Assessment of progression and prognosis in 'possible' and 'probable' Alzheimer's disease.
OBJECTIVE
The objective of this study was to assess the rate of progression and clinical predictors of decline in subjects with possible and probable Alzheimer's disease (AD).


METHODS
The annual rate of change (ARC) for cognitive/functional scales was calculated for 95 subjects with AD attending a memory clinic. Two consecutive ARCs were calculated for a subgroup of 39 subjects.


RESULTS
The ARCs were relatively normally distributed; however, there was a large degree of variability. Neither age nor duration of symptoms at presentations were predictive of the rate of decline. However, the data suggested an effect of gender, with males having a greater rate of decline in cognition (p = 0.02). Finally, the rate of progression over the first year did not predict the subsequent ARC (p = 0.25).


CONCLUSIONS
The high variability in ARCs observed in this study and poor correlation between consecutive ARCs suggest that neither mean ARC values nor the previous rate of decline can be used to aid clinicians in the assessment of response to acetylcholinesterase inhibitors or other specific treatments for AD.
Swanwick
G R
GR
Mercer's Institute for Research on Ageing, St Jame's Hospital, Dublin, Ireland.
Coen
R F
RF
Coakley
D
D
Lawlor
B A
BA
D000367:Age Factors; D000368:Aged; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000503:physiopathology; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000175:diagnosis* / Q000503:physiopathology; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D011379:Prognosis; D012044:Regression Analysis; D012189:Retrospective Studies; D012737:Sex Factors; D013997:Time Factors