The difference of long‐term outcome according to baseline dementia severity in Korean Alzheimer’s disease patients treated with anti‐dementia medications

Abstract

AbstractBackgroundTo describe the difference of long‐term outcome in Alzheimer’s disease (AD) according to initial dementia severity at the time of diagnosis in the clinical setting.MethodWe carried out retrospective chart review of patients who were diagnosed with Alzheimer’s disease on dementia clinic at an University Hospital in Korea from 2012 to 2019. Participants had been treated with donepezil or donepezil and memantine combination. We dichotomized participants into three groups by initial Clinical Dementia Rating (CDR); very mild group for CDR 0.5, mild group for CDR 1, and moderate group for CDR 2. The observation period was four years. All participants were assessed cognitive function, neuropsychiatric symptoms and severity of dementia by the Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological assessment battery (CERAD‐NP) including CDR, Minimal Mental Status Exam (MMSE), and Neuropsychiatric Inventory (NPI). The annual change of CDR‐SB(CDR‐sum of box), MMSE score, total score of CERAD‐NP, and total score of NPI were analyzed with general linear model multivariate analysis by SPSS version 22.ResultTwo hundred nine patients were finally enrolled. There were 73 participants in very mild group (mean age 80.11±6.99), 109 in mild group (mean age 80.42±7.27) and 27 in moderate group (mean age 83.15±8.29). The annual changes of CDR‐SB, MMSE score, and total score of CERAD‐NP were showed significant difference among three groups (moderate group > mild group > very mild group), except the total score of NPI. The declining rate of the total score of CERAD‐NP and MMSE were faster in the order of the moderate group, the mild group, and the very mind group.ConclusionOur result showed that the more advanced cognitive decline when a patient is diagnosed with AD can be associated with faster progression despite of receiving therapy with anti‐dementia medications. It is meaningful that we have studied these long‐term outcome of AD patients in real‐world clinical setting. In conclusion, the earlier treatment of AD, the slower progression of AD.