Lapses in treatment or switching from one drug to another are rec

Lapses in treatment or switching from one drug to another are recorded. To reconcile antidementia drug exposure that occurred by virtue Ixazomib clinical trial of participation in a clinical research trial, we obtained the blinding data from those trials. No attempt was made to quantify the dose of medication or distinguish between drug regimens (for example, monotherapy or combination therapy with a cholinesterase inhibitor and memantine or use of any particular antipsychotic drug). Covariates Baseline variables were age, sex, race (white versus non-white), disease severity based upon Mini-Mental Status Examination (MMSE) score [19], years of formal education, medical comorbidites present in the past or currently active (diabetes, hypertension, hyperlipidemia, coronary disease, or cerebrovascular disease), and the pre-progression rate (PPR) [20], a calculated rate of cognitive decline prior to enrollment.

Patients with AD progress at intrinsically different rates, but little is known about factors that explain the variance. The PPR has prognostic value in classifying patients as rapid, intermediate, or slow progressors [20]. It is calculated at the initial clinic visit by means of the following formula: (the MMSE score out of 30 – initial MMSE score) / physician’s estimate of symptom duration (in years). Patients are stratified into slow (decline of 0 to 1.9 MMSE points per year), intermediate (decline of 2 to 4.9 MMSE points per year), or rapid (decline of at least 5 MMSE points per year) progressors.

We used a time-dependent mechanism to assess the impact of changes in cognition measured by the MMSE, basic activities of daily living measured by the Physical Self-Maintenance Scale (PSMS) [21], time-dependent changes in the Persistency Index (PI) or exposure to antipsychotic and antidementia drugs, and the development of psychotic symptoms (hallucinations and delusions) on time to death. The PI is calculated as the total duration of drug treatment (in years) divided by the total duration of symptoms (in years) extended to the censoring date or death [10]. Only a few participants developed medical comorbidities following baseline evaluation and so it was not possible to use a time-dependent mechanism to assess this variable. Statistical analysis Time to death for all-cause mortality was evaluated by multivariable Cox proportional hazard regression analysis with stepwise selection process to evaluate baseline and time-dependent change in covariates or risk factors.

All analyses were performed by using SAS version 9.2 (SAS Institute Inc., Cary, NC, USA). Logistic regression was applied to determine the covariates significantly associated Anacetrapib with survival (determined by a P value of research use only not more than 0.05), and hazard ratios for significant covariates were determined in the final model. Results Median survival time among the 641 patients with probable AD following the onset of symptoms was 11.3 years (CI = 10.4 to 11.8), and there were 352 deaths.

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