摘要
目的:比较记忆中心特异性随访下阿尔茨海默症患者4年生存者与制度化常规护理患者认知和功能减退。 设计:4年纵向随访。设备:法国阿尔茨海默症网络记忆中心(REAL-FR研究)与法国基于人口的研究(3C研究)。 参与者:728例65岁以上,在家中生活,符合阿尔茨海默症的标准,认知功能精神状态简易速检表得分在10到26的患者。 测量:Cox比例风险模型被用来检测记忆中心的特异性随访(REAL-FR 研究)和制度化常规护理4年生存者(3C研究)的有效性。用线性混合模型来评价两组的认知和功能减退。 结果:在调整混淆变量后,记忆中心随访的4年生存者与常规护理的4年生存者无显著差别(常规护理:调整风险率(HRa)=0.87,95%置信区间(CI)0.53-1.43,p=0.59)。在记忆中心的特异性随访患者有更高的被制度化的风险(常规护理:HRa=0.24,95%CI 0.12-0.48,p<0.001)。随着时间流逝,它们也表现出显著的认知和功能减退。 结论:我们的研究没有发现记忆中心特异性随访在阿尔茨海默症自然史上的临床意义结果有任何有益帮助。在记忆中心护理会造成痴呆进程加快并成为阿尔茨海默症是一个更大的负担,这都会导致各种的有害预测结果。
关键词: 阿尔茨海默症,护理管理,记忆中心,常规护理,比较
Current Alzheimer Research
Title:Effectiveness of a Standardized and Specific Follow-Up in Memory Centers in Patients with Alzheimer’s Disease
Volume: 14 Issue: 3
Author(s): Laure Rouch, Philippe Cestac, Charlene Cool, Catherine Helmer, Jean-Francois Dartigues, Claudine Berr, Olivier Rouaud and Bruno Vellas, Sandrine Andrieu, the REAL-FR Study Group and the 3C Study Group.
Affiliation:
关键词: 阿尔茨海默症,护理管理,记忆中心,常规护理,比较
摘要: Objectives: To compare the 4-year survival, institutionalization, cognitive and functional decline of Alzheimer’s patients with specific follow-up in memory centers versus usual care.
Design: Four year longitudinal follow-up. Settings: The French Network of memory centers in Alzheimer’s disease (REAL-FR study) and The French population-based study (3C study). Participants: 728 patients aged ≥ 65, living at home, meeting criteria for probable Alzheimer’s disease and having Mini Mental State Examination (MMSE) scores between 10 and 26 at baseline were included. Measurements: Cox proportional hazards models were performed to test the effectiveness of a specific follow-up in memory centers (REAL-FR study) versus usual care (3C study) on the 4-year survival and institutionalization. Linear mixed models were used to assess cognitive and functional decline in both groups. Results: After adjustment for confounding factors, the 4-year survival did not differ significantly between patients followed-up in memory centers and those who had recourse to usual care (usual care: Hazard Ratio adjusted (HRa) = 0.87, 95% confidence interval (CI) 0.53-1.43, p=0.59). Patients with a specific follow-up in memory centers had a higher risk of being institutionalized (usual care: HRa = 0.24, 95% CI 0.12-0.48, p<0.001). They also exhibited a significant greater cognitive and functional decline over time. Conclusion: Our findings failed to demonstrate any potential benefits of a specific follow-up in memory centers on clinically meaningful outcomes in the natural history of Alzheimer’s disease. Recourse to care in memory centers may have been the consequence of a faster dementia progression and a greater burden of Alzheimer’s disease, all leading to detrimental consequences on various prognostic outcomes.Export Options
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Laure Rouch, Philippe Cestac, Charlene Cool, Catherine Helmer, Jean-Francois Dartigues, Claudine Berr, Olivier Rouaud and Bruno Vellas, Sandrine Andrieu, the REAL-FR Study Group and the 3C Study Group. , Effectiveness of a Standardized and Specific Follow-Up in Memory Centers in Patients with Alzheimer’s Disease, Current Alzheimer Research 2017; 14 (3) . https://dx.doi.org/10.2174/1567205013666161108114850
DOI https://dx.doi.org/10.2174/1567205013666161108114850 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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