恶化,且彼此之间往往没有高度相关性。认知变化测量的可靠性会随着随访时间的延长而增加,因此,治疗试验时间越长,检测药物对认知衰退速率影响的可能性就越大。日常生活活动的功能测量对于AD患者来说难以标准化,但对于确定AD治疗的总体临床和经济影响很重要。