Exploring the relationship between patient-relevant outcomes and Alzheimer’s disease progression assessed using the clinical dementia rating scale: a systematic literature review
BackgroundPeople with Alzheimer’s disease (AD) have difficulties in performing activities of daily living (ADLs) as the disease progresses, commonly experience neuropsychiatric symptoms (NPS), and often have comorbidities such as cardiovascular disease. These factors all contribute to a requirement...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-08-01
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| Series: | Frontiers in Neurology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fneur.2023.1208802/full |
| _version_ | 1797741330622840832 |
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| author | Jeffrey Cummings Julie Hviid Hahn-Pedersen Christian Stefan Eichinger Caroline Freeman Alice Clark Luis Rafael Solís Tarazona Krista Lanctôt Krista Lanctôt |
| author_facet | Jeffrey Cummings Julie Hviid Hahn-Pedersen Christian Stefan Eichinger Caroline Freeman Alice Clark Luis Rafael Solís Tarazona Krista Lanctôt Krista Lanctôt |
| author_sort | Jeffrey Cummings |
| collection | DOAJ |
| description | BackgroundPeople with Alzheimer’s disease (AD) have difficulties in performing activities of daily living (ADLs) as the disease progresses, commonly experience neuropsychiatric symptoms (NPS), and often have comorbidities such as cardiovascular disease. These factors all contribute to a requirement for care and considerable healthcare costs in AD. The Clinical Dementia Rating (CDR) scale is a widely used measure of dementia staging, but the correlations between scores on this scale and patient-/care partner-relevant outcomes have not been characterized fully. We conducted a systematic literature review to address this evidence gap.MethodsEmbase, MEDLINE, and the Cochrane Library were searched September 13, 2022, to identify published studies (no restriction by date or country) in populations with mild cognitive impairment due to AD or AD dementia. Studies of interest reported data on the relationships between CDR Global or CDR–Sum of Boxes (CDR-SB) scores and outcomes including NPS, comorbidities, ADLs, nursing home placement, healthcare costs, and resource use.ResultsOverall, 58 studies met the inclusion criteria (42 focusing on comorbidities, 14 on ADLs or dependence, five on nursing home placement, and six on economic outcomes). CDR/CDR-SB scores were correlated with the frequency of multiple NPS and with total scores on the Neuropsychiatric Inventory. For cardiovascular comorbidities, no single risk factor was consistently linked to AD progression. Increasing CDR/CDR-SB scores were correlated with decline in multiple different measures of ADLs and were also associated with nursing home placement and increasing costs of care.ConclusionNPS, ADLs, and costs of care are clearly linked to AD progression, as measured using CDR Global or CDR-SB scores, from the earliest stages of disease. This indicates that scores derived from the CDR are a meaningful way to describe the severity and burden of AD for patients and care partners across disease stages. |
| first_indexed | 2024-03-12T14:25:15Z |
| format | Article |
| id | doaj.art-665660399363400781a1f65acc5b782c |
| institution | Directory Open Access Journal |
| issn | 1664-2295 |
| language | English |
| last_indexed | 2024-03-12T14:25:15Z |
| publishDate | 2023-08-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Neurology |
| spelling | doaj.art-665660399363400781a1f65acc5b782c2023-08-18T07:44:23ZengFrontiers Media S.A.Frontiers in Neurology1664-22952023-08-011410.3389/fneur.2023.12088021208802Exploring the relationship between patient-relevant outcomes and Alzheimer’s disease progression assessed using the clinical dementia rating scale: a systematic literature reviewJeffrey Cummings0Julie Hviid Hahn-Pedersen1Christian Stefan Eichinger2Caroline Freeman3Alice Clark4Luis Rafael Solís Tarazona5Krista Lanctôt6Krista Lanctôt7Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV, United StatesNovo Nordisk A/S, Søborg, DenmarkOxford PharmaGenesis, Oxford, United KingdomOxford PharmaGenesis, Oxford, United KingdomNovo Nordisk A/S, Søborg, DenmarkNovo Nordisk