Abstract
Objective: To investigate the relationship between MMSE and ADAS-cog.
Background: There is a need to understand how the burden of cognitive impairment changes with severity. This will help target interventions to the most appropriate patients. Across western regions MMSE is the most widely used severity assessment in real world clinical practice, however many RCTs make use of the ADAS-cog. In order to understand the potential impact of new interventions in the real world we need to understand the comparability of these two severity assessments, before burden can be assessed.
Design/Methods: Data were drawn from the Adelphi ADAS-cog Study, a retrospective cross-sectional study of cognitively impaired patients in France, Germany, Italy, Spain, U.K., and the U.S. Patients with recently assessed ADAS-cog (most recent in last six months and second most recent in last 24 months), and recently assessed MMSE (within one month of ADAS-cog assessments) were identified. Generalized estimating equation regression with Gaussian errors, identity link, and exchangeable correlation was used to model the relationship between MMSE and ADAS-cog, with ADAS-cog as dependent variable and MMSE as independent variable. Analysis was repeated utilizing restricted cubic splines of MMSE, to allow for a non-linear relationship between ADAS-cog and MMSE. R-squared was calculated for recorded ADAS-cog and regression-predicted ADAS-cog.
Results: Analysis was conducted on 813 patients and 1520 paired MMSE/ADAS-cog assessments. There was a significant association between MMSE and ADAS-cog (p<0.001, R-squared =0.561). A decrease of one in MMSE was associated with an increase of 2.01 (95% CI [1.90, 2.11]) in ADAS-cog. Cubic spline terms for MMSE were not significant (p=0.298) indicating a linear relationship.
Conclusions: There is a strong association between the MMSE and ADAS-cog, indicating that where disease burden has been measured for one of these severity assessments, similar conclusions may be drawn for the other.
Disclosure: Dr. Khandker has nothing to disclose. Dr. Black has nothing to disclose. Dr. Pike has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Employees of Adelphi Real World and paid consultants for Biogen. Dr. Husbands has nothing to disclose. Dr. Ambegaonkar has nothing to disclose. Dr. Jones has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with employee of Adelphi Real World and paid consultants for Biogen.
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