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Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort
BACKGROUND: Modeling trajectories of decline can help describe the variability in progression of cognitive impairment in dementia. Better characterisation of these trajectories has significant implications for understanding disease progression, trial design and care planning. METHODS: Patients with...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5462385/ https://www.ncbi.nlm.nih.gov/pubmed/28591196 http://dx.doi.org/10.1371/journal.pone.0178562 |
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author | Baker, Elizabeth Iqbal, Ehtesham Johnston, Caroline Broadbent, Matthew Shetty, Hitesh Stewart, Robert Howard, Robert Newhouse, Stephen Khondoker, Mizanur Dobson, Richard J. B. |
author_facet | Baker, Elizabeth Iqbal, Ehtesham Johnston, Caroline Broadbent, Matthew Shetty, Hitesh Stewart, Robert Howard, Robert Newhouse, Stephen Khondoker, Mizanur Dobson, Richard J. B. |
author_sort | Baker, Elizabeth |
collection | PubMed |
description | BACKGROUND: Modeling trajectories of decline can help describe the variability in progression of cognitive impairment in dementia. Better characterisation of these trajectories has significant implications for understanding disease progression, trial design and care planning. METHODS: Patients with at least three Mini-mental State Examination (MMSE) scores recorded in the South London and Maudsley NHS Foundation Trust Electronic Health Records, UK were selected (N = 3441) to form a retrospective cohort. Trajectories of cognitive decline were identified through latent class growth analysis of longitudinal MMSE scores. Demographics, Health of Nation Outcome Scales and medications were compared across trajectories identified. RESULTS: Four of the six trajectories showed increased rate of decline with lower baseline MMSE. Two trajectories had similar initial MMSE scores but different rates of decline. In the faster declining trajectory of the two, a higher incidence of both behavioral problems and sertraline prescription were present. CONCLUSIONS: We find suggestive evidence for association of behavioral problems and sertraline prescription with rate of decline. Further work is needed to determine whether trajectories replicate in other datasets. |
format | Online Article Text |
id | pubmed-5462385 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-54623852017-06-22 Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort Baker, Elizabeth Iqbal, Ehtesham Johnston, Caroline Broadbent, Matthew Shetty, Hitesh Stewart, Robert Howard, Robert Newhouse, Stephen Khondoker, Mizanur Dobson, Richard J. B. PLoS One Research Article BACKGROUND: Modeling trajectories of decline can help describe the variability in progression of cognitive impairment in dementia. Better characterisation of these trajectories has significant implications for understanding disease progression, trial design and care planning. METHODS: Patients with at least three Mini-mental State Examination (MMSE) scores recorded in the South London and Maudsley NHS Foundation Trust Electronic Health Records, UK were selected (N = 3441) to form a retrospective cohort. Trajectories of cognitive decline were identified through latent class growth analysis of longitudinal MMSE scores. Demographics, Health of Nation Outcome Scales and medications were compared across trajectories identified. RESULTS: Four of the six trajectories showed increased rate of decline with lower baseline MMSE. Two trajectories had similar initial MMSE scores but different rates of decline. In the faster declining trajectory of the two, a higher incidence of both behavioral problems and sertraline prescription were present. CONCLUSIONS: We find suggestive evidence for association of behavioral problems and sertraline prescription with rate of decline. Further work is needed to determine whether trajectories replicate in other datasets. Public Library of Science 2017-06-07 /pmc/articles/PMC5462385/ /pubmed/28591196 http://dx.doi.org/10.1371/journal.pone.0178562 Text en © 2017 Baker et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Baker, Elizabeth Iqbal, Ehtesham Johnston, Caroline Broadbent, Matthew Shetty, Hitesh Stewart, Robert Howard, Robert Newhouse, Stephen Khondoker, Mizanur Dobson, Richard J. B. Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort |
title | Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort |
title_full | Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort |
title_fullStr | Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort |
title_full_unstemmed | Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort |
title_short | Trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort |
title_sort | trajectories of dementia-related cognitive decline in a large mental health records derived patient cohort |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5462385/ https://www.ncbi.nlm.nih.gov/pubmed/28591196 http://dx.doi.org/10.1371/journal.pone.0178562 |
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