Progression of Alzheimer disease in Europe: data from the European ICTUS study
Open accessAbstract
The clinical progression of Alzheimer disease (AD) was studied in European subjects under treatment with AChE inhibitors (AChE-I) in relation to geographical location over a 2-years period. One thousand three hundred and six subjects from 11 European countries were clustered into 3 regions (North, South, West) and investigated with biannual follow-up over 2 years. Primary outcomes were cognitive, functional and behavioral measures. Caregiver burden, hospital admission and admission to nursing home were also recorded. Participant cognitive function declined non-linearly over time (MMSE: -1.5 pts/first year, -2.5 pts/second year; ADAScog: + 3.5 pts/first year, + 4.8 pts/second year), while the progression of behavioral disturbances (NPI scale) was linear. Neither scale showed regional differences, and progression of the disease was similar across Europe despite different health care systems. Functional decline (ADL, IADL) tended to progress more rapidly in Southern Europe (p=0.09), while progression of caregiver burden (Zarit Burden Interview) was most rapid in Northern Europe (5.6 pts/y, p=0.04). Incidences of hospital admission (10.44, 95%CI: 8.13-12.75, p < 0.001) and admission to nursing home (2.97, 95%CI: 1.83-4.11, p < 0.001) were lowest in Southern Europe. In general cognitive and functional decline was slower than in former cohorts. European geographical location reflecting differences in culture and in health care system does not impact on the progression of AD but does influence the management of AD subjects and caregiver burden.
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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 [119]
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 [119]
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- Authors
- Vellas, B., Hausner, L., Frolich, L., Cantet, C., Gardette, V., Reynish, E., Gillette, S., Aguera-Morales, E., Auriacombe, S., Boada, M., Bullock, R., Byrne, J., Camus, V., Cherubini, A., Eriksdotter-Jonhagen, M., Frisoni, G. B., Hasselbalch, S., Jones, R. W., Martinez-Lage, P., Rikkert, M. O., Tsolaki, M., Ousset, P.-J., Pasquier, F., Ribera-Casado, J. M., Rigaud, A. S., Robert, P., Rodriguez, G., Salmon, E., Salva, A., Scheltens, P., Schneider, A., Sinclair, A., Spiru, L., Touchon, J., Zekry, D., Winblad, B., & Andrieu, S.
- Affiliations
- Inserm (FR)
- Heidelberg University (DE)
- Centre Hospitalier Universitaire de Toulouse (FR)
- Université de Bordeaux (FR)
- Instituto Peruano de Neurociencias (PE)
- University of Manchester (GB)
- Université de Tours (FR)
- Istituto Nazionale di Riposo e Cura per Anziani (IT)
- Centro San Giovanni di Dio Fatebenefratelli (IT)
- Rigshospitalet (DK)
- Royal United Hospital (GB)
- Radboud University Nijmegen (NL)
- Aristotle University of Thessaloniki (GR)
- Université de Lille (FR)
- Universidad Complutense de Madrid (ES)
- Assistance Publique – Hôpitaux de Paris (FR)
- Centre Hospitalier Universitaire de Nice (FR)
- University of Genoa (IT)
- University of Göttingen (DE)
- Carol Davila University of Medicine and Pharmacy (RO)
- Hôpital Gui de Chauliac (FR)
- University of Geneva (CH)
- Karolinska Institutet (SE)
- ORCID
- Venue
- Current Alzheimer Research
- Publisher
- Bentham Science Publishers Ltd.
- Published
- 2012-09-01
- Volume
- 9
- Issue
- 8
- Pages
- 902-912
- ISSN
- 1567-2050 (ISSN-L)
- OpenAlex
- W2117260220
- Cited by
- 50
- References
- 0
- Citations by year
- 2025: 2 · 2024: 2 · 2022: 1 · 2021: 2 · 2020: 1 · 2019: 5 · 2018: 4 · 2017: 5 · 2016: 6 · 2015: 9 · 2014: 8 · 2013: 5
- FWCI
- 5.02
- Type
- journal article
- Language
- en
- Open access
- Licence
- cc-by
- Locations
- Current Alzheimer Research (publishedVersion)
- PubMed (publishedVersion)
- Pure Amsterdam UMC (publishedVersion)
- Archive ouverte UNIGE (University of Geneva) (submittedVersion, cc-by)
- CINECA IRIS Institutial Research Information System (University of Genoa) (submittedVersion)
- Università Politecnica delle Marche (Università Politecnica delle Marche) (submittedVersion)
- GRO (submittedVersion)
- Research at the University of Copenhagen (University of Copenhagen) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- 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, clinical progression, acetylcholinesterase inhibitors, cognitive decline, functional decline, activities of daily living, behavioral problems, caregiver burden, hospitalization, nursing home admission, regional variation, health care system, Zarit Burden Interview, Mini-Mental State Examination, ADAS-Cog
- MeSH terms
- Aged, Alzheimer Disease, Europe, Female, Humans, Male, Neuropsychological Tests, Socioeconomic Factors, Disease Progression
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