title: Describing cognitive decline of patients at the mild or moderate stages of Alzheimer's disease using the Standardized MMSE.
abstract: OBJECTIVE
  To describe the progression of patients with mild or moderate Alzheimer's disease (AD) to a severe stage using the Standardized Mini-Mental State Examination (SMMSE).
  
  
  METHODS
  A cohort of 206 patients was stratified according to their baseline SMMSE scores: mild (19-24) and moderate (10-18). Proportional hazards analyses were used to determine the hazard of switching into a severe stage, defined as SMMSE score < 10.
  
  
  RESULTS
  Among patients at the mild stage, 25% reached the severe stage within 2.6 years, and in the moderate group within 1.5 years. Patients with hallucinations at the mild stage experienced more rapid decline. The previous rate of decline was also found to be an important predictor. At the moderate stage, key predictors were lower SMMSE score and longer time since onset.
  
  
  CONCLUSIONS
  Current SMMSE scores with other clinical details can be used to advise patients and caregivers about the expected progression of AD.
authors.affiliation: Caro Research Institute, Concord, Massachusetts 01742, USA. alexward@caroresearch.com
authors.forename: Alexandra
authors.initials: A
authors.lastname: Ward
authors.forename: J Jaime
authors.initials: JJ
authors.lastname: Caro
authors.forename: Heather
authors.initials: H
authors.lastname: Kelley
authors.forename: Andrew
authors.initials: A
authors.lastname: Eggleston
authors.forename: William
authors.initials: W
authors.lastname: Molloy
mesh_terms: D000368:Aged; D000544:Alzheimer Disease; D003072:Cognition Disorders / Q000175:diagnosis*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D012720:Severity of Illness Index