[Factors associated with the moderately severe stage of Alzheimer's disease: first results of the REAL.FR study].
OBJECTIVE
Most studies of Alzheimer's disease deal with the mild to moderate stages of the disease. However the great majority of cases evolve toward a stage of marked severity which can last many years. The few studies of severe dementia that have been carried out have included institutionalized patients. The aim of this study is to describe associated factors with a moderately severe Alzheimer's disease in a French community dwelling patients.


METHODS
Initial data from a French cohort Study of Alzheimer's patients (REAL.FR: Réseau sur la maladie d'Alzheimer français) were analysed. These included sociodemographic and medical factors and measures of cognitive and non cognitive performance. We compared two groups according the stage of the disease: moderately severe patients (Mini Mental Status score < 15) and mild to moderate patients (Mini Mental Status score > or = 15).


RESULTS
Moderately severe stage of disease was independently related to age (OR: 0.35; 95% CI: 0.16-0.78 for patient aged between 75-80 years compared to patient < or = 75 years), low educational level (non-obtention of french certificate of primary education, OR: 2.43; IC à 95%: 1.28-4.59) and disability to perform activities of daily living (OR: 3.35; 95% CI: 1.62-6.93). After multivariate analysis, there was no difference between the 2 groups for the other factors like behavioral symptoms.


CONCLUSIONS
Severe dementia represents major medical and socio-economical problem. Better knowledge of the natural history of the severe stage of the disease is necessary for better clinical practice.
Nourhashémi
F
F
Service de médecine interne et de gérontologie clinique, CHU Purpan-Casselardit, Unité Inserm 558, faculté de médecine, Toulouse, France. Fatinour@aol.com
Andrieu
S
S
Saffon
N
N
Cantet
C
C
Balardy
L
L
Vellas
B
B
D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis*; D005260:Female; D006801:Humans; D008297:Male; D008609:Mental Status Schedule; D008875:Middle Aged; D011446:Prospective Studies; D012720:Severity of Illness Index