Fuentes, Manuel, Klostermann, Arne, Kleineidam, Luca, Bauer, Chris, Schuchhardt, Johannes, Maier, Wolfgang, Jessen, Frank, Froelich, Lutz, Wiltfang, Jens, Kornhuber, Johannes, Kloeppel, Stefan, Schieting, Vera, Teipel, Stefan J., Wagner, Michael ORCID: 0000-0003-2589-6440 and Peters, Oliver (2020). Identification of a Cascade of Changes in Activities of Daily Living Preceding Short-Term Clinical Deterioration in Mild Alzheimer's Disease Dementia via Lead-Lag Analysis. J. Alzheimers Dis., 76 (3). S. 1005 - 1016. AMSTERDAM: IOS PRESS. ISSN 1875-8908

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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. Leadlag 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 (Delta MMSE 5.8 +/- 8.64; Delta CDR-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.

Item Type: Journal Article
Creators:
CreatorsEmailORCIDORCID Put Code
Fuentes, ManuelUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Klostermann, ArneUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kleineidam, LucaUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Bauer, ChrisUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schuchhardt, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Maier, WolfgangUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Jessen, FrankUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Froelich, LutzUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wiltfang, JensUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kornhuber, JohannesUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Kloeppel, StefanUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Schieting, VeraUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Teipel, Stefan J.UNSPECIFIEDUNSPECIFIEDUNSPECIFIED
Wagner, MichaelUNSPECIFIEDorcid.org/0000-0003-2589-6440UNSPECIFIED
Peters, OliverUNSPECIFIEDUNSPECIFIEDUNSPECIFIED
URN: urn:nbn:de:hbz:38-350378
DOI: 10.3233/JAD-200230
Journal or Publication Title: J. Alzheimers Dis.
Volume: 76
Number: 3
Page Range: S. 1005 - 1016
Date: 2020
Publisher: IOS PRESS
Place of Publication: AMSTERDAM
ISSN: 1875-8908
Language: English
Faculty: Unspecified
Divisions: Unspecified
Subjects: no entry
Uncontrolled Keywords:
KeywordsLanguage
COGNITIVE IMPAIRMENT; PROGRESSION; DECLINE; PEOPLEMultiple languages
NeurosciencesMultiple languages
URI: http://kups.ub.uni-koeln.de/id/eprint/35037

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