A hierarchy of predictors for dementia-free survival in old-age: results of the AgeCoDe study.
Acta Psychiatr Scand
; 129(1): 63-72, 2014 Jan.
Article
em En
| MEDLINE
| ID: mdl-23521526
ABSTRACT
OBJECTIVE:
Progression from cognitive impairment (CI) to dementia is predicted by several factors, but their relative importance and interaction are unclear.METHOD:
We investigated numerous such factors in the AgeCoDe study, a longitudinal study of general practice patients aged 75+. We used recursive partitioning analysis (RPA) to identify hierarchical patterns of baseline covariates that predicted dementia-free survival.RESULTS:
Among 784 non-demented patients with CI, 157 (20.0%) developed dementia over a follow-up interval of 4.5 years. RPA showed that more severe cognitive compromise, revealed by a Mini-Mental State Examination (MMSE) score < 27.47, was the strongest predictor of imminent dementia. Dementia-free survival time was shortest (mean 2.4 years) in such low-scoring patients who also had impaired instrumental activities of daily living (iADL) and subjective memory impairment with related worry (SMI-w). Patients with identical characteristics but without SMI-w had an estimated mean dementia-free survival time of 3.8 years, which was still shorter than in patients who had subthreshold MMSE scores but intact iADL (4.2-5.2 years).CONCLUSION:
Hierarchical patterns of readily available covariates can predict dementia-free survival in older general practice patients with CI. Although less widely appreciated than other variables, iADL impairment appears to be an especially noteworthy predictor of progression to dementia.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Atividades Cotidianas
/
Demência
/
Disfunção Cognitiva
/
Sintomas Prodrômicos
Tipo de estudo:
Etiology_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Aged80
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Female
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Humans
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Male
Idioma:
En
Revista:
Acta Psychiatr Scand
Ano de publicação:
2014
Tipo de documento:
Article
País de afiliação:
Canadá