Predictive Utility Of The Pre-Progression Rate Using The Cognitive Subscale Of The Alzheimer’s Disease Assessment Scale
Kiewel, Nicole A 1984-
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Alzheimer’s disease (AD) has been described as having a variable presentation and clinical course. The AD literature has examined various patient characteristics and patterns of performance on neuropsychological measures that may be associated with rate of dementia progression. A review of these studies has resulted in largely equivocal findings, which can be attributed to variations in the methodology employed across the studies. Other studies have found that a calculated pre-progression rate reliably predicts rate of change in cognitive, functional, and global performance measures. The present study used mixed model regression to examine the predictive utility of a pre-progression rate estimate based on the cognitive subscale of the Alzheimer’s Disease Assessment Scale (ADAS-cog). After controlling for initial level of dementia severity and additional covariates, it was found that the ADAS-cog pre-progression rate did not predict rate of change on any of the measures that were examined (all p’s > 0.006). However, when patients were grouped according to ADAS-cog pre-progression rate, those groups differed significantly in rate of change on Mini Mental State Examination scores (p = .002). Thus, while previous research has shown that pre-progression rates can be of predictive utility, the findings from the present study revealed that the ADAS-cog is of limited value when it is used within this context.