Predictors of Rapid Cognitive Decline in Patients with Mild-to-Moderate Alzheimer Disease: A Prospective Cohort Study with 12-Month Follow-Up Performed in Memory Clinics

Tchalla, Achille; Clément, Jean‐Pierre; Saulnier, Isabelle; Beaumatin, Betty; Lachal, Florent; Gayot, Caroline; Bosetti, Anaïs; Desormais, Iléana; Perrochon, Anaïck; Preux, Pierre‐Marie; Couratier, Philippe; Dantoine, Thierry

doi:10.1159/000487938

Cited by 34 publications

(47 citation statements)

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“…One study in rural areas of northern China indicates that risk factors for cognitive deficits were female sex, low education, and central obesity . Moreover, another study shows that female sex and lower education were associated with vascular cognitive impairment (VCI) in Chinese stroke patients TA B L E 4 Linear regression between 3-month MMSE scores and variables of stroke patients, adjusted R 2 = 0.416 (Mellon et al, 2015;Pendlebury, 2009;Tchalla et al, 2018), which is consistent with our results. In addition, among older AD patients with rapid cognitive decline (RCD), females had significantly lower MMSE scores after adjusting for other variables (Chen et al, 2016).…”

Section: Tions Can Inhibit Both Aβ Deposition and Tau Hyperphosphorylsupporting

confidence: 89%

“…In addition, among older AD patients with rapid cognitive decline (RCD), females had significantly lower MMSE scores after adjusting for other variables (Chen et al, 2016). Moreover, another study shows that female sex and lower education were associated with vascular cognitive impairment (VCI) in Chinese stroke patients TA B L E 4 Linear regression between 3-month MMSE scores and variables of stroke patients, adjusted R 2 = 0.416 (Mellon et al, 2015;Pendlebury, 2009;Tchalla et al, 2018), which is consistent with our results. In China, females prefer not to exercise outdoors and always stay away from ultraviolet light (UV), which leads to lower serum vitamin D (Vit D) levels (Montagne et al, 2018;Wang, Zhu, Liu, Tu, & He, 2018).…”

Section: Ta B L E 3 Relevance Between 3-month Mmse Scores and Baselinsupporting

confidence: 87%

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High levels of plasma fibrinogen are related to post‐stroke cognitive impairment

et al. 2019

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Introduction Studies have shown that high levels of the fibrinogen (FIB) are related to cognitive deficits. However, the relationship between fibrinogen and cognitive deficit after stroke remains unclear. Therefore, we explored the relationship between plasma fibrinogen and post‐stroke cognitive impairment (PSCI). Methods This study is carried out in the First Affiliated Hospital of Wenzhou Medical University, Wenzhou, Zhejiang Province, China. A total of 210 patients with acute ischemic stroke were enrolled in this study. Ultimately, 134 patients completed 3‐month follow‐up. Blood samples were collected at hospital admission. Cognitive function was evaluated 3 months after stroke. All patients underwent the Mini‐Mental State Examination (MMSE) after 3 months. Results Higher levels of fibrinogen were observed in patients with post‐stroke cognitive impairment compared with the non‐PSCI group (p < .001). Additionally, elevated plasma fibrinogen levels were independently associated with PSCI (odds ratio [OR] = 2.000, 95% CI 1.062–3.770 p = .032). The plasma fibrinogen levels were negatively correlated with the 3‐month MMSE scores (r = −.171, p = .048). In a multivariate linear regression, FIB was negatively associated with the 3‐month MMSE scores after adjustment for the other variables (β = −0.782, p = .035). Conclusion High levels of plasma fibrinogen were associated with the presence and severity of PSCI.

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Section: Tions Can Inhibit Both Aβ Deposition and Tau Hyperphosphorylsupporting

confidence: 89%

Section: Ta B L E 3 Relevance Between 3-month Mmse Scores and Baselinsupporting

confidence: 87%

High levels of plasma fibrinogen are related to post‐stroke cognitive impairment

et al. 2019

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“…In Table 2 are given the predictive factors of poorer outcomes in AD found in the different papers revised. Among demographic variables, there are four predictors that appeared consistently across many cohort studies: male gender [15][16][17][18][19][20][21][22][23] and extrapyramidal signs [24][25][26][27][28][29], which are associated with both shorter survival and faster cognitive decline. Only in one study the female gender was associated with poorer outcome [30].…”

