Follow-up Study of Treatment Adherence and Mortality in Alzheimer’s Disease

Introduction: Alzheimer’s disease (AD) has a heterogeneous course and there is a dearth of long-term follow-up data on treatment adherence and mortality in AD patients from India. Materials and Methods: A total of 99 AD patients consecutively evaluated in a geriatric clinic in a tertiary care hospital in South India were followed up either by direct evaluation in a geriatric clinic/home visit where feasible or by teleconsultation. This was a retrospective study with a cross-sectional assessment. All AD patients had baseline dementia work-up including neuroimaging and evaluations using Clinical Dementia Rating, Hindi Mental State Examination, Everyday Abilities Scale for India, and Neuropsychiatric Inventory were undertaken in the clinic. Results: It was found that 31 AD patients have died and three patients had wandered away in this cohort of 99 AD patients over a mean follow-up duration of 36.25 ± 15.25 months. Out of 72 patients on irregular follow-up, 30 patients (41.67%) died. 54.55% of patients with severe AD had died before follow-up as compared to 20.6% of people with mild and moderate AD. 56% of AD patients in our sample were on regular treatment with cholinesterase inhibitors. 40% of AD patients in this sample were on treatment with antipsychotics. Conclusion: Patients having irregular follow-up with medical facilities and having severe dementia at baseline have a significantly higher mortality rate as compared to patients having regular follow-up and having mild or moderate dementia at baseline. In this study it was found that patients having an irregular follow-up with a medical facility have a significantly higher mortality as compared to patients having a regular follow-up and hence a better accessibility to a medical care facility might improve the outcomes of AD patients.