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Motor signs predict poor outcomes in Alzheimer disease
dc.creator | Scarmeas, N. | en |
dc.creator | Albert, M. | en |
dc.creator | Brandt, J. | en |
dc.creator | Blacker, D. | en |
dc.creator | Hadjigeorgiou, G. | en |
dc.creator | Papadimitriou, A. | en |
dc.creator | Dubois, B. | en |
dc.creator | Sarazin, M. | en |
dc.creator | Wegesin, D. | en |
dc.creator | Marder, K. | en |
dc.creator | Bell, K. | en |
dc.creator | Honig, L. | en |
dc.creator | Stern, Y. | en |
dc.date.accessioned | 2015-11-23T10:47:06Z | |
dc.date.available | 2015-11-23T10:47:06Z | |
dc.date.issued | 2005 | |
dc.identifier | 10.1212/01.wnl.0000162054.15428.e9 | |
dc.identifier.issn | 0028-3878 | |
dc.identifier.uri | http://hdl.handle.net/11615/32927 | |
dc.description.abstract | Objective: To examine whether the presence of motor signs has predictive value for important outcomes in Alzheimer disease (AD). Methods: A total of 533 patients with AD at early stages (mean Folstein Mini-Mental State Examination [MMSE] 21/30 at entry) were recruited and followed semiannually for up to 13.1 years (mean 3) in five University-based AD centers in the United States and European Union. Four outcomes, assessed every 6 months, were used in Cox models: cognitive endpoint (Columbia Mini-Mental State Examination <= 20/57 [similar to MMSE <= 10/30]), functional endpoint ( Blessed Dementia Rating Scale >= 10), institutionalization equivalent index, and death. Using a standardized portion of the Unified PD Rating Scale (administered every 6 months for a total of 3,149 visit-assessments, average 5.9 per patient), the presence of motor signs, as well as of individual motor sign domains, was examined as time-dependent predictor. The models controlled for cohort, recruitment center, sex, age, education, a comorbidity index, and baseline cognitive and functional performance. Results: A total of 39% of the patients reached the cognitive, 41% the functional, 54% the institutionalization, and 47% the mortality endpoint. Motor signs were noted for 14% of patients at baseline and for 45% at any evaluation. Their presence was associated with increased risk for cognitive decline (RR, 1.72; 95% CI, 1.24 to 2.38), functional decline (1.80 [1.33 to 2.45]), institutionalization (1.68 [1.26 to 2.25]), and death (1.38 [1.05 to 1.82]). Tremor was associated with increased risk for reaching the cognitive and bradykinesia for reaching the functional endpoints. Postural-gait abnormalities carried increased risk for institutionalization and mortality. Faster rates of motor sign accumulation were associated with increased risk for all outcomes. Conclusions: Motor signs predict cognitive and functional decline, institutionalization, and mortality in Alzheimer disease. Different motor sign domains predict different outcomes. | en |
dc.source | Neurology | en |
dc.source.uri | <Go to ISI>://WOS:000229312900008 | |
dc.subject | LEWY BODY VARIANT | en |
dc.subject | EXTRAPYRAMIDAL SIGNS | en |
dc.subject | PARKINSONS-DISEASE | en |
dc.subject | COGNITIVE | en |
dc.subject | DECLINE | en |
dc.subject | INCIDENT DEMENTIA | en |
dc.subject | ASSOCIATION | en |
dc.subject | PROGRESSION | en |
dc.subject | MORTALITY | en |
dc.subject | SURVIVAL | en |
dc.subject | BODIES | en |
dc.subject | Clinical Neurology | en |
dc.title | Motor signs predict poor outcomes in Alzheimer disease | en |
dc.type | journalArticle | en |
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