Rapid cognitive decline in Alzheimer's disease. Consensus paper.

M. E. Soto; S. Andrieu; C. Arbus; Mathieu Ceccaldi; Philippe Couratier; Thierry Dantoine; Jean-François Dartigues; S. Gillette-Guyonnet; Fati Nourashemi; P.-J. Ousset; M. Poncet; F. Portet; J. Touchon; B. Vellas

doi:10.1007/BF03028618

Article dans une revue

Rapid cognitive decline in Alzheimer's disease. Consensus paper.

M. E. Soto ¹ S. Andrieu ^{2, 3, 4} C. Arbus ⁵ Mathieu Ceccaldi ⁶ Philippe Couratier ⁷ Thierry Dantoine ⁸ Jean-François Dartigues ^{9, 10} S. Gillette-Guyonnet ^{1, 3, 4} Fati Nourashemi ^{1, 3, 4} P.-J. Ousset ^{1, 3, 4} M. Poncet ⁶ F. Portet ¹¹ J. Touchon ¹¹ B. Vellas ^{1, 3, 4}

1 Service de médecine gériatrique

2 Département d'épidémiologie et santé publique

3 LEASP - Epidémiologie et Analyses en Santé Publique : risques, maladies chroniques et handicap

4 UT3 - Université Toulouse III - Paul Sabatier

5 Service de psychatrie adulte

6 Service de neurologie

7 Service de Neurologie [CHU Limoges]

8 Service de Médecine Gériatrique [CHU Limoges]

9 Epidémiologie et Biostatistique [Bordeaux]

10 Département d'épidémiologie et santé publique

11 Département de neurologie [Montpellier]

Abstract : The rate of cognitive decline in Alzheimer's disease (AD) varies considerably between individuals, with some subjects showing substantial deterioration and others showing little or no change over the course of the disease. These wide variations support the relatively new concept of Rapid Cognitive Decline (RCD). Patients with an accelerated rate of cognitive decline have showed to present a worse evolution in terms of mortality, loss of autonomy and institutionalisation. The conclusions from RCD studies conducted in the past years remain very heterogeneous and sometimes contradictory. This is possibly due to methodological differences, mainly the different "a priori" definitions of RCD used to identify rapid decliners. Consequently of this, there is considerable variation in reported frequency of patients with RCD which may vary from 9.5% to 54%. The lack of both consensus definition and consensual clinical assessment tools is one of the major barriers for establishing an appropriated management of rapid decliners in clinical practice. Presently, management of rapid decliners in AD remains to be a challenge waiting to better know predictive factors of a RCD. To date no specific guidelines exist to follow-up or to treat patients with this condition. This consensus paper proposes the loss of 3 points or greater in Mini-Mental State Examination (MMSE) during six months as an empirical definition of rapid cognitive decline to be used in routine medical practice and to be relevant for clinical-decision making in patients with mild to moderately-severe AD.

Type de document :

Article dans une revue

Domaine :

Sciences du Vivant [q-bio] / Neurosciences [q-bio.NC]

Sciences du Vivant [q-bio] / Médecine humaine et pathologie / Gériatrie et gérontologie

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https://hal-unilim.archives-ouvertes.fr/hal-00625053
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Soumis le : mardi 20 septembre 2011 - 15:17:28
Dernière modification le : lundi 11 octobre 2021 - 13:23:40

Rapid cognitive decline in Alzheimer's disease. Consensus paper.

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