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Trajectory of cognitive decline as a predictor of psychosis in early Alzheimer disease in the cardiovascular health study.
Tuesday,2012-11-06 12:19 America/Los_Angeles — eenright
| Title | Trajectory of cognitive decline as a predictor of psychosis in early Alzheimer disease in the cardiovascular health study. |
| Publication Type | Journal Article |
| Year of Publication | 2011 |
| Authors | Emanuel, JE, Lopez, OL, Houck, PR, Becker, JT, Weamer, EA, Demichele-Sweet, MAnn A, Kuller, L, Sweet, RA |
| Journal | Am J Geriatr Psychiatry |
| Volume | 19 |
| Issue | 2 |
| Pagination | 160-8 |
| Date Published | 2011 Feb |
| ISSN | 1545-7214 |
| Keywords | Aged, Alzheimer Disease, Chi-Square Distribution, Female, Follow-Up Studies, Humans, Longitudinal Studies, Male, Neuropsychological Tests, Psychiatric Status Rating Scales, Psychotic Disorders, Time Factors |
| Abstract | <p><b>OBJECTIVE: </b>To compare the trajectories of cognitive decline between groups with, and without, the later development of psychotic symptoms during Alzheimer disease (AD) or mild cognitive impairment (MCI).</p><p><b>DESIGN: </b>: The authors examined cognitive function in a new analysis of an existing data set, the Cardiovascular Health Study, an epidemiologic, longitudinal follow-up study. Our analyses examined 9 years of follow-up data.</p><p><b>SETTING: </b>Community.</p><p><b>PARTICIPANTS: </b>The authors examined subjects who were without dementia at study entry, received a diagnosis of AD or MCI during follow-up, and had been rated on the Neuropsychiatric Inventory for the presence of psychosis; 362 participants for the modified Mini-Mental State Examination (3MS) analysis and 350 participants for the digit symbol substitution test (DSST) analysis had sufficient follow-up data and apolipoprotein-∊ (APOE) genotyping.</p><p><b>MEASUREMENTS: </b>The 3MS and DSST were administered annually and analyzed using mixed-effects models including APOE4 status.</p><p><b>RESULTS: </b>: Mean 3MS and DSST scores did not differ between AD with psychosis (AD + P) and without psychosis groups at baseline. The 3MS and DSST scores decreased more rapidly in subjects who ultimately developed psychosis.</p><p><b>CONCLUSIONS: </b>Individuals who ultimately develop psychosis have more rapid cognitive deterioration during the earliest phases of AD than individuals with AD not developing psychosis. The genetic and other neurobiologic factors leading to the expression of AD + P may exert their effects by acceleration of the neurodegenerative process.</p> |
| DOI | 10.1097/JGP.0b013e3181e446c8 |
| Alternate Journal | Am J Geriatr Psychiatry |
| PubMed ID | 20808116 |
| PubMed Central ID | PMC3000865 |
| Grant List | N01 HC085086 / HC / NHLBI NIH HHS / United States AG15928 / AG / NIA NIH HHS / United States R01 AG015928-02 / AG / NIA NIH HHS / United States N01 HC085081 / HC / NHLBI NIH HHS / United States U01 HL080295-04 / HL / NHLBI NIH HHS / United States R01 AG015928 / AG / NIA NIH HHS / United States U01 HL080295 / HL / NHLBI NIH HHS / United States N01 HC075150 / HC / NHLBI NIH HHS / United States R01 AG027224-04 / AG / NIA NIH HHS / United States N01 HC015103 / HC / NHLBI NIH HHS / United States N01 HC085083 / HC / NHLBI NIH HHS / United States N01 HC085085 / HC / NHLBI NIH HHS / United States N01HC55222 / HL / NHLBI NIH HHS / United States N01-HC-85086 / HC / NHLBI NIH HHS / United States N01HC85086 / HL / NHLBI NIH HHS / United States N01 HC085082 / HC / NHLBI NIH HHS / United States N01 HC085080 / HC / NHLBI NIH HHS / United States N01 HC-55222 / HC / NHLBI NIH HHS / United States AG05133 / AG / NIA NIH HHS / United States N01 HC055222 / HC / NHLBI NIH HHS / United States N01-HC-75150 / HC / NHLBI NIH HHS / United States P50 AG005133 / AG / NIA NIH HHS / United States N01 HC085084 / HC / NHLBI NIH HHS / United States R01 AG020098 / AG / NIA NIH HHS / United States N01HC75150 / HL / NHLBI NIH HHS / United States R01 AG027224 / AG / NIA NIH HHS / United States N01-HC-85079 / HC / NHLBI NIH HHS / United States P50 AG005133-210020 / AG / NIA NIH HHS / United States N01HC85079 / HL / NHLBI NIH HHS / United States N01 HC085079 / HC / NHLBI NIH HHS / United States N01 HC045133 / HC / NHLBI NIH HHS / United States N01 HC035129 / HC / NHLBI NIH HHS / United States AG027224 / AG / NIA NIH HHS / United States |