Changes in the characteristics of Alzheimer patients at the first visit in centers for dementia: a 10-year follow-up study

Background and aims: The Cronos project is an observational study on the Alzheimer's disease (AD), created by Italy's Ministry of Public Health in 2000. The aim of our study is to evaluate if clinical characteristics at the first visit of patients recruited in UVA (Alzheimer Evaluation Unit) have changed from September 2000 to December 2009, and to investigate the possible reasons for this evolution. Methods: 1532 consecutive patients have been enrolled in two different UVAs (September, 2000 through to December, 2009) in a retrospective, descriptive study, employing medical record as the primary source of data. Results: Patients' age at the first visit was not different throughout the period of observation. No differences have been observed with regards to education and functional characteristics too. However, a reduction of severity of cognitive impairment has been found during the period of evaluation; patients consecutively recruited in the first years were more cognitively, functionally, and psycho behaviourally compromised than patients recruited in the following years observed. Conclusions: Data show a change of the characteristics at the first visit in patients affected by cognitive deterioration during the years of observation. This finding indicates new clinical needs of patients, requiring a change in pharmacological treatments and in general of the clinical approach.