Effectiveness of a Standardized and Specific Follow-Up in Memory Centers in Patients with Alzheimer's Disease.

Details

Serval ID
serval:BIB_000B01039AB3
Type
Article: article from journal or magazin.
Collection
Publications
Title
Effectiveness of a Standardized and Specific Follow-Up in Memory Centers in Patients with Alzheimer's Disease.
Journal
Current Alzheimer research
Author(s)
Rouch L., Cestac P., Cool C., Helmer C., Dartigues J.F., Berr C., Rouaud O., Vellas B., Andrieu S.
Working group(s)
REAL-FR Study Group and the 3C Study Group
ISSN
1875-5828 (Electronic)
ISSN-L
1567-2050
Publication state
Published
Issued date
2017
Peer-reviewed
Oui
Volume
14
Number
3
Pages
255-267
Language
english
Notes
Publication types: Journal Article ; Multicenter Study
Publication Status: ppublish
Abstract
To compare the 4-year survival, institutionalization, cognitive and functional decline of Alzheimer's patients with specific follow-up in memory centers versus usual care.
Four year longitudinal follow-up.
The French Network of memory centers in Alzheimer's disease (REAL-FR study) and The French population-based study (3C study).
728 patients aged ≥ 65, living at home, meeting criteria for probable Alzheimer's disease and having Mini Mental State Examination (MMSE) scores between 10 and 26 at baseline were included.
Cox proportional hazards models were performed to test the effectiveness of a specific follow-up in memory centers (REAL-FR study) versus usual care (3C study) on the 4-year survival and institutionalization. Linear mixed models were used to assess cognitive and functional decline in both groups.
After adjustment for confounding factors, the 4-year survival did not differ significantly between patients followed-up in memory centers and those who had recourse to usual care (usual care: Hazard Ratio adjusted (HRa) = 0.87, 95% confidence interval (CI) 0.53-1.43, p=0.59). Patients with a specific follow-up in memory centers had a higher risk of being institutionalized (usual care: HRa = 0.24, 95% CI 0.12-0.48, p<0.001). They also exhibited a significant greater cognitive and functional decline over time.
Our findings failed to demonstrate any potential benefits of a specific follow-up in memory centers on clinically meaningful outcomes in the natural history of Alzheimer's disease. Recourse to care in memory centers may have been the consequence of a faster dementia progression and a greater burden of Alzheimer's disease, all leading to detrimental consequences on various prognostic outcomes.
Keywords
Aged, Aged, 80 and over, Alzheimer Disease/mortality, Alzheimer Disease/therapy, Female, Follow-Up Studies, France, Humans, Kaplan-Meier Estimate, Linear Models, Male, Mental Status Schedule, Multivariate Analysis, Proportional Hazards Models, Prospective Studies, Severity of Illness Index, Socioeconomic Factors, Superior Sagittal Sinus, Treatment Failure, Alzheimer's disease, care management, comparison., memory centers, usual care
Pubmed
Web of science
Create date
23/08/2024 12:31
Last modification date
24/08/2024 7:07
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