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000153342 0247_ $$2doi$$a10.3233/JAD-200230
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000153342 037__ $$aDZNE-2020-01339
000153342 041__ $$aEnglish
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000153342 1001_ $$0P:(DE-2719)2812289$$aFuentes Casan, Manuel$$b0$$eFirst author$$udzne
000153342 245__ $$aIdentification of a Cascade of Changes in Activities of Daily Living Preceding Short-Term Clinical Deterioration in Mild Alzheimer’s Disease Dementia via Lead-Lag Analysis
000153342 260__ $$aAmsterdam$$bIOS Press$$c2020
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000153342 520__ $$aBackground:Cognitive functions and activities of daily living (ADL) become increasingly impaired with progressing Alzheimer’s disease. However, the temporal dynamics of this decline are inconsistent.Objective:To gain insight into the classical temporal cascade of specific cognitive and ADL changes, which may aid in improving detection of an impending clinical deterioration in patients, and to select ADL items and tests most sensitive to change in a specific disease stage.Methods:Patients with mild Alzheimer’s dementia (AD; MMSE = 23.9±2.88) were followed at 12 and 24 months. Lead-lag analysis of changes in cognitive and functional outcome measures (CDR-SOB, 12 neuropsychological subtest scores from the CERAD + test battery, 25 Bayer-ADL items) was applied to rank the temporal sequence of changes on an ordinal scale.Results:Of 164 patients with mild AD, moderate disease progression was identified in 84 patients over 24 months (ΔMMSE 5.8±8.64; ΔCDR-SOB 4.32±4.03). Ten Bayer-ADL item measures were altered early in moderate progressors and included in a new ADL composite score. Accordingly, the new ADL score surpassed all neuropsychological measures in repeated lead-lag analysis. The Bayer-ADL total score, TMT-A, and MMSE were lagging variables in all lead-lag analyses.Conclusion:Short-term clinical deterioration in mild AD is initially preceded by changes (i.e., decline) in a well-defined set of ADL and not in classical cognitive measures.
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000153342 650_2 $$2MeSH$$aActivities of Daily Living: psychology
000153342 650_2 $$2MeSH$$aAged
000153342 650_2 $$2MeSH$$aAlzheimer Disease: psychology
000153342 650_2 $$2MeSH$$aClinical Deterioration
000153342 650_2 $$2MeSH$$aCognition: physiology
000153342 650_2 $$2MeSH$$aDisease Progression
000153342 650_2 $$2MeSH$$aFemale
000153342 650_2 $$2MeSH$$aHumans
000153342 650_2 $$2MeSH$$aMale
000153342 650_2 $$2MeSH$$aNeuropsychological Tests
000153342 650_2 $$2MeSH$$aTime Factors
000153342 7001_ $$aKlostermann, Arne$$b1
000153342 7001_ $$0P:(DE-2719)2812139$$aKleineidam, Luca$$b2$$udzne
000153342 7001_ $$aBauer, Chris$$b3
000153342 7001_ $$aSchuchhardt, Johannes$$b4
000153342 7001_ $$0P:(DE-HGF)0$$aMaier, Wolfgang$$b5
000153342 7001_ $$0P:(DE-HGF)0$$aJessen, Frank$$b6
000153342 7001_ $$0P:(DE-HGF)0$$aFrölich, Lutz$$b7
000153342 7001_ $$0P:(DE-2719)2811317$$aWiltfang, Jens$$b8$$udzne
000153342 7001_ $$aKornhuber, Johannes$$b9
000153342 7001_ $$aKlöppel, Stefan$$b10
000153342 7001_ $$aSchieting, Vera$$b11
000153342 7001_ $$0P:(DE-2719)2000026$$aTeipel, Stefan J.$$b12$$udzne
000153342 7001_ $$0P:(DE-2719)2000057$$aWagner, Michael$$b13$$udzne
000153342 7001_ $$0P:(DE-2719)2811024$$aPeters, Oliver$$b14$$eLast author$$udzne
000153342 773__ $$0PERI:(DE-600)2070772-1$$a10.3233/JAD-200230$$gVol. 76, no. 3, p. 1005 - 1015$$n3$$p1005 - 1015$$tJournal of Alzheimer's disease$$v76$$x1875-8908$$y2020
000153342 8564_ $$uhttps://content.iospress.com/articles/journal-of-alzheimers-disease/jad200230
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