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Dokumenttyp:
journal article 
Autor(en):
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 
Titel:
A hierarchy of predictors for dementia-free survival in old-age: results of the AgeCoDe study. 
Abstract:
Progression from cognitive impairment (CI) to dementia is predicted by several factors, but their relative importance and interaction are unclear.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.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).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. 
Zeitschriftentitel:
Acta Psychiatr Scand 
Jahr:
2014 
Band / Volume:
129 
Heft / Issue:
Seitenangaben Beitrag:
63-72 
Sprache:
eng 
Print-ISSN:
0001-690X 
TUM Einrichtung:
Klinik und Poliklinik für Psychiatrie und Psychotherapie