RAPID progression: tool for screening aggressive course of disease (ACD) in Alzheimer dementia

J Med Assoc Thai. 2011 Apr;94(4):485-9.

Abstract

Objective: There is a need for a tool in clinical practice to assess the rate of progression of Alzheimer's disease (AD) patients. The present study purpose was to develop a tool for screening and progression assessing of AD patients with Aggressive Course of Disease (ACD).

Material and method: The Thai Realtime Assessment of Progression In Dementia (RAPID) was developed for screening AD patients with ACD through a caregiver questionnaire. At baseline and at a 6-month follow up visit, patients were tested by the Alzheimer's Disease Assessment Scale cognitive component (ADAS-Cog), while their caregivers completed the Thai RAPID. The tests were run by a team of psychiatrists in the Department of Psychiatry, Chulalongkorn Memorial Hospital.

Results: Fifty patients with cognitive impairment were recruited. As a screening tool, the Thai RAPID cut-off point of 9-points yielded a fair sensitivity and specificity (0.625 and 0.643, respectively) for rapid progression as defined by 4 point or greater deterioration in ADAS-Cog. As a progression assessment tool, a cutoff point of 3-points yielded a good sensitivity and specificity (0.875 and 0.810, respectively).

Conclusion: The present pilot study suggests that the Thai RAPID can be a valuable tool for the ACD screening and for progression assessment in AD patients.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Alzheimer Disease / diagnosis
  • Alzheimer Disease / physiopathology*
  • Alzheimer Disease / psychology
  • Area Under Curve
  • Caregivers / psychology
  • Cognition
  • Cognition Disorders / diagnosis*
  • Disease Progression*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests
  • Predictive Value of Tests
  • Prognosis
  • Psychiatric Status Rating Scales
  • Psychometrics / instrumentation*
  • ROC Curve
  • Sensitivity and Specificity
  • Severity of Illness Index
  • Surveys and Questionnaires*
  • Thailand