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Cited by 64Dementia and Cognitive Impairment ResearchAlzheimer's disease research and treatmentsCholinesterase and Neurodegenerative Diseases

Long-term progression of Alzheimer's disease in patients under antidementia drugs

Gillette‐Guyonnet, Sophie, Andrieu, Sandrine, Nourhashemi, Fati, Gardette, Virginie, Coley, Nicola, Cantet, Christelle, Gauthier, Serge, Ousset, Pierre‐Jean +2 more·2011·Alzheimer's & Dementia
DOI 10.1016/j.jalz.2011.02.009
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Abstract

BACKGROUND: Patients with Alzheimer's disease (AD), even in the presence of symptomatic relief from medical intervention, face a persistent worsening of cognitive decline and performance in activities of daily living. Data regarding the long-term disease progression outside of therapeutic trials are lacking. We examined the effects of standard of care for AD patients on the prognosis of the disease in a real-life study over a 4-year period. METHODS: A total of 686 patients with mild-moderate AD were enrolled in 16 memory clinics (REseau sur la maladie d' Alzheimer FRançais [REAL.FR] cohort) and followed up twice annually with tools used in therapeutic trials (Mini-Mental Status Examination, Alzheimer Disease Assessment Scale-cognitive subscale [ADAS-cog]: cognitive function, Clinical Dementia Rating: dementia severity, Activity of Daily Living [ADL]: incapacities, NeuroPsychiatric Inventory: neuropsychiatric symptom). RESULTS: More than 90% of the patients used AD-specific medication over 4 years. Patients lost on average 2.4 points per year on the Mini-Mental Status Examination and gained 4.5 points on the ADAS-cog. ADL and NeuroPsychiatric Inventory scores became significantly worse over time. Incidence of incapacities for ADL and worsening of neuropsychiatric symptoms were 52.5 (95% confidence interval [CI]: 47.7-57.4) and 51.1 (95% CI: 46.2-56.1), respectively. Rates of mortality and institutionalization were 7.4 (95% CI: 6.2-8.5) and 13.4 (95% CI: 11.7-15.1). In all, 17% of patients in mild stage at baseline (Clinical Dementia Rating = 0.5) did not experience a major event (functional disabilities, neuropsychiatric symptoms, or death) over a 4-year period. CONCLUSIONS: As compared with previous surveys, the current study shows slower rates of decline in AD patients. The present data also underline the high level of variability of disease progression among AD patients. Outcome measures commonly used in clinical trials will need to take into account the recent changes in the prognosis of the disease.

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Crossref · 10.1016/j.jalz.2011.02.009

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  • Longer-term prospective observational clinical patient cohort studies report reduced clinical decline in patients with AD treated at any stage.

    “Longer-term prospective observational clinical patient cohort studies report reduced clinical decline in patients with AD treated at any stage.[114][115][116][117][118][119]”

    From The Alzheimer’s Disease Clinical Spectrum (2019) · cites this paper as [118]

  • Short-term randomized controlled trials, longer-term open-label extensions, and long-term observational prospective clinical cohort effectiveness studies support the safety and benefits of anti-AD treatments in combination, most frequently as memantine added on to a stable regimen of background cholinesterase inhibitor treatment.

    “Short-term (6-12 months) RCTs (level I evidence), longer-term (12-36 months) openlabel extensions of RCTs (level II or III evidence), and long-term (2 to 5-plus years) observational prospective clinical cohort effectiveness studies (level II evidence) support the safety and benefits of anti-AD treatments in combination, most frequently as memantine added on to a stable regimen of background ChEI”

    From The Alzheimer’s Disease Clinical Spectrum (2019) · cites this paper as [118]

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Authors
Gillette‐Guyonnet, S., Andrieu, S., Nourhashemi, F., Gardette, V., Coley, N., Cantet, C., Gauthier, S., Ousset, P., Vellas, B., & REAL.FR study group
Affiliations
  • Department of Internal Medicine and Geriatrics Purpan University Hospital Gerontopole Toulouse University Hospital Toulouse France
  • Université Toulouse III - Paul Sabatier (FR)
  • Douglas Mental Health University Institute (CA)
ORCID
Venue
Alzheimer's & Dementia
Publisher
Wiley
Published
2011-11
Volume
7
Issue
6
Pages
579-592
ISSN
  • 1552-5260 (ISSN-L)
  • 1552-5279
DOI
10.1016/j.jalz.2011.02.009
OpenAlex
W2055645281
Cited by
64
References
42
Citations by year
2025: 6 · 2023: 2 · 2022: 4 · 2021: 4 · 2020: 5 · 2019: 6 · 2018: 3 · 2017: 2 · 2016: 7 · 2015: 10 · 2014: 6 · 2013: 8 · 2012: 1
FWCI
3.28
Type
journal article
Language
en
Open access
closed
Licence
onlinelibrary.wiley.com/termsAndConditions#vor (vor)
Locations
  • Alzheimer s & Dementia (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • French Ministry of Health (PHRC 98-47 N, PHRC 18-05)
  • University Hospital Centre of Toulouse
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
  • Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
  • Health Sciences › Medicine › Pharmacology › Cholinesterase and Neurodegenerative Diseases
Keywords
Alzheimer's disease, disease progression
MeSH terms
Activities of Daily Living, Aged, Alzheimer Disease, Female, Follow-Up Studies, Humans, Male, Neuropsychological Tests, Cohort Studies, Disease Progression, Nootropic Agents

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