Peter Morin, Byron J Aguilar, Dan Berlowitz, Raymond Zhang, Amir Abbas Tahami Monfared, Quanwu Zhang, Weiming Xia
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引用次数: 0
摘要
目的：我们旨在研究在退伍军人事务医疗保健系统（VAHS）中接受基于神经认知测试评分的阿尔茨海默病（AD）分期评估的美国退伍军人的临床特征：以AD特定阶段的测试日期为索引日期，研究痴呆症的行为和心理症状（BPSD）以及与使用/工作和死亡时间相关的其他患者特征：我们通过退伍军人医疗服务系统的电子健康记录（EHR）确定了患有痴呆症并接受过神经认知评估的退伍军人：焦虑和睡眠障碍/紊乱是所有AD严重程度阶段中记录最多的BPSD。轻度AD退伍军人的磁共振成像、神经内科和精神病学咨询以及神经精神病学评估略高于晚期AD退伍军人。从首次AD严重程度记录到死亡的总体平均时间，轻度AD患者为5年，中度/重度AD患者为4年：结论：我们发现轻度、中度和重度 AD 患者在临床症状、医疗保健利用率和存活率方面存在差异。这些差异受到基于测试评分的 AD 分期退伍军人中 BPSDs 记录较少的限制。这些数据支持了我们的假设，即我们的队列代表了基于疾病严重程度的AD患者的一致亚组。
Clinical Characterization of Veterans With Alzheimer Disease by Disease Severity in the United States.
Purpose: We aimed to examine the clinical characteristics of US veterans who underwent neurocognitive test score-based assessments of Alzheimer disease (AD) stage in the Veterans Affairs Healthcare System (VAHS).
Methods: Test dates for specific stages of AD were referenced as index dates to study behavioral and psychological symptoms of dementia (BPSD) and other patient characteristics related to utilization/work-up and time to death.
Patients: We identified veterans with AD and neurocognitive evaluations using the VAHS Electronic Health Record (EHR).
Results: Anxiety and sleep disorders/disturbances were the most documented BPSDs across all AD severity stages. Magnetic resonance imaging, neurology and psychiatry consultations, and neuropsychiatric evaluations were slightly higher in veterans with mild AD than in those at later stages. The overall average time to death from the first AD severity record was 5 years for mild and 4 years for moderate/severe AD.
Conclusion: We found differences in clinical symptoms, healthcare utilization, and survival among the mild, moderate, and severe stages of AD. These differences are limited by the low documentation of BPSDs among veterans with test score-based AD stages. These data support the hypothesis that our cohorts represent coherent subgroups of patients with AD based on disease severity.
期刊介绍：
Alzheimer Disease & Associated Disorders is a peer-reviewed, multidisciplinary journal directed to an audience of clinicians and researchers, with primary emphasis on Alzheimer disease and associated disorders. The journal publishes original articles emphasizing research in humans including epidemiologic studies, clinical trials and experimental studies, studies of diagnosis and biomarkers, as well as research on the health of persons with dementia and their caregivers. The scientific portion of the journal is augmented by reviews of the current literature, concepts, conjectures, and hypotheses in dementia, brief reports, and letters to the editor.
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