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Disruptive Behavior as a predictor in Alzheimer disease
dc.creator | Scarmeas, N. | en |
dc.creator | Brandt, J. | en |
dc.creator | Blacker, D. | en |
dc.creator | Albert, M. | en |
dc.creator | Hadjigeorgiou, G. | en |
dc.creator | Dubois, B. | en |
dc.creator | Devanand, D. | 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 | 2007 | |
dc.identifier | 10.1001/archneur.64.12.1755 | |
dc.identifier.issn | 0003-9942 | |
dc.identifier.uri | http://hdl.handle.net/11615/32929 | |
dc.description.abstract | Background: Disruptive behavior is common in Alzheimer disease (AD). There are conflicting reports regarding its ability to predict cognitive decline, functional decline, institutionalization, and mortality. Objective: To examine whether the presence of disruptive behavior has predictive value for important outcomes in AD. Design: Using the Columbia University Scale for Psychopathology in Alzheimer Disease (administered every 6 months, for a total of 3438 visit-assessments and an average of 6.9 per patient), the presence of disruptive behavior (wandering, verbal outbursts, physical threats/violence, agitation/restlessness, and sundowning) was extracted and examined as a time-dependent predictor in Cox models. The models controlled for the recruitment cohort, recruitment center, informant status, sex, age, education, a comorbidity index, baseline cognitive and functional performance, and neuroleptic use. Setting: Five university-based AD centers in the United States and Europe (Predictors Study). Participants: Four hundred ninety-seven patients with early-stage AD (mean Folstein Mini-Mental State Examination score, 20 of 30 at entry) who were recruited and who underwent semiannual follow-up for as long as 14 (mean, 4.4) years. Main Outcome Measures: Cognitive (Columbia Mini-Mental State Examination score, <= 20 of 57 [approximate Folstein Mini-Mental State Examination score, <= 10 of 30]) and functional ( Blessed Dementia Rating Scale score, parts I and II, >= 10) ratings, institutionalization equivalent index, and death. Results: At least 1 disruptive behavioral symptom was noted in 48% of patients at baseline and in 83% at any evaluation. Their presence was associated with increased risks of cognitive decline (hazard ratio 1.45 [95% confidence interval (CI), 1.03-2.03]), functional decline (1.66 [95% CI, 1.17-2.36]), and institutionalization (1.47 [95% CI, 1.101.97]). Sundowning was associated with faster cognitive decline, wandering with faster functional decline and institutionalization, and agitation/restlessness with faster cognitive and functional decline. There was no association between disruptive behavior and mortality (hazard ratio, 0.94 [95% CI, 0.71-1.25]). Conclusion: Disruptive behavior is very common in AD and predicts cognitive decline, functional decline, and institutionalization but not mortality. | en |
dc.source | Archives of Neurology | en |
dc.source.uri | <Go to ISI>://WOS:000251538300010 | |
dc.subject | MINI-MENTAL-STATE | en |
dc.subject | PSYCHIATRIC-SYMPTOMS | en |
dc.subject | COGNITIVE DECLINE | en |
dc.subject | PSYCHOPATHOLOGICAL FEATURES | en |
dc.subject | PSYCHOLOGICAL SYMPTOMS | en |
dc.subject | EXTRAPYRAMIDAL | en |
dc.subject | SIGNS | en |
dc.subject | AGGRESSIVE-BEHAVIOR | en |
dc.subject | MOTOR SIGNS | en |
dc.subject | DEMENTIA | en |
dc.subject | PROGRESSION | en |
dc.subject | Clinical Neurology | en |
dc.title | Disruptive Behavior as a predictor in Alzheimer disease | en |
dc.type | journalArticle | en |
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