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Progression of Alzheimer's disease during a three-year follow-up using the CERAD-NB total score: Kuopio ALSOVA study

Published online by Cambridge University Press:  16 May 2013

Ilona Hallikainen ,
Tuomo Hänninen ,
Mikael Fraunberg ,
Kristiina Hongisto ,
Tarja Välimäki ,
Asta Hiltunen ,
Pertti Karppi ,
Juhani Sivenius ,
Hilkka Soininen  and
Anne M. Koivisto
Ilona Hallikainen
Affiliation:
School of Medicine, Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
Tuomo Hänninen
Affiliation:
Neurology of Neuro Center, Kuopio University Hospital, Kuopio, Finland
Mikael Fraunberg
Affiliation:
Neurosurgery of Neuro Center, Kuopio University Hospital, Kuopio, Finland
Kristiina Hongisto
Affiliation:
School of Medicine, Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
Tarja Välimäki
Affiliation:
Finnish Doctoral Program in Nursing Science, University of Eastern Finland, Kuopio, Finland Department of Nursing Science, University of Eastern Finland, Kuopio, Finland
Asta Hiltunen
Affiliation:
Department of Neurology, North Karelia Central Hospital, Joensuu, Finland
Pertti Karppi
Affiliation:
Mikkeli Central Hospital, Mikkeli, Finland
Juhani Sivenius
Affiliation:
School of Medicine, Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland Brain Research and Rehabilitation Center Neuron, Kuopio, Finland
Hilkka Soininen
Affiliation:
School of Medicine, Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland Neurology of Neuro Center, Kuopio University Hospital, Kuopio, Finland
Anne M. Koivisto*
Affiliation:
School of Medicine, Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland Neurology of Neuro Center, Kuopio University Hospital, Kuopio, Finland
*
Correspondence should be addressed to: Anne Maria Koivisto, MD, PhD, Neurology of Neuro Center, Kuopio University Hospital, P.O. Box 1777, FIN-70211 Kuopio, Finland. Phone: +358-40-738 9049, +358-44-717 5629; Fax: +358-17-172305. Email: anne.koivisto@kuh.fi.
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Abstract

Background: We studied the suitability of The Consortium to Establish a Registry for Alzheimer's Disease Neuropsychological Battery (CERAD-NB) total score for monitoring Alzheimer's disease (AD) progression in early-diagnosed medicated patients. We also investigated possible differences in progression between patients with very mild or mild baseline AD.

Methods: In this three-year follow-up of 115 ALSOVA study patients with clinical dementia ratings (CDR) of very mild (0.5) or mild (1) AD, we analyzed total CERAD-NB, Mini-Mental State Examination (MMSE), Neuropsychiatric Inventory (NPI), The Alzheimer's Disease Cooperative Study-Activities of Daily Living Inventory, and Clinical Dementia Rating Sum of Boxes scores. Correlations were identified with efficacy parameters.

Results: Over three years, total CERAD-NB declined significantly in both groups. Annual change rates of total CERAD-NB were also significant. Total CERAD-NB revealed annual differences in cognition between study groups, while MMSE did not. Total CERAD-NB correlated well with other cognitive and global measures, but not with NPI. For almost two years, the CDR-0.5 group maintained a higher activities of daily living than the CDR-1 group exhibited at baseline. Furthermore, the CDR-0.5 group showed milder neuropsychiatric symptoms at the end of follow-up than the CDR-1 group showed at baseline.

Conclusions: The CERAD total score is a suitable and sensitive follow-up tool in longitudinal AD trials. Cognition progression rates did not significantly differ between study groups; however, patients with very mild AD at baseline had milder neuropsychiatric symptoms after long-term follow-up. This emphasizes the importance of early diagnosis and assessment of neuropsychiatric symptoms at the diagnostic visit and during follow-up.

Keywords

Alzheimer's diseasedementiaCERADactivities of daily livingneuropsychiatric symptomsprogression
Type
Research Article
Information
International Psychogeriatrics , Volume 25 , Issue 8: Elder abuse an international perspective , August 2013 , pp. 1335 - 1344
Copyright
Copyright © International Psychogeriatric Association 2013 

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