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- Document type:
- Journal Article; Research Support, Non-U.S. Gov't; Article
- Author(s):
- 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
- Title:
- 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.
- Journal title abbreviation:
- Acta Psychiatr Scand
- Year:
- 2014
- Journal volume:
- 129
- Journal issue:
- 1
- Pages contribution:
- 63-72
- Language:
- eng
- Fulltext / DOI:
- doi:10.1111/acps.12129
- Pubmed ID:
- http://view.ncbi.nlm.nih.gov/pubmed/23521526
- Print-ISSN:
- 0001-690X
- TUM Institution:
- Klinik und Poliklinik für Psychiatrie und Psychotherapie
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