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Patients in Australian Memory Clinics: baseline characteristics and predictors of decline at six months

Published online by Cambridge University Press:  14 April 2011

Henry Brodaty ,
Michael Woodward ,
Karyn Boundy ,
David Ames  and
Robert Balshaw
Henry Brodaty*
Affiliation:
Dementia Collaborative Research Centre, School of Psychiatry, University of NSW, Sydney, Australia Prince of Wales Hospital, Randwick, NSW, Australia
Michael Woodward
Affiliation:
Austin Health, Heidelberg Repatriation Hospital, Heidelberg, VIC, Australia
Karyn Boundy
Affiliation:
The Queen Elizabeth Hospital, Woodville South, SA, Australia
David Ames
Affiliation:
National Ageing Research Institute, Melbourne, VIC, Australia Ageing and Health, University of Melbourne, VIC, Australia
Robert Balshaw
Affiliation:
Syreon Corporation, Vancouver, Canada
*
Correspondence should be addressed to: Professor Henry Brodaty, School of Psychiatry, University of NSW, Sydney, NSW 2052, Australia. Phone: +61 2 9385 2585; Fax: +61 2 9385 2200. Email: [email protected].
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Abstract

Background: The Prospective Research In MEmory clinics (PRIME) is a three-year non-prescriptive, observational study identifying and measuring relationships among predictor and outcome variables.

Methods: Patients from nine memory clinics, diagnosed with dementia or mild cognitive impairment (MCI), living in the community with <40 hours/week nursing care were divided into diagnostic groups defined at baseline as Alzheimer's disease (AD) early or late onset, frontotemporal dementia (FTD), vascular dementia (VaD), mixed (AD and VaD) and other dementia. To achieve outcome measures, baseline and change over six months in all measures by diagnostic group, and predictors of change at six months were examined.

Results: Of the 970 patients enrolled, 967 were eligible for analysis. The most common disorder was AD (late onset) accounting for 46.5% of this population. Patients had an overall slight worsening on all assessment scales over the six-month period. Patients with FTD had a more marked change (decline) in cognition, function and behavior over six months compared to other diagnostic groups. However, in the regression analysis the difference was not significant between groups. Predictors of decline in Mini-Mental State Examination (MMSE) scores were not robust at six months, and longer follow-up is required. Patients with FTD were more likely to be prescribed psychotropics.

Conclusion: The PRIME study is continuing and will provide important data on predictors of decline along with differences between diagnosis groups on the rate of change.

Keywords

dementiamild cognitive impairmentpredictorsAlzheimer's diseaseprospective study
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 7 , September 2011 , pp. 1086 - 1096
Copyright
Copyright © International Psychogeriatric Association 2011