Section: Demographic Factorsmentioning

confidence: 99%

“…13. Signs of parkinsonism [26][27][28][29]43,61] 14. Nutritional status [30,74] Determinants of Progression and Mortality in Alzheimer's disease: A Systematic Review the HR did not reach statistical significance (HR: 1.22) [22].…”

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confidence: 99%

Determinants of Progression and Mortality in Alzheimers disease: A Systematic Review

Modrego¹,

Lobò²

2018

Neuropsychiatry

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Neuropsychiatric symptoms (NPS) have been regarded as predictors of poor outcomes, and the use of neuroleptics as well, but with contradictory results. The objective of this article is to perform a systematic review of published works dealing with progression and survival in AD. Methods We searched articles aimed at determining the factors predicting faster cognitive decline and mortality in AD, published from January 1987 to April, 2018. We gave priority to prospective and retrospective cohorts analysing the influence of gender, NPS, neuropsychological predictors, co morbidities, and the use of neuroleptics/ antidepressants. The data-sources were 42 prospective cohorts including 24,711 patients; Hazard ratios/relative risks of mortality and faster cognitive decline were obtained for NPS and the use of psychotropic drugs. The risk of mortality for neuroleptics and ChEI was also obtained from 7 retrospective cohorts totalling 242,013 patients followed up. Results High levels of NPS were predictors of both mortality and faster cognitive decline Considered in isolation, agitation/aggression, hallucinations, and depression predicted mortality. However the results for apathy and psychosis/delusions varied across the studies. According to prospective cohort studies there is no clear evidence that neuroleptics increase mortality. The use of neuroleptics is associated with faster cognitive deterioration. Conventional neuroleptics for NPS did not result in lower mortality rates than the atypical ones. Conclusions The presence of NPS is associated with poor outcomes in AD such as mortality and greater cognitive decline. Atypical neuroleptics do not shorten survival but are associated with faster cognitive decline

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“…Among them, malnutrition was recognized as a risk factor of dementia and AD [6,7]. Recent evidence suggests that malnutrition is associated with rapid cognitive decline, disease progression and the degree of impairment in daily functioning in patients with dementia [8][9][10]. While studies have shown that patients with dementia or AD were more likely to suffer from a poor nutritional status [11,12].…”

Section: Introductionmentioning

confidence: 99%

Associations of cognitive condition with nutritional status in an elderly population: an analysis based on a 7-year database in Chongqing, the Southwest of China

Liu

et al. 2020

Preprint

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Background: Malnutrition is one of the health problems in the elderly population, which increases the risk of poor clinical outcomes. The purpose of this investigation was to evaluate the nutritional status and cognitive function of an elderly Chinese population, to explore the association between malnutrition and cognitive condition as well as the cognitive domain.Methods: A cross-sectional study was conducted in 2365 participants aged 60 years or above from January 2013 to September 2019. We used the Mini Nutritional Assessment Short Form (MNA-SF), and the Mini Mental State Examination (MMSE) to assess the impact of malnutrition on cognitive function.Nutrition-associated factors were analyzed.Results: 33.45% of the participants were identified as malnutrition risk and 5.54% were malnourished, while 36.74% had cognitive impairments. 48.63% had nutritional deficits and 53.65% had cognitive impairment in those over 80 years old. Malnutrition is associated with global cognition (ρ= 0.349, P < 0.0001) and the cognitive domain particularly in orientation (ρ= 0.343, P < 0.0001). The impact was extended to attention and calculation (ρ=0.310, P < 0.0001) as well as language (ρ= 0.302, P < 0.0001) of those over 80 years of age. Malnutrition is an independent risk factor for cognitive impairment after adjusting for other variables (OR=2.004, 95% CI: 1.621-2.479).Conclusion: The prevalence of malnutrition and cognitive impairment was relatively high and increased with age. Malnutrition leads to cognitive decline and disorientation, and also contributes to attention problems, calculation problem and language impairment in the oldest old. Thus, clinicians should assess the nutritional and cognitive status of the elderly regularly to the early dictation and timely intervention.

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Predictors of Rapid Cognitive Decline in Patients with Mild-to-Moderate Alzheimer Disease: A Prospective Cohort Study with 12-Month Follow-Up Performed in Memory Clinics

Cited by 34 publications

References 42 publications

High levels of plasma fibrinogen are related to post‐stroke cognitive impairment

High levels of plasma fibrinogen are related to post‐stroke cognitive impairment

Determinants of Progression and Mortality in Alzheimers disease: A Systematic Review

Associations of cognitive condition with nutritional status in an elderly population: an analysis based on a 7-year database in Chongqing, the Southwest of China

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