PDF(Pubmed)
Abstract：
UNASSIGNED: We aimed to examine the factors associated with treatment outcomes in patients with Alzheimer\'s disease (AD) after 1 year of acetylcholinesterase inhibitors (AChEI) treatment.
UNASSIGNED: We obtained electronic medical records from a medical center in Southern Taiwan between January 2015 and September 2021. Participants aged ≥60 who were newly diagnosed with AD and had been prescribed AChEIs were included. Cognitive assessments were performed before the AChEIs were prescribed and at the 1 year follow-up. Cognition progressors were defined as a Mini-Mental State Examination decline of >3 or a Clinical Dementia Rating decline of ≥1 after 1 year of AChEI treatment. The relationship between the baseline characteristics and cognitive status after follow-up was investigated using logistic regression analysis after adjusting for potential confounders.
UNASSIGNED: A total of 1370 patients were included in our study (mean age, 79.86 ± 8.14 years). After adjustment, the body mass index (BMI) was found to be significantly lower in the progressor group [adjusted odds ratio (AOR): 0.970, 95% confidence intervals (95% CIs): 0.943 to 0.997, P = 0.033]. The usage of antipsychotics was significantly higher in the progressor group (AOR: 1.599, 95% CIs: 1.202 to 2.202, P = 0.001). The usage of benzodiazepine receptor agonists also tended to be significantly higher in the progressor group (AOR: 1.290, 95% CIs: 0.996 to 1.697, p = 0.054).
UNASSIGNED: These results suggest that patients with AD who receive 1 year of AChEI treatment and have a lower BMI or concurrent treatment with antipsychotics and benzodiazepine receptor agonists are more likely to suffer from cognitive decline.
UNASSIGNED: We obtained electronic medical records from a medical center in Southern Taiwan between January 2015 and September 2021. Participants aged ≥60 who were newly diagnosed with AD and had been prescribed AChEIs were included. Cognitive assessments were performed before the AChEIs were prescribed and at the 1 year follow-up. Cognition progressors were defined as a Mini-Mental State Examination decline of >3 or a Clinical Dementia Rating decline of ≥1 after 1 year of AChEI treatment. The relationship between the baseline characteristics and cognitive status after follow-up was investigated using logistic regression analysis after adjusting for potential confounders.
UNASSIGNED: A total of 1370 patients were included in our study (mean age, 79.86 ± 8.14 years). After adjustment, the body mass index (BMI) was found to be significantly lower in the progressor group [adjusted odds ratio (AOR): 0.970, 95% confidence intervals (95% CIs): 0.943 to 0.997, P = 0.033]. The usage of antipsychotics was significantly higher in the progressor group (AOR: 1.599, 95% CIs: 1.202 to 2.202, P = 0.001). The usage of benzodiazepine receptor agonists also tended to be significantly higher in the progressor group (AOR: 1.290, 95% CIs: 0.996 to 1.697, p = 0.054).
UNASSIGNED: These results suggest that patients with AD who receive 1 year of AChEI treatment and have a lower BMI or concurrent treatment with antipsychotics and benzodiazepine receptor agonists are more likely to suffer from cognitive decline.
摘要：
■我们旨在研究乙酰胆碱酯酶抑制剂（AChEI）治疗1年后与阿尔茨海默病（AD）患者治疗结果相关的因素。
■我们在2015年1月至2021年9月期间从台湾南部的一家医疗中心获得了电子病历。纳入新诊断为AD并已处方AChEI的年龄≥60岁的参与者。在规定AChEI之前和1年随访时进行认知评估。认知进展者定义为AChEI治疗1年后迷你精神状态检查下降>3或临床痴呆评分下降≥1。在校正潜在的混杂因素后，使用逻辑回归分析研究基线特征与随访后认知状态之间的关系。
■本研究共纳入1370例患者(平均年龄，79.86±8.14年）。调整后,进展组的体重指数(BMI)显著降低[校正比值比(AOR):0.970,95%置信区间(95%CIs):0.943~0.997,P=0.033].进展组抗精神病药的使用率明显较高（AOR：1.599，95％CIs：1.202至2.202，P=0.001）。苯二氮卓受体激动剂的使用率在进展者组中也倾向于显着更高（AOR：1.290，95％CIs：0.996至1.697，p=0.054）。
■这些结果表明，接受1年AChEI治疗且BMI较低或同时使用抗精神病药和苯二氮卓受体激动剂治疗的AD患者更容易出现认知功能下降。
■我们在2015年1月至2021年9月期间从台湾南部的一家医疗中心获得了电子病历。纳入新诊断为AD并已处方AChEI的年龄≥60岁的参与者。在规定AChEI之前和1年随访时进行认知评估。认知进展者定义为AChEI治疗1年后迷你精神状态检查下降>3或临床痴呆评分下降≥1。在校正潜在的混杂因素后，使用逻辑回归分析研究基线特征与随访后认知状态之间的关系。
■本研究共纳入1370例患者(平均年龄，79.86±8.14年）。调整后,进展组的体重指数(BMI)显著降低[校正比值比(AOR):0.970,95%置信区间(95%CIs):0.943~0.997,P=0.033].进展组抗精神病药的使用率明显较高（AOR：1.599，95％CIs：1.202至2.202，P=0.001）。苯二氮卓受体激动剂的使用率在进展者组中也倾向于显着更高（AOR：1.290，95％CIs：0.996至1.697，p=0.054）。
■这些结果表明，接受1年AChEI治疗且BMI较低或同时使用抗精神病药和苯二氮卓受体激动剂治疗的AD患者更容易出现认知功能下降。
