The neglected half of Alzheimer disease: cognitive and functional concomitants of severe dementia.

Abstract:

OBJECTIVE:Traditional mental status and psychometric assessments bottom out in the late stages of Alzheimer disease (AD). A method adapted from cognitive testing in infants, the Ordinal Scales of Psychological Development was modified (M-OSPD) and applied to a severely demented population. The concurrent validity of this method was tested in comparison with Functional Assessment Staging (FAST). Internal consistency as a measure for reliability was also determined. DESIGN:Cross sectional study. SETTING:Subjects were generally evaluated in their residence, usually a nursing home or a private home. PATIENTS:Severely cognitively impaired subjects who fulfilled criteria for probable AD were studied. MEASUREMENTS:Evaluation consisted of clinical global, mental status, functional, and cognitive assessments including the Global Deterioration Scale (GDS) and the Mini-Mental State Examination (MMSE). RESULTS:Seventy patients were evaluated. Traditional mental status assessments (eg, the MMSE) manifested virtually uniform bottom scores in all GDS stage 7 subjects (n = 46), and GDS stage 6 subjects had MMSE scores within one standard deviation unit of zero. In contrast, the M-OSPD scale continued to show results in the last stages of the disease. The Spearman correlation coefficient between the M-OSPD total score and the 11 FAST substages represented in this sample was -0.77 (P < 0.001). CONCLUSIONS:The results indicate that patients who are functionally more impaired also show continuing increments in cognitive loss. These cognitive and functional assessments for measuring the magnitude of deterioration in AD can be applied to the estimated half-million nursing home residents presently labeled "untestable" with the goal of optimization of care and residual capacities.

journal_name

J Am Geriatr Soc

authors

Auer SR,Sclan SG,Yaffee RA,Reisberg B

doi

10.1111/j.1532-5415.1994.tb06509.x

subject

Has Abstract

pub_date

1994-12-01 00:00:00

pages

1266-72

issue

12

eissn

0002-8614

issn

1532-5415

journal_volume

42

pub_type

临床试验,杂志文章
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    更新日期:1999-02-01 00:00:00

  • Age and Sex Distributions of Age-Related Biomarker Values in Healthy Older Adults from the Long Life Family Study.

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    更新日期:2009-01-01 00:00:00

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    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章,随机对照试验

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    更新日期:2012-09-01 00:00:00

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    pub_type: 杂志文章,多中心研究

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    pub_type: 杂志文章

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    更新日期:1990-05-01 00:00:00

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    更新日期:2004-03-01 00:00:00

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    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

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    更新日期:2012-09-01 00:00:00

  • Establishing a case-finding and referral system for at-risk older individuals in the emergency department setting: the SIGNET model.

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    pub_type: 杂志文章

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    更新日期:2001-10-01 00:00:00

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    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

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    pub_type: 杂志文章

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    更新日期:2011-09-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1046/j.1532-5415.2002.50110.x

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    更新日期:2002-03-01 00:00:00

  • An evaluative study of Silver's Cerebral Function Test.

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    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1977.tb00409.x

    authors: Ross N,de L Horne DJ

    更新日期:1977-06-01 00:00:00

  • Effects of a procaine preparation (Gerovital H3) in hospitalized geriatric patients: a double-blind study.

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    journal_title:Journal of the American Geriatrics Society

    pub_type: 临床试验,杂志文章

    doi:10.1111/j.1532-5415.1975.tb00326.x

    authors: Zwerling I,Plutchik R,Hotz M,Kling R,Rubin L,Grossman J,Siegel B

    更新日期:1975-08-01 00:00:00

  • Geriatric targeting criteria as predictors of survival and health care utilization.

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    journal_title:Journal of the American Geriatrics Society

    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.1996.tb01860.x

    authors: Satish S,Winograd CH,Chavez C,Bloch DA

    更新日期:1996-08-01 00:00:00

  • Elderly patients' knowledge of drug benefit caps and communication with providers about exceeding caps.

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    pub_type: 杂志文章

    doi:10.1111/j.1532-5415.2009.02244.x

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    更新日期:2003-12-01 00:00:00

  • Motor and Cognitive Trajectories Before Dementia: Results from Gait and Brain Study.

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    pub_type: 杂志文章

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    pub_type: 杂志文章,评审

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    doi:10.1111/j.1532-5415.1985.tb07121.x

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