Cumulative risks of developing extrapyramidal signs, psychosis, or myoclonus in the course of Alzheimer's disease
J. Y. Chen, Y. Stern, M. Sano and R. Mayeux
Department of Neurology, Columbia University, College of Physicians and Surgeons, New York, NY.
Cumulative risks of developing extrapyramidal signs, psychosis, and
myoclonus in the course of Alzheimer's disease (AD) were estimated in 72
patients with probable AD by the Kaplan-Meier survival method. The
cumulative risk functions were found to increase at different rates for
different signs as AD progressed. Comparisons of the cumulative risk
functions revealed that in the early stages of AD, extrapyramidal signs and
psychosis were more likely to develop than myoclonus. As AD progressed, the
risk of developing myoclonus became as great as that of developing the
other two signs. This study suggests that extrapyramidal signs, psychosis,
and myoclonus represent developmental features that mark the progression of
AD, rather than indicators of disease subtypes. The estimated cumulative
risk functions set a reasonable expectation for the timing and likelihood
of the emergence of the clinical signs. This, in turn, might aid in disease
prognosis because the biological bases of these signs have been established
and they have been shown to be predictive of other markers of disease
course.
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