Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2002 Aug 19:2:6.
doi: 10.1186/1471-2377-2-6.

To what degree does cognitive impairment in Alzheimer's disease predict dependence of patients on caregivers?

Jaime Caro  1 , Alexandra Ward, Khajak Ishak, Kristen Migliaccio-Walle, Denis Getsios, George Papadopoulos, Koen Torfs
Affiliations

To what degree does cognitive impairment in Alzheimer's disease predict dependence of patients on caregivers?

Jaime Caro et al. BMC Neurol. .

Abstract

Background: Patients with Alzheimer's disease experience a progressive loss of cognitive function, and the ability to independently perform activities of daily life. Sometimes a dependent stage is reached quite early in the disease, when caregivers decide that the patients can no longer be left alone safely. This is an important aspect of Alzheimer's for patients, their families, and also health care providers. Understanding the relationship between a patient's current cognitive status and their need for care may assist clinicians when recommending an appropriate management plan. In this study, we investigated the relationship of cognitive function to dependence on caregivers before the patients reach a severe stage of the disease.

Methods: Data were obtained on 1,289 patients with mild-to-moderate Alzheimer's disease studied in two randomised clinical trials of galantamine (ReminylcircledR;). Cognition was assessed using the cognitive part of the Alzheimer's Disease Assessment Scale (ADAS-cog) and Mini-Mental State Examination (MMSE). Patients were considered dependent if they required >12 hours of supervision each day or had high care needs. The Disability Assessment for Dementia (DAD) scale was also used as a measure of dependence. Disability was predicted directly using MMSE and ADAS-cog and compared to predictions from converted scores.

Results: The odds ratio of dependence was significantly higher amongst the patients with worse cognitive impairment, adjusting for age, gender and antipsychotic medication use. For example, a 4-point difference in ADAS-cog score was associated with an increase of 17% (95% CI 11-23) in the adjusted odds for >12 hours of supervision, and of 35% (95% CI 28-43) for dependence. Disability predicted directly using actual ADAS-cog and scores converted from MMSE values had close agreement using the models developed.

Conclusion: In patients with mild-to-moderate Alzheimer's disease, even relatively small degrees of poorer cognitive function increased the risk of losing the ability to live independently.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Mean predictions of DAD scores based on actual and converted ADAS-cog scores.
See this image and copyright information in PMC

References

    1. Stern Y, Hesdorffer D, Sano M M, Mayeux R. Measurement and prediction of functional capacity in Alzheimer's disease. Neurology. 1990;40:8–14. - PubMed
    1. Moore M, Clipp E. Alzheimer's disease and caregiver time. Lancet. 1994;343:239–240. doi: 10.1016/S0140-6736(94)91027-8. - DOI - PubMed
    1. Clipp EC, Moore MJ. Caregiver time use: an outcome measure in clinical trial research on Alzheimer's disease. Clin Pharm Ther. 1995;58:228–236. - PubMed
    1. Davis K, Marin DB, Kane R, Patrick D, Peskind ER, Raskind MA, Puder KL. The caregiver activity survey (CAS): development and validation of a new measure for caregivers of persons with Alzheimer's disease. Int J Geriatr Psychiatry. 1997;12:978–988. doi: 10.1002/(SICI)1099-1166(199710)12:10<978::AID-GPS659>3.0.CO;2-1. - DOI - PubMed
    1. Schmeidler J, Mohs RC, Aryan M. Relationship of disease severity to decline on specific cognitive and functional measures in Alzheimer's disease. Alzheimer Dis Assoc Disord. 1998;12:146–151. - PubMed

Publication types