RAPID Progression: Tool for Screening Aggressive Course of Disease (ACD) in Alzheimer Dementia
Nuntika Thavichachart MD, MSc*, Puangsoy Worakul MEd*, Martin R Farlow MD**
Affiliation : * Department of Psychiatry Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand ** Department of Neurology Indiana University School of Medicine, Indianapolis, Indiana, USA
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
