Regional Variation on the Presentation of Alzheimer's Disease Patients in Memory Clinics within Europe: Data from the ICTUS Study

Citation

Hausner L, Frolich L, Gardette V, Reynish E, Ousset P, Andrieu S & Vellas B (2010) Regional Variation on the Presentation of Alzheimer's Disease Patients in Memory Clinics within Europe: Data from the ICTUS Study. Journal of Alzheimer's Disease, 21 (1), pp. 155-165. https://doi.org/10.3233/JAD-2010-091489

Abstract
This study set out to describe the variations within Europe for Alzheimer's disease (AD) patients with regards to clinical and socio-demographic features, co-morbidities, drug treatment, and psychosocial care. 1,379 mild to moderate AD subjects from the ICTUS study were clustered into four geographic regions according to WHO-classification of European countries. Northern patients showed the mildest severity of dementia (MMSE: 21.6 ± 3.7, p less than 0.001), received the lowest rate of concomitant psychotropic drug treatment (24.3%, p less than 0.001), and appeared to be healthier than patients in the rest of Europe. Western subjects were diagnosed earliest (0.5 ± 0.9 month, p less than 0.001), received the highest rate of formal care (45.0%, p less than 0.001), and had the highest rates of antidementia drug treatment (60.4%, p less than 0.001). Southern subjects had the shortest education period (5.6 ± 4.0, p less than 0.001), the most severe cognitive decline in MMSE: 19.8 ± 4.0, $p less than $ 0.001 and ADAScog: 24.2 9.6, p  less than 0.001 and received less antidementia drug treatment (37.6%; p less than 0.001), lived more often with their caregivers (74.4%, p less than 0.001), and had the highest caregiver burden (22.6 ± 15.2, p=0.049). Eastern AD subjects received more concomitant psychopharmacological drugs (68.6%, p less than 0.001), caregivers were more often different (18.6%, p less than 0.001) from spouse or offspring, caregiver burden was lowest (18.7 ± 12.4, p=0.049), nearly all subjects received only informal care (95.7%, p less than 0.001) and were affected more by co-morbidities. Overall, these data show differences in socio-demographic and clinical characteristics between AD patients from four European geographical regions. The presentation and management of AD in Europe appears to differ according to European regions and likely reflects differences in cultural factors and health politics.

Keywords
Alzheimer's disease; clinical course; cross-sectional data; dementia; drug usage; Europe; multi-centre study; observational study

Notes
On behalf of the ICTUS-EADC study group: B. Vellas, E. Reynish (Coordinating Centre Toulouse), P. Scheltens (Amsterdam), M. Boada (Barcelona), R.W. Jones (Bath), J.F. Dartigues (Bordeaux), G. Frisoni (Brescia), L. Spiru (Bucharest), S. Hasselbalch (Copenhagen), E. Agüera-Morales (Córdoba), G. Rodriguez (Genoa), A. Salva (Girona), J.P. Michel (Geneva), G. Stiens (Göttingen), E. Salmon (Liège), F. Pasquier (Lille), J.M. Ribera-Casado (Madrid), A. Burns (Manchester), L. Frölich (Mannheim), J. Touchon (Montpellier), Ph. Robert (Nice), M. Olde Rikkert (Nijmegen), P. Martinez-Lage (Pamplona), A.S. Rigaud (Paris), A. Cherubini (Perugia), B. Winblad/M. Eriksdotter Jönhagen (Stockholm), R. Bullock (Swindon), M. Costa-Tsolaki (Thessaloniki), V. Camus (Tours), A. Malick (Warwick)

Journal
Journal of Alzheimer's Disease: Volume 21, Issue 1