title: Progression of Alzheimer's disease during a three-year follow-up using the CERAD-NB total score: Kuopio ALSOVA study.
abstract: BACKGROUND
  We studied the suitability of The Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery (CERAD-NB) total score for monitoring Alzheimer's disease (AD) progression in early-diagnosed medicated patients. We also investigated possible differences in progression between patients with very mild or mild baseline AD.
  
  
  METHODS
  In this three-year follow-up of 115 ALSOVA study patients with clinical dementia ratings (CDR) of very mild (0.5) or mild (1) AD, we analyzed total CERAD-NB, Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), The Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory, and Clinical Dementia Rating Sum of Boxes scores. Correlations were identified with efficacy parameters.
  
  
  RESULTS
  Over three years, total CERAD-NB declined significantly in both groups. Annual change rates of total CERAD-NB were also significant. Total CERAD-NB revealed annual differences in cognition between study groups, while MMSE did not. Total CERAD-NB correlated well with other cognitive and global measures, but not with NPI. For almost two years, the CDR-0.5 group maintained a higher activities of daily living than the CDR-1 group exhibited at baseline. Furthermore, the CDR-0.5 group showed milder neuropsychiatric symptoms at the end of follow-up than the CDR-1 group showed at baseline.
  
  
  CONCLUSIONS
  The CERAD total score is a suitable and sensitive follow-up tool in longitudinal AD trials. Cognition progression rates did not significantly differ between study groups; however, patients with very mild AD at baseline had milder neuropsychiatric symptoms after long-term follow-up. This emphasizes the importance of early diagnosis and assessment of neuropsychiatric symptoms at the diagnostic visit and during follow-up.
authors.affiliation: School of Medicine, Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland.
authors.forename: Ilona
authors.initials: I
authors.lastname: Hallikainen
authors.forename: Tuomo
authors.initials: T
authors.lastname: Hänninen
authors.forename: Mikael
authors.initials: M
authors.lastname: Fraunberg
authors.forename: Kristiina
authors.initials: K
authors.lastname: Hongisto
authors.forename: Tarja
authors.initials: T
authors.lastname: Välimäki
authors.forename: Asta
authors.initials: A
authors.lastname: Hiltunen
authors.forename: Pertti
authors.initials: P
authors.lastname: Karppi
authors.forename: Juhani
authors.initials: J
authors.lastname: Sivenius
authors.forename: Hilkka
authors.initials: H
authors.lastname: Soininen
authors.forename: Anne M
authors.initials: AM
authors.lastname: Koivisto
mesh_terms: D000203:Activities of Daily Living; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000175:diagnosis* / Q000523:psychology; D003071:Cognition; D003704:Dementia / Q000175:diagnosis* / Q000523:psychology; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires