Prognosis of Alzheimer's disease: The Rotterdam study

The aim of this study was to construct a prognostic model to predict the pr ogression of Alzheimer's disease (AD). Prevalent and incident cases with AD came from the Rotterdam Study, a population-based prospective cohort study of persons aged 55 years and older, including those living in institutions . Rate of cognitive decline, as measured by the Mini Mental State Examinati on (MMSE score), was predicted by a random effects model. Risk of instituti onalization and death were estimated with polytomous logistic regression an alysis. At baseline, 306 subjects were diagnosed with prevalent AD and had complete data on living conditions and cognitive function, After a mean fol low-up of 2.1 years, 95 subjects with incident AD had been diagnosed. Preva lent patients showed a slower decline in cognitive function than incident p atients (p = 0.004). For prevalent and incident AD patients, high age and l ow cognitive performance were the strongest predictors for institutionaliza tion and death. These prognostic risk functions can provide information on the decline of Alzheimer patients and might be used to better evaluate the effect of treatments for AD. Copyright (C) 2001 S. Karger AG, Basel.