A hierarchy of predictors for dementia-free survival in old-age: results of the AgeCoDe study
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A hierarchy of predictors for dementia-free survival in old-age: results of the AgeCoDe study. / Luck, T; Riedel-Heller, S G; Luppa, M; Wiese, B; Bachmann, C; Jessen, F; Bickel, H; Weyerer, S; Pentzek, M; König, H-H; Prokein, J; Eisele, M; Wagner, M; Mösch, E; Werle, J; Fuchs, A; Brettschneider, C; Scherer, M; Breitner, J C S; Maier, W.
in: ACTA PSYCHIAT SCAND, Jahrgang 129, Nr. 1, 01.01.2014, S. 63-72.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - A hierarchy of predictors for dementia-free survival in old-age: results of the AgeCoDe study
AU - Luck, T
AU - Riedel-Heller, S G
AU - Luppa, M
AU - Wiese, B
AU - Bachmann, C
AU - Jessen, F
AU - Bickel, H
AU - Weyerer, S
AU - Pentzek, M
AU - König, H-H
AU - Prokein, J
AU - Eisele, M
AU - Wagner, M
AU - Mösch, E
AU - Werle, J
AU - Fuchs, A
AU - Brettschneider, C
AU - Scherer, M
AU - Breitner, J C S
AU - Maier, W
N1 - © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
PY - 2014/1/1
Y1 - 2014/1/1
N2 - OBJECTIVE: Progression from cognitive impairment (CI) to dementia is predicted by several factors, but their relative importance and interaction are unclear.METHOD: We investigated numerous such factors in the AgeCoDe study, a longitudinal study of general practice patients aged 75+. We used recursive partitioning analysis (RPA) to identify hierarchical patterns of baseline covariates that predicted dementia-free survival.RESULTS: Among 784 non-demented patients with CI, 157 (20.0%) developed dementia over a follow-up interval of 4.5 years. RPA showed that more severe cognitive compromise, revealed by a Mini-Mental State Examination (MMSE) score < 27.47, was the strongest predictor of imminent dementia. Dementia-free survival time was shortest (mean 2.4 years) in such low-scoring patients who also had impaired instrumental activities of daily living (iADL) and subjective memory impairment with related worry (SMI-w). Patients with identical characteristics but without SMI-w had an estimated mean dementia-free survival time of 3.8 years, which was still shorter than in patients who had subthreshold MMSE scores but intact iADL (4.2-5.2 years).CONCLUSION: Hierarchical patterns of readily available covariates can predict dementia-free survival in older general practice patients with CI. Although less widely appreciated than other variables, iADL impairment appears to be an especially noteworthy predictor of progression to dementia.
AB - OBJECTIVE: Progression from cognitive impairment (CI) to dementia is predicted by several factors, but their relative importance and interaction are unclear.METHOD: We investigated numerous such factors in the AgeCoDe study, a longitudinal study of general practice patients aged 75+. We used recursive partitioning analysis (RPA) to identify hierarchical patterns of baseline covariates that predicted dementia-free survival.RESULTS: Among 784 non-demented patients with CI, 157 (20.0%) developed dementia over a follow-up interval of 4.5 years. RPA showed that more severe cognitive compromise, revealed by a Mini-Mental State Examination (MMSE) score < 27.47, was the strongest predictor of imminent dementia. Dementia-free survival time was shortest (mean 2.4 years) in such low-scoring patients who also had impaired instrumental activities of daily living (iADL) and subjective memory impairment with related worry (SMI-w). Patients with identical characteristics but without SMI-w had an estimated mean dementia-free survival time of 3.8 years, which was still shorter than in patients who had subthreshold MMSE scores but intact iADL (4.2-5.2 years).CONCLUSION: Hierarchical patterns of readily available covariates can predict dementia-free survival in older general practice patients with CI. Although less widely appreciated than other variables, iADL impairment appears to be an especially noteworthy predictor of progression to dementia.
U2 - 10.1111/acps.12129
DO - 10.1111/acps.12129
M3 - SCORING: Journal article
C2 - 23521526
VL - 129
SP - 63
EP - 72
JO - ACTA PSYCHIAT SCAND
JF - ACTA PSYCHIAT SCAND
SN - 0001-690X
IS - 1
ER -