title: Predictors of patient dependence in mild-to-moderate Alzheimer's disease.
abstract: BACKGROUND
  Patient dependence has rarely been studied in mild-to-moderate Alzheimer's disease (AD).
  
  
  OBJECTIVE
  To identify factors which predict patient dependence in mild-to-moderate AD.
  
  
  METHODS
  We studied 398 non-institutionalized AD patients (234 females) of the ongoing Prospective Registry on Dementia (PRODEM) in Austria. The Dependence Scale (DS) was used to assess patient dependence. Patient assessment comprised functional abilities, neuropsychiatric symptoms and cognitive functions. A multiple linear regression analysis was performed to identify predictors of patient dependence.
  
  
  RESULTS
  AD patients were mildly-to-moderately impaired (mean scores and SDs were: CDR 0.84 ± 0.43; DAD 74.4 ± 23.3, MMSE = 22.5 ± 3.6). Psychopathology and caregiver burden were in the low range (mean NPI score 13.2, range 0 to 98; mean ZBI score 18, range 0-64). Seventy five percent of patients were classified as having a mild level of patient dependence (DS sum score 0 to 6). Patient dependence correlated significantly and positively with age, functional measures, psychopathology and depression, disease duration, and caregiver burden. Significant negative, but low correlations were found between patient dependence, cognitive variables, and global cognition. Activities of daily living, patient age, and disease severity accounted for 63% of variance in patient dependence, whereas cognitive variables accounted for only 11%.
  
  
  CONCLUSIONS
  Dependence in this cohort was mainly related to age and functional impairment, and less so to cognitive and neuropsychiatric variables. This differs from studies investigating patients in more advanced disease stages which found abnormal behavior and impairments of cognition as main predictors of patient dependence.
authors.affiliation: Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Thomas
authors.initials: T
authors.lastname: Benke
authors.affiliation: Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria.
authors.forename: Günter
authors.initials: G
authors.lastname: Sanin
authors.affiliation: Department of Neurology, Medical University of Graz, Graz, Austria.
authors.forename: Anita
authors.initials: A
authors.lastname: Lechner
authors.affiliation: Department of Neurology, Medical University of Vienna, Vienna, Austria.
authors.forename: Peter
authors.initials: P
authors.lastname: Dal-Bianco
authors.affiliation: Department of Neurology and Psychiatry, General Hospital Linz, Linz, Austria.
authors.forename: Gerhard
authors.initials: G
authors.lastname: Ransmayr
authors.affiliation: Landesnervenklinik Sigmund Freud Graz, Graz, Austria.
authors.forename: Margarete
authors.initials: M
authors.lastname: Uranüs
authors.affiliation: Department of Psychiatry and Psychotherapy, Regional Hospital Hall in Tirol, Hall in Tirol, Austria.
authors.forename: Josef
authors.initials: J
authors.lastname: Marksteiner
authors.affiliation: Janssen Alzheimer Immunotherapy, Health Economics & Market Access, Dublin, Ireland.
authors.forename: Maren
authors.initials: M
authors.lastname: Gaudig
authors.affiliation: Department of Neurology, Medical University of Graz, Graz, Austria.
authors.forename: Reinhold
authors.initials: R
authors.lastname: Schmidt
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications* / Q000523:psychology*; D001317:Austria; D017028:Caregivers / Q000523:psychology; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D015331:Cohort Studies; D003858:Dependency, Psychological; D006233:Persons with Disabilities; D005260:Female; D006801:Humans; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011237:Predictive Value of Tests; D011569:Psychiatric Status Rating Scales; D012042:Registries
keywords: Alzheimer's disease; patient dependence