title: Long-term cognitive and functional decline in late onset Alzheimer's disease: therapeutic implications.
abstract: BACKGROUND
  National Institute of Clinical Excellence guidelines advocate the use of the Mini-Mental Test Examination and a functional assessment as a means of measuring treatment response. However, there is little knowledge of the change expected in those with Alzheimer's disease in clinical practice.
  
  
  OBJECTIVE
  to describe the long-term variability of the Mini-Mental Test Examination and Blessed Dementia Rating Scale.
  
  
  METHODS
  374 Alzheimer's disease patients referred to psychiatric services in southeast London were followed annually over a 3-year period.
  
  
  RESULTS
  the mean Mini-Mental Test Examination score for the total group at baseline was 9.9 points. Individual variability in the rate of cognitive and functional decline is large and around 40% of patients after 1 year, and up to one-quarter of patients after 3 years who survived, show no change or an improvement in scores compared with baseline measures.
  
  
  CONCLUSIONS
  in the evaluation of individual treatment response the rate of change, as measured by the Mini-Mental Test Examination and Blessed Dementia Rating Scale, is of limited value.
authors.affiliation: University of Southampton, Clinical Neurosciences Research Division, Memory Assessment and Research Centre, Moorgreen Hospital, Botley Road, Southampton SO30 3JB, UK. ch4@soton.ac.uk
authors.forename: Clive
authors.initials: C
authors.lastname: Holmes
authors.forename: Simon
authors.initials: S
authors.lastname: Lovestone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011569:Psychiatric Status Rating Scales