Research article summary (published 23 Sep 2001):

Measuring Alzheimer's disease progression with transition probabilities: estimates from CERAD.

Full Abstract

OBJECTIVES: To estimate annual transition probabilities (i.e., the likelihood that a patient will move from one disease stage to another in a given time period) for AD progression. Transition probabilities are estimated by disease stages (mild, moderate, severe) and settings of care (community, nursing home), accounting for differences in age, gender, and behavioral symptoms as well as the length of time a patient has been in a disease stage. Methods: Using data from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), the authors employed a modified survival analysis to estimate stage-to-stage and stage-to-nursing home transition probabilities. To account for individual variability, a Cox proportional hazards model was fit to the CERAD data to estimate hazard ratios for gender, age (50 to 64, 65 to 74, and more than 75 years), and level of behavioral symptoms (low/high, according to responses to the Behavioral Rating Scale for Dementia) for each of the key stage-to-stage and stage-to-nursing home transitions. RESULTS: The transition probabilities underscore the rapid progression of patients into more severe disease stages and into nursing homes and the differences among population subgroups. In general, male gender, age under 65, and high level of behavioral symptoms were associated with higher transition probabilities to more severe disease stages. Disease progression is roughly constant as a function of the time a patient has spent in a particular stage. CONCLUSIONS: Transition probabilities provide a useful means of characterizing AD progression. Economic models of interventions for AD should consider the varied course of progression for different population subgroups, particularly those defined by high levels of behavioral symptoms.

Author information

Author/s: Neumann, P J (PJ); Araki, S S (SS); Arcelus, A (A); Longo, A (A); Papadopoulos, G (G); Kosik, K S (KS); Kuntz, K M (KM); Bhattacharjya, A (A);

Affiliation: Program on the Economic Evaluation of Medical Technology, Center for Risk Analysis, Harvard School of Public Health, Boston, MA 02115, USA. pneumann(-atsign-)hsph.harvard.edu

Journal and publication information

Publication Type: Journal Article; Research Support, Non-U.S. Gov't

Journal: Neurology (Neurology), published in United States. (Language: eng)

Reference: 2001-Sep; vol 57 (issue 6) : pp 957-64

Dates: Created 2001/09/25; Completed 2001/10/18; Revised 2006/11/15;

PMID: 11571317, status: MEDLINE (last retrieved date: 2/18/2009)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

Comments and Corrections

CommentIn: Neurology. 2001 Sep 25;57(6):943-4. (PMID: 11571313)

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.

MeSH headings (categories)

This article was linked to the MeSH Headings (categories) shown below.

Aged Aged, 80 and over Alzheimer Disease - classification; diagnosis; economics; epidemiology Disease Progression Female Homes for the Aged - economics Humans

Male Models, Economic Nursing Homes - economics Probability Proportional Hazards Models Registries - statistics & numerical data United States - epidemiology

Note: Bold headings indicate primary MeSH headings or qualifiers.

Related articles

These are the most related articles currently in our database:

• A multi-center blinded prospective study of urine neural thread protein measurements in patients with suspected Alzheimer's disease. 27 Sep 2006
• Predictive validity of neuropsychiatric subgroups on nursing home placement and survival in patients with Alzheimer disease. 30 Mar 2007
• Grip strength and the risk of incident Alzheimer's disease. 6 Oct 2007
• Behavioral and psychological symptoms of dementia in relation to level of cognitive impairment. 15 Apr 2008
• Education and Alzheimer disease without dementia: support for the cognitive reserve hypothesis. 14 Jan 2007
• Depression is associated with low plasma Abeta42 independently of cardiovascular disease in the homebound elderly. 30 May 2007
• An estimate of the prevalence of dementia among residents of long-term care geriatric institutions in the Jerusalem area. 29 Nov 2006
• Quantitative EEG findings in different stages of Alzheimer's disease. 29 Sep 2006
• Interlaboratory comparison of assessments of Alzheimer disease-related lesions: a study of the BrainNet Europe Consortium. 30 Jul 2006
• Fast cognitive decline at the time of dementia diagnosis: a major prognostic factor for survival in the community. 24 Apr 2007

See 100+ related articles.

Related Article Map

Legend: - FREE Full text Article. - Abstract only. - Title only. More help.

See a larger map of 100+ related articles.