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References

American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental Disorders, text revision, 4th edn (DSM-IV-TR). Washington, DC: American Psychiatric Association.Google Scholar
Australian Institute of Health and Welfare (2006). Dementia in Australia: National Data Analysis and Development. Canberra: AIHW. Available at: www.aihw.gov.au/publications/age/dandad/dandad-c00.pdf; last accessed March 2010.Google Scholar
Australian Institute of Health and Welfare (2010). Australia's Health. Canberra: AIHW Available at: http://www.aihw.gov.au/publications/aus/ah10/11374-c04.pdf; last accessed September 2010.Google Scholar
Bédard, M. et al. (2001). The Zarit Burden Interview: a new short version and screening version. Gerontologist, 41, 652–657.Google Scholar
Burns, A. et al. (2006). Clinical practice with anti-dementia drugs: a consensus statement from British Association for Psychopharmacology. Journal of Psychopharmacology, 20, 732–755.Google Scholar
Chow, T. W., Hynan, L. S. and Liptonde, A. M. (2006). MMSE scores decline at a greater rate in frontotemporal degeneration than in AD. Dementia and Geriatric Cognitive Disorders, 22, 194–199.Google Scholar
Cummings, J. L. (1997). The Neuropsychiatric Inventory: assessing psychopathology in dementia patients. Neurology, 48, S10–S16.CrossRefGoogle ScholarPubMed
Cummings, J. L. et al. (1994). The Neuropsychiatric Inventory: comprehensive assessment of psychopathology in dementia. Neurology, 44, 2308–2314.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.Google Scholar
González-Salvador, M. T. et al. (1999). The stress and psychological morbidity of the Alzheimer patient caregiver. International Journal of Geriatric Psychiatry, 14, 701–710.3.0.CO;2-#>CrossRefGoogle ScholarPubMed
Hebert, R., Carrier, R. and Bilodeau, A. (1988). The Functional Autonomy Measurement System (SMAF): description and validation of an instrument for the measurement of handicaps. Age and Ageing, 17, 293–302.Google Scholar
Lawlor, B. (2002). Managing behavioural and psychological symptoms in dementia. British Journal of Psychiatry, 181, 463–465.Google Scholar
McKeith, I. (2002). Dementia with Lewy bodies. British Journal of Psychiatry, 180, 144–147.CrossRefGoogle ScholarPubMed
McShane, R., Keene, J. and Gedling, K. (1997). Do neuroleptic drugs hasten cognitive decline in dementia? Prospective study with necropsy follow up. BMJ, 314, 266–270.Google Scholar
Morris, J. C. (1993). The Clinical Dementia Rating (CDR): current version and scoring rules. Neurology, 43, 2412–4241.CrossRefGoogle ScholarPubMed
Musicco, M. et al. (2009). Predictors of progression of cognitive decline in Alzheimer's disease: the role of vascular and sociodemographic factors. Journal of Neurology, 256, 1288–1295.Google Scholar
National Prescribing Service (2008). Memantine (Ebixa) for moderately severe Alzheimer's disease. Available from: http://www.nps.org.au/health_professionals/publications/nps_radar/issues/current/august_2008/memantine#PBS_listing; last accessed 10 August 2009.Google Scholar
Prince, M. and Jackson, J. (2009). World Alzheimer Report. Alzheimer's Disease International. Available at: http://www.alz.co.uk/research/files/World%20Alzheimer%20Report.pdf; last accessed 25 March 2010.Google Scholar
Rascovsky, K. et al. (2005). Rate of progression differs in frontotemporal dementia and Alzheimer disease. Neurology; 65, 397–403.Google Scholar
Richards, M., Touchon, J., Ledesert, B. and Ritchie, K. (2002). Mild extrapyramidal signs and functional impairment in ageing. International Journal of Geriatric Psychiatry, 17, 150–153.Google Scholar
Roselli, F. et al. (2009). Rate of MMSE score change in Alzheimer's disease: influence of education and vascular risk factors. Clinical Neurology and Neurosurgery, 111, 327–330.CrossRefGoogle ScholarPubMed
Rosen, W. G., Mohs, R. C. and Davis, K. L. (1984). A new rating scale for Alzheimer's disease. American Journal of Psychiatry, 141, 1356–1364.Google Scholar
Sambrook, R. et al. (2004). Canadian Outcomes Study in Dementia: study methods and patient characteristics. Canadian Journal of Psychiatry, 49, 417–427.Google Scholar
Sunderland, T. et al. (1989). Clock drawing in Alzheimer's disease: a novel measure of dementia severity. Journal of the American Geriatrics Society, 37, 725–279.CrossRefGoogle ScholarPubMed
Wilkinson, D., Francis, P., Schwam, E. and Payne-Parrish, J. (2004). Cholinesterase inhibitors used in the treatment of Alzheimer's disease: the relationship between pharmacological effects and clinical efficacy. Drugs and Aging, 21, 453–478.CrossRefGoogle ScholarPubMed
Wilson, R. S. et al. (2010). Cognitive decline in incident Alzheimer disease in a community population. Neurology, 74, 942–944.Google Scholar
Winblad, B. et al. (2004). Mild cognitive impairment – beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of Internal Medicine, 256, 240–246.Google Scholar
Woodward, M. and Woodward, E. (2009). A national survey of memory clinics in Australia. International Psychogeriatrics, 21, 696–702.Google Scholar
Woodward, M. et al. (2010). Differentiating the frontal variant of Alzheimer's disease. International Journal of Geriatric Psychiatry, 25, 732–738.Google Scholar
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