1. Predictors of Patient Dependence in Mild-to-Moderate Alzheimer's Disease
- Author
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Reinhold Schmidt, Maren Gaudig, Anita Lechner, Josef Marksteiner, Günter Sanin, Thomas Benke, Margarete Uranüs, Peter Dal-Bianco, and Gerhard Ransmayr
- Subjects
Male ,medicine.medical_specialty ,Activities of daily living ,Dependency, Psychological ,Disease ,Neuropsychological Tests ,Cohort Studies ,Alzheimer Disease ,Predictive Value of Tests ,Internal medicine ,Humans ,Medicine ,Dementia ,Disabled Persons ,Registries ,Depression (differential diagnoses) ,Aged ,Aged, 80 and over ,Psychiatric Status Rating Scales ,business.industry ,General Neuroscience ,Age Factors ,Cognition ,General Medicine ,Caregiver burden ,Middle Aged ,medicine.disease ,Psychiatry and Mental health ,Clinical Psychology ,Caregivers ,Austria ,Cohort ,Linear Models ,Female ,Geriatrics and Gerontology ,Cognition Disorders ,business ,Psychopathology - Abstract
Background Patient dependence has rarely been studied in mild-to-moderate Alzheimer's disease (AD). Objective To identify factors which predict patient dependence in mild-to-moderate AD. Methods We studied 398 non-institutionalized AD patients (234 females) of the ongoing Prospective Registry on Dementia (PRODEM) in Austria. The Dependence Scale (DS) was used to assess patient dependence. Patient assessment comprised functional abilities, neuropsychiatric symptoms and cognitive functions. A multiple linear regression analysis was performed to identify predictors of patient dependence. Results AD patients were mildly-to-moderately impaired (mean scores and SDs were: CDR 0.84 ± 0.43; DAD 74.4 ± 23.3, MMSE = 22.5 ± 3.6). Psychopathology and caregiver burden were in the low range (mean NPI score 13.2, range 0 to 98; mean ZBI score 18, range 0-64). Seventy five percent of patients were classified as having a mild level of patient dependence (DS sum score 0 to 6). Patient dependence correlated significantly and positively with age, functional measures, psychopathology and depression, disease duration, and caregiver burden. Significant negative, but low correlations were found between patient dependence, cognitive variables, and global cognition. Activities of daily living, patient age, and disease severity accounted for 63% of variance in patient dependence, whereas cognitive variables accounted for only 11%. Conclusion Dependence in this cohort was mainly related to age and functional impairment, and less so to cognitive and neuropsychiatric variables. This differs from studies investigating patients in more advanced disease stages which found abnormal behavior and impairments of cognition as main predictors of patient dependence.
- Published
- 2014
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