A/S, Søborg, DenmarkHurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, CanadaDepartment of Psychiatry, University of Toronto, Toronto, ON, CanadaBackgroundPeople with Alzheimer’s disease (AD) have difficulties in performing activities of daily living (ADLs) as the disease progresses, commonly experience neuropsychiatric symptoms (NPS), and often have comorbidities such as cardiovascular disease. These factors all contribute to a requirement for care and considerable healthcare costs in AD. The Clinical Dementia Rating (CDR) scale is a widely used measure of dementia staging, but the correlations between scores on this scale and patient-/care partner-relevant outcomes have not been characterized fully. We conducted a systematic literature review to address this evidence gap.MethodsEmbase, MEDLINE, and the Cochrane Library were searched September 13, 2022, to identify published studies (no restriction by date or country) in populations with mild cognitive impairment due to AD or AD dementia. Studies of interest reported data on the relationships between CDR Global or CDR–Sum of Boxes (CDR-SB) scores and outcomes including NPS, comorbidities, ADLs, nursing home placement, healthcare costs, and resource use.ResultsOverall, 58 studies met the inclusion criteria (42 focusing on comorbidities, 14 on ADLs or dependence, five on nursing home placement, and six on economic outcomes). CDR/CDR-SB scores were correlated with the frequency of multiple NPS and with total scores on the Neuropsychiatric Inventory. For cardiovascular comorbidities, no single risk factor was consistently linked to AD progression. Increasing CDR/CDR-SB scores were correlated with decline in multiple different measures of ADLs and were also associated with nursing home placement and increasing costs of care.ConclusionNPS, ADLs, and costs of care are clearly linked to AD progression, as measured using CDR Global or CDR-SB scores, from the earliest stages of disease. This indicates that scores derived from the CDR are a meaningful way to describe the severity and burden of AD for patients and care partners across disease stages.https://www.frontiersin.org/articles/10.3389/fneur.2023.1208802/fullactivities of daily livingAlzheimer’s diseaseclinical dementia rating (CDR)comorbidityhealthcare costshealthcare resource use |
| spellingShingle | Jeffrey Cummings Julie Hviid Hahn-Pedersen Christian Stefan Eichinger Caroline Freeman Alice Clark Luis Rafael Solís Tarazona Krista Lanctôt Krista Lanctôt Exploring the relationship between patient-relevant outcomes and Alzheimer’s disease progression assessed using the clinical dementia rating scale: a systematic literature review Frontiers in Neurology activities of daily living Alzheimer’s disease clinical dementia rating (CDR) comorbidity healthcare costs healthcare resource use |
| title | Exploring the relationship between patient-relevant outcomes and Alzheimer’s disease progression assessed using the clinical dementia rating scale: a systematic literature review |
| title_full | Exploring the relationship between patient-relevant outcomes and Alzheimer’s disease progression assessed using the clinical dementia rating scale: a systematic literature review |
| title_fullStr | Exploring the relationship between patient-relevant outcomes and Alzheimer’s disease progression assessed using the clinical dementia rating scale: a systematic literature review |
| title_full_unstemmed | Exploring the relationship between patient-relevant outcomes and Alzheimer’s disease progression assessed using the clinical dementia rating scale: a systematic literature review |
| title_short | Exploring the relationship between patient-relevant outcomes and Alzheimer’s disease progression assessed using the clinical dementia rating scale: a systematic literature review |
| title_sort | exploring the relationship between patient relevant outcomes and alzheimer s disease progression assessed using the clinical dementia rating scale a systematic literature review |
| topic | activities of daily living Alzheimer’s disease clinical dementia rating (CDR) comorbidity healthcare costs healthcare resource use |
| url | https://www.frontiersin.org/articles/10.3389/fneur.2023.1208802/full |
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