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P1‐013: INCIDENCE OF ALZHEIMER'S DISEASE IN HISPANICS: ROLE OF APOLIPOPROTEIN E GENOTYPES AND AMBULATORY BLOOD PRESSURE MONITORING
Author(s) -
Melgarejo Jesus D.,
Aguirre-Acevedo Daniel C.,
Mena Luis Javier,
Zhezhen Jin,
Chavez Carlos A.,
Pirela Rosa V.,
Gaona Ciro,
De Eurasquin Gabriel,
Terwilliger Joe,
Lee Joseph H.,
Maestre Gladys E.
Publication year - 2018
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2018.06.014
Subject(s) - medicine , dementia , blood pressure , cohort , confounding , ambulatory blood pressure , proportional hazards model , apolipoprotein e , ambulatory , pulse pressure , gerontology , cohort study , disease , cardiology , demography , sociology
gender, education, chronic disease count, social network index, anticholinergic cognitive burden (ACB) score, Apoε4 status and antipsychotic drug use. Results: The best fitting model contained two classes; class 1 was the largest (N1⁄4389, 76%) and showed the slowest progression on both MMSE and ADL (figures 1 and 2; blue curves). Individuals in class 2 (N1⁄4123, 24%) demonstrated more rapid worsening on both outcomes (red curves), often followed by death within 5 years after dementia diagnosis (N1⁄494). Significant predictors of membership in the rapidly declining class 2, relative to class 1, were higher ACB score (OR1⁄41.35, 95%-CI: 1.01-1.81) and higher age (OR1⁄41.10, 95%-CI: 1.00-1.20). Conclusions: Our study shows that most individuals were members of a class with relatively slow disease progression. This presents a more optimistic prospect for the majority of patients as compared to the mean progression rate of the entire sample. This is important for informing newly diagnosed dementia patients and their caregivers about the course of the disease. The observed relationship between ACB and rapid decline in cognition and functioning urges caution in prescribing anticholinergic drugs and polypharmacy for individuals with dementia. This is especially relevant given that most antipsychotics used in dementia have a high ACB score.