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P2‐320: HOW TO DO BETTER PROGNOSTICATION IN ADVANCED DEMENTIA
Author(s) -
Wong Wai Ming
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.2018.06.1010
Subject(s) - medicine , dementia , logistic regression , residence , charlson comorbidity index , retrospective cohort study , surprise , cohort , emergency medicine , receiver operating characteristic , gerontology , family medicine , demography , disease , psychology , social psychology , sociology
Background:A disease progression model is essential to describe the disease state of degenerative diseases. We aimed to develop an Alzheimer’s disease model showing cognitive decline from asymptomatic to clinical stages using accelerated longitudinal model. Methods:All data used in the present study were obtained from the Alzheimer’s Disease Neuroimaging Initiative. We enrolled 564 patients who took amyloid PET. Four cohorts were combined in an accelerated longitudinal design: Cognitive normal (CN), Early mild cognitive impairment (EMCI), late mild cognitive impairment (LMCI) and Alzheimer’s dementia (AD). We plotted line of the change in MMSE over time. Mixed effect model for each disease cohort was used with a random effect for subject and a fixed effect for time. From the predicted values and its 95% confidence intervals for MMSE in all individuals for each cohort, overlapped intervals between two consecutive cohorts and corresponding time periods were calculated. LOWESS (Locally weighted scatter plot smoothing) was used to create a smooth line through a scatter plot. Results:Regardless of the result of amyloid PET, we calculate the time taken e from CN to AD and it took 13.99 years based on MMSE. In the amyloid PET positive group, it was found that EMCI state came 3.45years after CN state, LMCI stage came 2.09 years after EMCI, and AD state came 5.08 years after LMCI state. The MMSE decreased from 28.062.6 (mean 6SD) to 20.9 6 3.8 during the course from normal to AD, taking a total of 10.62 years. In the amyloid PET negative group, , EMCI state came 6.03 years after CN state, LMCI stage came 1.37 years after EMCI, and AD state came 11.63 years after LMCI state. the MMSE decreased from 28.861.6 (mean 6SD) to 20.9 6 3.8 during the course from normal to AD, taking a total of 19.03 years. Conclusions: This model helps patients to predict where they are currently on the disease course. In addition, it will be helpful to predict how the course of disease will vary according to the results of amyloid PETand it will be helpful to predict patient consultation and therapeutic effects.