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Vascular risk as a predictor of cognitive decline in a cohort of elderly patients with mild to moderate dementia.

Curiati PK, Magaldi RM, Suemoto CK, Bottino CM, Nitrini R, Farfel JM, Jacob-Filho W - Dement Geriatr Cogn Dis Extra (2014)

Bottom Line: The association between baseline clinical variables and cognitive and functional decline was investigated during 3 years of follow-up through the use of generalized linear mixed effects models.A trend was found towards steeper cognitive decline in patients with less vascular burden according to the HIS (β = 0.056, p = 0.09), better cognitive performance according to the CDR score (β = 0.313, p = 0.06) and worse caregiver burden according to the Burden Interview Scale score (β = -0.012, p = 0.07) at baseline.Further studies with larger samples are necessary to confirm and expand our findings.

View Article: PubMed Central - PubMed

Affiliation: Discipline of Geriatrics, Department of Internal Medicine, Clinical Hospital, São Paulo, Brazil.

ABSTRACT

Background/aims: The purpose of our study was to evaluate vascular risk factors and other clinical variables as predictors of cognitive and functional decline in elderly patients with mild to moderate dementia.

Methods: The clinical characteristics of 82 elderly patients (mean age 79.0 ± 5.9 years; 67.1% females) with mild to moderate dementia were obtained at baseline, including years of education, Framingham Coronary Heart Disease Risk score, Hachinski Ischemic Score (HIS), Clinical Dementia Rating (CDR), Mini-Mental State Examination (MMSE) score, Functional Activities Questionnaire (FAQ) score, Burden Interview Scale score, and Neuropsychiatric Inventory (NPI) score. Changes in MMSE and FAQ scores over time were assessed annually. The association between baseline clinical variables and cognitive and functional decline was investigated during 3 years of follow-up through the use of generalized linear mixed effects models.

Results: A trend was found towards steeper cognitive decline in patients with less vascular burden according to the HIS (β = 0.056, p = 0.09), better cognitive performance according to the CDR score (β = 0.313, p = 0.06) and worse caregiver burden according to the Burden Interview Scale score (β = -0.012, p = 0.07) at baseline.

Conclusion: Further studies with larger samples are necessary to confirm and expand our findings.

No MeSH data available.


Related in: MedlinePlus

Flow chart of study participants.
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Figure 1: Flow chart of study participants.

Mentions: Enrollment information is summarized in figure 1. From January 1, 2005, to December 31, 2010, 296 subjects were referred to CEREDIC for cognitive evaluation. Among them, 150 did not fulfill the inclusion criteria: 101 were diagnosed with conditions other than dementia; 1 had severe dementia; 19 were <60 years; and 25 did not have appropriate medical records of all relevant data regarding the initial evaluation and follow-up (a few patients did not fulfill more than one inclusion criteria). Of the 146 remaining subjects, 64 met the exclusion criteria: 17 had a history of alcohol abuse; 13 had a history of traumatic brain injury; 12 had vitamin B12 or folic acid deficiency; 9 were lost to follow-up before the first annual reassessment; 7 had epilepsy; 5 had an intracranial tumor; 1 had neurocysticercosis; 1 had psychosis; and 1 had cognitive adverse effects of an anticholinergic drug during the first evaluation (a few patients fulfilled more than one exclusion criteria). Finally, a sample of 82 subjects was followed for a mean of 3.2 ± 1.8 years. Fifty-nine subjects completed 3 years of follow-up, whereas 7 died, 12 were lost to follow-up, and 4 were referred to ambulatory care specialized in advanced cognitive impairment between the first and the third annual reassessments.


Vascular risk as a predictor of cognitive decline in a cohort of elderly patients with mild to moderate dementia.

Curiati PK, Magaldi RM, Suemoto CK, Bottino CM, Nitrini R, Farfel JM, Jacob-Filho W - Dement Geriatr Cogn Dis Extra (2014)

Flow chart of study participants.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4255991&req=5

Figure 1: Flow chart of study participants.
Mentions: Enrollment information is summarized in figure 1. From January 1, 2005, to December 31, 2010, 296 subjects were referred to CEREDIC for cognitive evaluation. Among them, 150 did not fulfill the inclusion criteria: 101 were diagnosed with conditions other than dementia; 1 had severe dementia; 19 were <60 years; and 25 did not have appropriate medical records of all relevant data regarding the initial evaluation and follow-up (a few patients did not fulfill more than one inclusion criteria). Of the 146 remaining subjects, 64 met the exclusion criteria: 17 had a history of alcohol abuse; 13 had a history of traumatic brain injury; 12 had vitamin B12 or folic acid deficiency; 9 were lost to follow-up before the first annual reassessment; 7 had epilepsy; 5 had an intracranial tumor; 1 had neurocysticercosis; 1 had psychosis; and 1 had cognitive adverse effects of an anticholinergic drug during the first evaluation (a few patients fulfilled more than one exclusion criteria). Finally, a sample of 82 subjects was followed for a mean of 3.2 ± 1.8 years. Fifty-nine subjects completed 3 years of follow-up, whereas 7 died, 12 were lost to follow-up, and 4 were referred to ambulatory care specialized in advanced cognitive impairment between the first and the third annual reassessments.

Bottom Line: The association between baseline clinical variables and cognitive and functional decline was investigated during 3 years of follow-up through the use of generalized linear mixed effects models.A trend was found towards steeper cognitive decline in patients with less vascular burden according to the HIS (β = 0.056, p = 0.09), better cognitive performance according to the CDR score (β = 0.313, p = 0.06) and worse caregiver burden according to the Burden Interview Scale score (β = -0.012, p = 0.07) at baseline.Further studies with larger samples are necessary to confirm and expand our findings.

View Article: PubMed Central - PubMed

Affiliation: Discipline of Geriatrics, Department of Internal Medicine, Clinical Hospital, São Paulo, Brazil.

ABSTRACT

Background/aims: The purpose of our study was to evaluate vascular risk factors and other clinical variables as predictors of cognitive and functional decline in elderly patients with mild to moderate dementia.

Methods: The clinical characteristics of 82 elderly patients (mean age 79.0 ± 5.9 years; 67.1% females) with mild to moderate dementia were obtained at baseline, including years of education, Framingham Coronary Heart Disease Risk score, Hachinski Ischemic Score (HIS), Clinical Dementia Rating (CDR), Mini-Mental State Examination (MMSE) score, Functional Activities Questionnaire (FAQ) score, Burden Interview Scale score, and Neuropsychiatric Inventory (NPI) score. Changes in MMSE and FAQ scores over time were assessed annually. The association between baseline clinical variables and cognitive and functional decline was investigated during 3 years of follow-up through the use of generalized linear mixed effects models.

Results: A trend was found towards steeper cognitive decline in patients with less vascular burden according to the HIS (β = 0.056, p = 0.09), better cognitive performance according to the CDR score (β = 0.313, p = 0.06) and worse caregiver burden according to the Burden Interview Scale score (β = -0.012, p = 0.07) at baseline.

Conclusion: Further studies with larger samples are necessary to confirm and expand our findings.

No MeSH data available.


Related in: MedlinePlus