title: Cognitive decline in patients with Alzheimer's disease and its related factors in a memory clinic setting, Shanghai, China.
abstract: OBJECTIVE
  Progressive cognitive decline is a characteristic hallmark of AD. It is important to identify prognostic markers to improve patient care and long-term planning. We aimed to identify the characteristics of disease progression in AD patients, focusing on cognitive decline and its related factors.
  
  
  METHODS
  Clinically diagnosed AD patients in a memory clinic were followed. The mini-mental state examination (MMSE) and a battery of other neuropsychological tests were performed to assess the rate of cognitive decline and to analyze the related factors.
  
  
  RESULTS
  A total of 165 AD patients were analyzed for cognitive changes. The MMSE scores declined at a rate of 1.52 points per year. Most neuropsychological test scores deteriorated significantly over time. Younger and early-onset AD patients deteriorated more rapidly than older and late-onset patients in global cognition and executive function. Men declined faster in memory but slower in attention than women. Higher education was associated with more rapid deterioration in visuo-spatial ability. Family history, hypertension and cerebral vascular disease were also associated with disease progression.
  
  
  CONCLUSIONS
  Attention, executive and visuo-spatial functions deteriorate at faster rates than other cognitive functions in AD patients. Age and age at onset were the main factors that associated with deterioration.
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China; Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Qianhua
authors.initials: Q
authors.lastname: Zhao
authors.affiliation: Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhou
authors.affiliation: Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Ding
authors.initials: D
authors.lastname: Ding
authors.affiliation: Department of Clinical Trial Design and Management, Translational Research Center Kyoto University Hospital, Kyoto, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Teramukai
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China; Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Qihao
authors.initials: Q
authors.lastname: Guo
authors.affiliation: Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan.
authors.forename: Masanori
authors.initials: M
authors.lastname: Fukushima
authors.affiliation: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China; Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Hong
mesh_terms: D000367:Age Factors; D017668:Age of Onset; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000503:physiopathology*; D002681:China; D003072:Cognition Disorders / Q000503:physiopathology*; D005260:Female; D006801:Humans; D006973:Hypertension / Q000503:physiopathology; D008297:Male; D008568:Memory / Q000502:physiology*; D009483:Neuropsychological Tests
references.citation: Clin Neurol Neurosurg. 2009 May;111(4):327-30
references.pmid: 19036496
references.citation: J Gerontol B Psychol Sci Soc Sci. 1999 May;54(3):P155-60
references.pmid: 10363036
references.citation: Neurology. 2009 Oct 27;73(17):1359-66
references.pmid: 19858457
references.citation: Neurology. 2003 Sep 23;61(6):812-6
references.pmid: 14504326
references.citation: Neurology. 2009 Feb 3;72(5):460-5
references.pmid: 19188578
references.citation: Int J Geriatr Psychiatry. 2010 Nov;25(11):1168-76
references.pmid: 20054836
references.citation: J Neurol. 2009 Aug;256(8):1288-95
references.pmid: 19353221
references.citation: Arch Neurol. 2001 Aug;58(8):1243-7
references.pmid: 11493164
references.citation: Neurology. 2007 Oct 23;69(17):1657-64
references.pmid: 17954781
references.citation: Arch Neurol. 2007 Dec;64(12):1749-54
references.pmid: 18071038
references.citation: Neurology. 1988 Mar;38(3):359-64
references.pmid: 3347338
references.citation: J Gerontol A Biol Sci Med Sci. 1997 Sep;52(5):M299-304
references.pmid: 9310084
references.citation: Rev Neurol. 2004 Apr 1-15;38(7):675-81
references.pmid: 15098191
references.citation: Eur J Neurol. 2007 Apr;14(4):440-6
references.pmid: 17388995
references.citation: Clin Neuropsychol. 2009 Apr;23(3):501-9
references.pmid: 18671154
references.citation: Lancet. 2013 Jun 8;381(9882):2016-23
references.pmid: 23746902
references.citation: Alzheimer Dis Assoc Disord. 1998 Dec;12(4):347-55
references.pmid: 9876964
references.citation: Neurology. 2007 Nov 6;69(19):1850-8
references.pmid: 17984453
references.citation: Psychol Res. 1994;56(4):293-300
references.pmid: 8090863
references.citation: Neurology. 2006 Oct 24;67(8):1357-62
references.pmid: 17060560
references.citation: Dement Geriatr Cogn Disord. 2010;30(3):219-28
references.pmid: 20838048
references.citation: J Clin Exp Neuropsychol. 1995 May;17(3):390-415
references.pmid: 7650102
references.citation: Arch Neurol. 1999 Jul;56(7):857-62
references.pmid: 10404988
references.citation: Lancet. 2011 Mar 19;377(9770):1019-31
references.pmid: 21371747
references.citation: Dement Geriatr Cogn Disord. 2006;22(4):367-77
references.pmid: 16954693
references.citation: Neurology. 2004 Oct 12;63(7):1198-202
references.pmid: 15477538
references.citation: Alzheimer Dis Assoc Disord. 2009 Jul-Sep;23(3):253-9
references.pmid: 19812468
references.citation: Neurology. 2005 Dec 27;65(12):1888-93
references.pmid: 16380608
references.citation: J Neurol Neurosurg Psychiatry. 2004 Jan;75(1):126-9
references.pmid: 14707321
references.citation: Arch Neurol. 2012 Jul;69(7):901-5
references.pmid: 22431834
references.citation: J Alzheimers Dis. 2010;22(2):673-82
references.pmid: 20847419
references.citation: Arch Gen Psychiatry. 2001 Sep;58(9):853-8
references.pmid: 11545668
references.citation: Lancet. 2005 Dec 17;366(9503):2112-7
references.pmid: 16360788
references.citation: Int J Geriatr Psychiatry. 2004 Sep;19(9):817-24
references.pmid: 15352138
references.citation: Arch Neurol. 2011 Sep;68(9):1124-30
references.pmid: 21911694