title: Predictors of Response to Cholinesterase Inhibitors Treatment of Alzheimer's Disease: Date Mining from the TREDEM Registry.
abstract: BACKGROUND
  The pharmacological treatment of Alzheimer's disease (AD) is based largely on cholinesterase inhibitors (ChEI).
  
  
  OBJECTIVE
  To investigate whether or not some non-pharmacological and contextual factors measured prior to starting treatment such as past occupation, lifestyles, marital status, degree of autonomy and cognitive impairment, living alone or with others, and the degree of brain atrophy are associated with a better response to ChEI treatment.
  
  
  METHODS
  Eighty-four AD and six AD with cerebrovascular disease (AD + CVD) outpatients of Treviso Dementia (TREDEM) Registry, with an average cholinesterase inhibitors treatment length of four years, were considered. The outpatients had undergone a complete evaluation and some non-pharmacological and contextual factors were collected. We defined responder a patient with a delta score T0 - T1 equal or inferior to 2.0 points per year of MMSE and a non-responder a patient with a delta score T0 - T1 superior to 2.0 points per year. In order to identify hidden relationships between variables related to response and non-response, we use a special kind of artificial neural network called Auto-CM, able to create a semantic connectivity map of the variables considered in the study.
  
  
  RESULTS
  A higher cognitive profile, a previous intellectual occupation, healthier lifestyles, being married and not living alone, a higher degree of autonomy, and lower degree of brain atrophy at baseline resulted in affecting the response to long-term ChEI therapy.
  
  
  CONCLUSIONS
  Non-pharmacological and contextual factors appear to influence the effectiveness of treatment with ChEI in the long term.
authors.affiliation: Cognitive Impairment Center, Local Health Authority 9 of Treviso, Treviso, Italy.
authors.forename: Maurizio
authors.initials: M
authors.lastname: Gallucci
authors.affiliation: Cognitive Impairment Center, Local Health Authority 9 of Treviso, Treviso, Italy.
authors.forename: Pierpaolo
authors.initials: P
authors.lastname: Spagnolo
authors.affiliation: Cognitive Impairment Center, Local Health Authority 9 of Treviso, Treviso, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Aricò
authors.affiliation: Villa Santa Maria Institute, Tavernerio, Italy.|Semeion Research Centre of Sciences of Communication, Rome, Italy.
authors.forename: Enzo
authors.initials: E
authors.lastname: Grossi
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy* / Q000473:pathology; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000473:pathology; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008019:Life Style; D008297:Male; D017533:Marital Status; D008609:Mental Status Schedule; D016571:Neural Networks, Computer; D009483:Neuropsychological Tests; D009790:Occupations; D010045:Outpatients; D011379:Prognosis; D012042:Registries; D016896:Treatment Outcome
chemical_list: D002800:Cholinesterase Inhibitors
keywords: Alzheimer’s disease; Auto-CM system; TREDEM; brain and cognitive reserve; brain atrophy; cholinesterase inhibitors; environmental enrichment