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Detecting treatment effects with combinations of the ADAS-cog items in patients with mild and moderate Alzheimer's disease.
Int J Geriatr Psychiatry. 2012 Jan; 27(1):15-21.IJ

Abstract

OBJECTIVE

When complex cognitive functions are measured with multi-item scales like the Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-cog), it seems valuable information can be lost due to combination of the ADAS-cog items results into a total score. We hypothesized, that an analysis of the results of different ADAS-cog item combinations may reveal drug treatment effects in distinct cognitive domains and/or enhance the sensitivity to detect such treatment effects. Here, we present a novel approach called 'subsetting analysis' for assessment of drug treatment effects with multi-item scales, like the ADAS-cog.

METHODS

The subsetting approach is a mathematical algorithm designed to select and group scale items in a subset detecting drug treatment effects in a particular study population. The approach was applied in a post-hoc analysis of ADAS-cog results from two randomized, placebo-controlled and double-blind clinical trials with memantine in mild to moderate Alzheimer's disease (AD). The subsetting analysis of the ADAS-cog combined database aimed at selecting the scale items showing no worsening at study end compared to baseline due to memantine treatment in mild AD (Mini-Mental State Examination (MMSE >19)) patients.

RESULTS

Two ADAS-cog subsets were finally revealed by the analysis: a subset of five ADAS-cog items, identified as most sensitive to memantine effects in mild AD patients, and a subset of six ADAS-cog items shown to detect significant memantine effects in moderate AD patients.

CONCLUSION

The subsetting approach of analyzing ADAS-cog data is a powerful alternative for gaining information about drug effects on cognitive performance in mild and moderate AD patients.

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Publisher Full Text (DOI)

Authors+Show Affiliations

Ihl R
Geriatric Psychiatry Centre, Alexian Hospital Maria-Hilf, Krefeld and Department of Psychiatry and Psychotherapy, University of Duesseldorf, Germany. ralf.ihl@maria-hilf.de
Ferris S
No affiliation info available
Robert P
No affiliation info available
Winblad B
No affiliation info available
Gauthier S
No affiliation info available
Tennigkeit F
No affiliation info available

MeSH

AgedAged, 80 and overAlgorithmsAlzheimer DiseaseCognitionCognition DisordersDopamine AgentsFemaleHumansMaleMemantineMiddle AgedNeuropsychological TestsPsychiatric Status Rating Scales

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

21384431

Citation

Ihl, Ralf, et al. "Detecting Treatment Effects With Combinations of the ADAS-cog Items in Patients With Mild and Moderate Alzheimer's Disease." International Journal of Geriatric Psychiatry, vol. 27, no. 1, 2012, pp. 15-21.
Ihl R, Ferris S, Robert P, et al. Detecting treatment effects with combinations of the ADAS-cog items in patients with mild and moderate Alzheimer's disease. Int J Geriatr Psychiatry. 2012;27(1):15-21.
Ihl, R., Ferris, S., Robert, P., Winblad, B., Gauthier, S., & Tennigkeit, F. (2012). Detecting treatment effects with combinations of the ADAS-cog items in patients with mild and moderate Alzheimer's disease. International Journal of Geriatric Psychiatry, 27(1), 15-21. https://doi.org/10.1002/gps.2679
Ihl R, et al. Detecting Treatment Effects With Combinations of the ADAS-cog Items in Patients With Mild and Moderate Alzheimer's Disease. Int J Geriatr Psychiatry. 2012;27(1):15-21. PubMed PMID: 21384431.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Detecting treatment effects with combinations of the ADAS-cog items in patients with mild and moderate Alzheimer's disease. AU - Ihl,Ralf, AU - Ferris,Steven, AU - Robert,Philippe, AU - Winblad,Bengt, AU - Gauthier,Serge, AU - Tennigkeit,Frank, Y1 - 2011/03/08/ PY - 2010/08/13/received PY - 2010/11/29/accepted PY - 2011/3/9/entrez PY - 2011/3/9/pubmed PY - 2012/1/26/medline SP - 15 EP - 21 JF - International journal of geriatric psychiatry JO - Int J Geriatr Psychiatry VL - 27 IS - 1 N2 - OBJECTIVE: When complex cognitive functions are measured with multi-item scales like the Alzheimer's Disease Assessment Scale - cognitive subscale (ADAS-cog), it seems valuable information can be lost due to combination of the ADAS-cog items results into a total score. We hypothesized, that an analysis of the results of different ADAS-cog item combinations may reveal drug treatment effects in distinct cognitive domains and/or enhance the sensitivity to detect such treatment effects. Here, we present a novel approach called 'subsetting analysis' for assessment of drug treatment effects with multi-item scales, like the ADAS-cog. METHODS: The subsetting approach is a mathematical algorithm designed to select and group scale items in a subset detecting drug treatment effects in a particular study population. The approach was applied in a post-hoc analysis of ADAS-cog results from two randomized, placebo-controlled and double-blind clinical trials with memantine in mild to moderate Alzheimer's disease (AD). The subsetting analysis of the ADAS-cog combined database aimed at selecting the scale items showing no worsening at study end compared to baseline due to memantine treatment in mild AD (Mini-Mental State Examination (MMSE >19)) patients. RESULTS: Two ADAS-cog subsets were finally revealed by the analysis: a subset of five ADAS-cog items, identified as most sensitive to memantine effects in mild AD patients, and a subset of six ADAS-cog items shown to detect significant memantine effects in moderate AD patients. CONCLUSION: The subsetting approach of analyzing ADAS-cog data is a powerful alternative for gaining information about drug effects on cognitive performance in mild and moderate AD patients. SN - 1099-1166 UR - https://www.unboundmedicine.com/medline/citation/21384431/Detecting_treatment_effects_with_combinations_of_the_ADAS_cog_items_in_patients_with_mild_and_moderate_Alzheimer's_disease_ DB - PRIME DP - Unbound Medicine ER -