Journal article
Longitudinal Neuropsychiatric Predictors of Death in Alzheimer's Disease
Journal of Alzheimer's disease, Vol.48(3), pp.627-636
2015
DOI: 10.3233/JAD-150391
PMID: 26402103
Abstract
Characteristics associated with life expectancy in Alzheimer's disease (AD) are still far from known. Here we aimed at examining the ability of baseline/longitudinal clinical variables to predict time to death. One-hundred fifty AD outpatients underwent diagnostic, neuropsychiatric, and functional assessment at baseline (when ApoE ɛ4 was also investigated) and at each subsequent annual visit. A random effects joint modeling approach was used to simultaneously model the baseline and longitudinal trajectory of each factor and predict the time to death, adjusting for demographic covariates. An ancillary analysis of ApoE ɛ4 status as a predictor was also conducted. Kaplan-Meier survival curves were constructed to elucidate the relationship between each factor and the estimated probability of death over time. Shorter survival was associated with male gender, higher education, older age, lower cognition, and worse functioning in daily life, but not ApoE ɛ4 status. Longitudinal trajectories increased predictive power over using just baseline levels highlighting apathy, and secondarily aberrant motor behaviors and sleep disorders, as a highly reliable predictor for mortality. Apathy was the strongest neuropsychiatric predictor of time to death, which supports its role in the pathogenesis of the disorder. An increased knowledge of factors modulating survival in AD is a strategic prerequisite to plan therapeutic interventions.
Details
- Title: Subtitle
- Longitudinal Neuropsychiatric Predictors of Death in Alzheimer's Disease
- Creators
- Gianfranco Spalletta - Beth K. and Stuart C. Yudofsky Division of Neuropsychiatry, Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, TX, USAJeffrey D Long - Department of Biostatistics, University of Iowa, Iowa City, IA, USARobert G Robinson - Department of Psychiatry, University of Iowa, Iowa City, IA, USAAlberto Trequattrini - ASL1 Umbria, Perugia, ItalySonia Pizzoli - IRCCS Santa Lucia Foundation, Rome, ItalyCarlo Caltagirone - Department of Medicine of Systems, Tor Vergata University, Rome, ItalyMaria D Orfei - IRCCS Santa Lucia Foundation, Rome, Italy
- Resource Type
- Journal article
- Publication Details
- Journal of Alzheimer's disease, Vol.48(3), pp.627-636
- Publisher
- Netherlands
- DOI
- 10.3233/JAD-150391
- PMID
- 26402103
- ISSN
- 1387-2877
- eISSN
- 1875-8908
- Language
- English
- Date published
- 2015
- Academic Unit
- Psychiatry; Biostatistics
- Record Identifier
- 9984003486502771
Metrics
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