A hierarchy of predictors for dementia-free survival in old-age: results of the AgeCoDe study.
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| Title: | A hierarchy of predictors for dementia-free survival in old-age: results of the AgeCoDe study. |
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| Authors: | Luck, T., Riedel‐Heller, S. G., Luppa, M., Wiese, B., Bachmann, C., Jessen, F., Bickel, H., Weyerer, S., Pentzek, M., König, H.‐H., Prokein, J., Eisele, M., Wagner, M., Mösch, E., Werle, J., Fuchs, A., Brettschneider, C., Scherer, M., Breitner, J. C. S., Maier, W. |
| Source: | Acta Psychiatrica Scandinavica. Jan2014, Vol. 129 Issue 1, p63-72. 10p. |
| Subjects: | Dementia, Disease progression, Cognition disorders, Mini-Mental State Examination, Activities of daily living |
| Abstract: | Objective Progression from cognitive impairment ( CI) to dementia is predicted by several factors, but their relative importance and interaction are unclear. Method We investigated numerous such factors in the AgeCoDe study, a longitudinal study of general practice patients aged 75+. We used recursive partitioning analysis ( RPA) to identify hierarchical patterns of baseline covariates that predicted dementia-free survival. Results Among 784 non-demented patients with CI, 157 (20.0%) developed dementia over a follow-up interval of 4.5 years. RPA showed that more severe cognitive compromise, revealed by a Mini-Mental State Examination (MMSE) score < 27.47, was the strongest predictor of imminent dementia. Dementia-free survival time was shortest (mean 2.4 years) in such low-scoring patients who also had impaired instrumental activities of daily living ( iADL) and subjective memory impairment with related worry (SMI-w). Patients with identical characteristics but without SMI-w had an estimated mean dementia-free survival time of 3.8 years, which was still shorter than in patients who had subthreshold MMSE scores but intact iADL (4.2-5.2 years). Conclusion Hierarchical patterns of readily available covariates can predict dementia-free survival in older general practice patients with CI. Although less widely appreciated than other variables, iADL impairment appears to be an especially noteworthy predictor of progression to dementia. [ABSTRACT FROM AUTHOR] |
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| Database: | Psychology and Behavioral Sciences Collection |
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| Abstract: | Objective Progression from cognitive impairment ( CI) to dementia is predicted by several factors, but their relative importance and interaction are unclear. Method We investigated numerous such factors in the AgeCoDe study, a longitudinal study of general practice patients aged 75+. We used recursive partitioning analysis ( RPA) to identify hierarchical patterns of baseline covariates that predicted dementia-free survival. Results Among 784 non-demented patients with CI, 157 (20.0%) developed dementia over a follow-up interval of 4.5 years. RPA showed that more severe cognitive compromise, revealed by a Mini-Mental State Examination (MMSE) score < 27.47, was the strongest predictor of imminent dementia. Dementia-free survival time was shortest (mean 2.4 years) in such low-scoring patients who also had impaired instrumental activities of daily living ( iADL) and subjective memory impairment with related worry (SMI-w). Patients with identical characteristics but without SMI-w had an estimated mean dementia-free survival time of 3.8 years, which was still shorter than in patients who had subthreshold MMSE scores but intact iADL (4.2-5.2 years). Conclusion Hierarchical patterns of readily available covariates can predict dementia-free survival in older general practice patients with CI. Although less widely appreciated than other variables, iADL impairment appears to be an especially noteworthy predictor of progression to dementia. [ABSTRACT FROM AUTHOR] |
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| ISSN: | 0001690X |
| DOI: | 10.1111/acps.12129 |
