Comorbidity and progression of late onset Alzheimer's disease: A systematic review

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Haaksma, Miriam L. (author)

Comorbidity and progression of late onset Alzheimer's disease : A systematic review

Article/chapterEnglish2017

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2017-05-04
Public Library of Science (PLoS),2017
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LIBRIS-ID:oai:DiVA.org:su-144847
https://urn.kb.se/resolve?urn=urn:nbn:se:su:diva-144847URI
https://doi.org/10.1371/journal.pone.0177044DOI
http://kipublications.ki.se/Default.aspx?queryparsed=id:135899045URI

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Language:English
Summary in:English

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BackgroundAlzheimer's disease is a neurodegenerative syndrome characterized by multiple dimensions including cognitive decline, decreased daily functioning and psychiatric symptoms. This systematic review aims to investigate the relation between somatic comorbidity burden and progression in late-onset Alzheimer's disease (LOAD).MethodsWe searched four databases for observational studies that examined cross-sectional or longitudinal associations of cognitive or functional or neuropsychiatric outcomes with comorbidity in individuals with LOAD. From the 7966 articles identified originally, 11 studies were included in this review. The Newcastle-Ottawa quality assessment was used. The large variation in progression measures, comorbidity indexes and study designs hampered the ability to perform a meta-analysis. This review was registered with PROSPERO under DIO: 10.15124/CRD42015027046.ResultsNine studies indicated that comorbidity burden was associated with deterioration in at least one of the three dimensions of LOAD examined. Seven out of ten studies investigating cognition found comorbidities to be related to decreased cognitive performance. Five out of the seven studies investigating daily functioning showed an association between comorbidity burden and decreased daily functioning. Neuropsychiatric symptoms (NPS) increased with increasing comorbidity burden in two out of three studies investigating NPS. Associations were predominantly found in studies analyzing the association cross-sectionally, in a time-varying manner or across short follow-up (<= 2 years). Rarely baseline comorbidity burden appeared to be associated with outcomes in studies analyzing progression over longer follow-up periods (>2 years).Conclusion This review provides evidence of an association between somatic comorbidities and multifaceted LOAD progression. Given that time-varying comorbidity burden, but much less so baseline comorbidity burden, was associated with the three dimensions prospectively, this relationship cannot be reduced to a simple cause-effect relation and is more likely to be dynamic. Therefore, both future studies and clinical practice may benefit from regarding comorbidity as a modifiable factor with a possibly fluctuating influence on LOAD.

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Vilela, Lara R. (author)
Marengoni, AlessandraKarolinska Institutet,Stockholms universitet,Centrum för forskning om äldre och åldrande (ARC), (tills m KI),University of Brescia, Italy (author)
Calderón-Larrañaga, AmaiaKarolinska Institutet,Stockholms universitet,Centrum för forskning om äldre och åldrande (ARC), (tills m KI),Miguel Servet University Hospital, Spain; University of Brescia, Italy; Carlos III Health Institute, Spain (author)
Leoutsakos, Jeannie-Marie S. (author)
Rikkert, Marcel G. M. Olde (author)
Melis, René J. F. (author)
Stockholms universitetCentrum för forskning om äldre och åldrande (ARC), (tills m KI) (creator_code:org_t)

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In:PLOS ONE: Public Library of Science (PLoS)12:51932-6203

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