摘要
背景:阿尔茨海默病(AD)患者对胆碱酯酶抑制剂(CHI)治疗的反应不同,个体特异性反应是否直接影响到疗养院安置时间(NHP)。 目的:探讨6个月对CHI的反应与住院治疗的关系。 方法:采用前瞻性、观察性、多中心研究的方法,对881例门诊患者在CHI治疗开始时(基线)进行临床诊断和简易精神状态评分(10-26分),采用认知、整体和日常生活活动能力量表(ADL)进行评定,每半年一次,记录进NHP的日期。 结果:在本研究中,213例(24%)患者入院,从基线(AD诊断)到NHP的平均±标准差时间(AD)为20.8±9.3个月,经过6个月的CHI治疗后,改善或未改变的患者对NHP的治疗时间比恶化的患者长,认知反应延长3个月(p=0.022),整体反应延长4个月(p=0.004),基础不良反应6个月。3个量表均有反应(p<0.001)和8个月(p<0.001),改善组与未变化组在任何量表上均无显着性差异(P>0.05)。 结论:对CHI有阳性短期反应的患者可期望在家中待3~8个月,这些发现强调了综合临床检查的重要性,包括各种评估量表,以评估治疗效果并提供更准确的预后。
关键词: 阿尔茨海默病,胆碱酯酶抑制剂,治疗效果,日常生活能力,认知,养老院安置,预测因子,统计模型。
Current Alzheimer Research
Title:Short-Term Response to Cholinesterase Inhibitors in Alzheimer’s Disease Delays Time to Nursing Home Placement
Volume: 15 Issue: 10
关键词: 阿尔茨海默病,胆碱酯酶抑制剂,治疗效果,日常生活能力,认知,养老院安置,预测因子,统计模型。
摘要: Background: A varying response to cholinesterase inhibitor (ChEI) treatment has been reported among patients with Alzheimer’s disease (AD). Whether the individual-specific response directly affects time to nursing home placement (NHP) was not investigated.
Objective: We examined the relationship between the 6-month response to ChEI and institutionalization.
Methods: In a prospective, observational, multicenter study, 881 outpatients with a clinical AD diagnosis and a Mini-Mental State Examination score of 10-26 at the start of ChEI therapy (baseline) were included. The participants were evaluated using cognitive, global, and activities of daily living (ADL) scales at baseline and semiannually over 3 years. The date of NHP was recorded.
Results: During the study, 213 patients (24%) were admitted to nursing homes. The mean ± standard deviation time from baseline (AD diagnosis) to NHP was 20.8 ± 9.3 months. After 6 months of ChEI treatment, the improved/unchanged individuals had longer time to NHP than those who worsened. The prolonged time to NHP was 3 months for cognitive response (P=0.022), 4 months for global response (P=0.004), 6 months for basic ADL response (P<0.001), and 8 months for response in all three scales (P<0.001). No differences were detected between the improved and unchanged groups in any scales.
Conclusion: Patients who exhibit a positive short-term response to ChEI can expect to stay in their own home for 3-8 months longer. These findings underline the importance of a comprehensive clinical examination including various assessment scales to evaluate treatment response and provide a more accurate prognosis.
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Cite this article as:
Short-Term Response to Cholinesterase Inhibitors in Alzheimer’s Disease Delays Time to Nursing Home Placement, Current Alzheimer Research 2018; 15 (10) . https://dx.doi.org/10.2174/1567205015666180507105326
DOI https://dx.doi.org/10.2174/1567205015666180507105326 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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Neuroinflammation is an invariable hallmark of chronic and acute neurodegenerative disorders and has long been considered a potential drug target for Alzheimer?s disease (AD) and dementia. Significant evidence of inflammatory processes as a feature of AD is provided by the presence of inflammatory markers in plasma, CSF and postmortem brain ...read more
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