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@ARTICLE{FuentesCasan:153342,
      author       = {Fuentes Casan, Manuel and Klostermann, Arne and Kleineidam,
                      Luca and Bauer, Chris and Schuchhardt, Johannes and Maier,
                      Wolfgang and Jessen, Frank and Frölich, Lutz and Wiltfang,
                      Jens and Kornhuber, Johannes and Klöppel, Stefan and
                      Schieting, Vera and Teipel, Stefan J. and Wagner, Michael
                      and Peters, Oliver},
      title        = {{I}dentification of a {C}ascade of {C}hanges in
                      {A}ctivities of {D}aily {L}iving {P}receding {S}hort-{T}erm
                      {C}linical {D}eterioration in {M}ild {A}lzheimer’s
                      {D}isease {D}ementia via {L}ead-{L}ag {A}nalysis},
      journal      = {Journal of Alzheimer's disease},
      volume       = {76},
      number       = {3},
      issn         = {1875-8908},
      address      = {Amsterdam},
      publisher    = {IOS Press},
      reportid     = {DZNE-2020-01339},
      pages        = {1005 - 1015},
      year         = {2020},
      abstract     = {Background: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.},
      keywords     = {Activities of Daily Living: psychology / Aged / Alzheimer
                      Disease: psychology / Clinical Deterioration / Cognition:
                      physiology / Disease Progression / Female / Humans / Male /
                      Neuropsychological Tests / Time Factors},
      cin          = {AG Endres / AG Wiltfang / U Clinical Researchers - Bonn /
                      AG Teipel / AG Wagner},
      ddc          = {610},
      cid          = {I:(DE-2719)1811005 / I:(DE-2719)1410006 /
                      I:(DE-2719)7000001 / I:(DE-2719)1510100 /
                      I:(DE-2719)1011201},
      pnm          = {342 - Disease Mechanisms and Model Systems (POF3-342) / 344
                      - Clinical and Health Care Research (POF3-344)},
      pid          = {G:(DE-HGF)POF3-342 / G:(DE-HGF)POF3-344},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:32597807},
      pmc          = {pmc:PMC7504993},
      doi          = {10.3233/JAD-200230},
      url          = {https://pub.dzne.de/record/153342},
}