J Med Assoc Thai 2011; 94 (4):485

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RAPID Progression: Tool for Screening Aggressive Course of Disease (ACD) in Alzheimer Dementia
Thavichachart N Mail, Worakul P , Farlow MR

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.

Keywords:
ADAS-Cog, Aggressive course of disease, Alzheimer dementia, RAPID

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