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Alzheimers Dement. 2017 May;13(5):592-597. doi: 10.1016/j.jalz.2017.01.007. Epub 2017 Feb 24.

Consensus-based recommendations for the management of rapid cognitive decline due to Alzheimer's disease.

Author information

1
Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China. Electronic address: jjp@ccmu.edu.cn.
2
Department of Neurology, Alzheimer's Disease Research Unit, McGill Centre for Studies in Aging, Montreal, Quebec, Canada. Electronic address: serge.gauthier@mcgill.ca.
3
McGill University Medical School, Montreal, Quebec, Canada.
4
Department of Neurology, Tianjin Huanhu Hospital, Tianjin, China.
5
Department of Neurology, Huadong Hospital Affiliated to Fudan University, Shanghai, China.
6
Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
7
Department of Neurology, China-Japan Friendship Hospital, Beijing, China.
8
Department of Neurology, Huashan Hospital Affiliated to Fudan University, Shanghai, China.
9
Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, China.
10
Department of Neurology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
11
West China Hospital, Sichuan University, Sichuan, China.
12
Department of Neurology, Zhongnan Hospital of Wuhan University, Hubei, China.

Abstract

INTRODUCTION:

Rapid cognitive decline (RCD) occurs in dementia due to Alzheimer's disease (AD).

METHODS:

Literature review, consensus meetings, and a retrospective chart review of patients with probable AD were conducted.

RESULTS:

Literature review showed that RCD definitions varied. Mini-Mental State Examination scores <20 at treatment onset, vascular risk factors, age <70 years at symptom onset, higher education levels, and early appearance of hallucinations, psychosis, or extrapyramidal symptoms are recognized RCD risk factors. Chart review showed that RCD (Mini-Mental State Examination score decline ≥3 points/year) is more common in moderate (43.2%) than in mild patients (20.1%; P < .001). Rapid and slow decliners had similar age, gender, and education levels at baseline.

DISCUSSION:

RCD is sufficiently common to interfere with randomized clinical trials. We propose a 6-month prerandomization determination of the decline rate or use of an RCD risk score to ensure balanced allocation among treatment groups.

KEYWORDS:

Alzheimer's disease; Definition; Dementia; Rapid cognitive decline; Risk factors

PMID:
28238739
DOI:
10.1016/j.jalz.2017.01.007
[Indexed for MEDLINE]

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