Cognitive impairment and decline in cognitively normal older adults with high amyloid-β: A meta-analysis.
Cognitive impairment and decline in cognitively normal older adults with high amyloid-β: A meta-analysis.
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DOI：
10.1016/j.dadm.2016.09.002
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发表时间：
2017
期刊：
影响因子：
--
通讯作者：
Maruff P
中科院分区：
文献类型：
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作者：
Baker JE;Lim YY;Pietrzak RH;Hassenstab J;Snyder PJ;Masters CL;Maruff P
这项荟萃分析旨在描述淀粉样蛋白（Aβ）相关认知损害的性质和程度，以及认知正常（CN）老年人的衰退。检索MEDLINE奥维德2012年至2016年6月期间报告脑脊液或正电子发射断层扫描（PET）Aβ水平与CN老年人认知功能障碍（横断面）和衰退（纵向）之间关系的研究。神经心理学数据被分为情景记忆，执行功能，工作记忆，加工速度，视觉空间功能，语义记忆和整体认知领域。Aβ测量的类型、如何分析Aβ负荷、纳入控制变量以及用于排除受试者的临床标准被视为调节因素。随机效应模型用于分析，效应量表示为Cohen d。共有38项研究符合入选标准，提供了30份横断面（N = 5005）和14份纵向（N = 2584）样本。在整体认知方面观察到β相关的认知障碍（d = 0.32），视空间功能（d = 0.25），加工速度（d = 0.18），情景记忆和执行功能（两个d均= 0.15），观察到整体认知下降（d = 0.30）、语义记忆（d = 0.28）、视空间功能（d = 0.25）和情景记忆（d = 0.24）。Aβ相关损害受年龄、淀粉样蛋白测量、分析类型和纳入对照变量的调节，下降受淀粉样蛋白测量、分析类型、纳入对照变量和使用的排除标准的调节。高Aβ CN老年人表现出轻微的一般认知障碍，情节记忆、视觉空间功能、语义记忆和整体认知出现轻微至中度下降。
This meta-analysis aimed to characterize the nature and magnitude of amyloid (Aβ)-related cognitive impairment and decline in cognitively normal (CN) older individuals. MEDLINE Ovid was searched from 2012 to June 2016 for studies reporting relationships between cerebrospinal fluid or positron emission tomography (PET) Aβ levels and cognitive impairment (cross-sectional) and decline (longitudinal) in CN older adults. Neuropsychological data were classified into domains of episodic memory, executive function, working memory, processing speed, visuospatial function, semantic memory, and global cognition. Type of Aβ measure, how Aβ burden was analyzed, inclusion of control variables, and clinical criteria used to exclude participants, were considered as moderators. Random-effects models were used for analyses with effect sizes expressed as Cohen's d. A total of 38 studies met inclusion criteria contributing 30 cross-sectional (N = 5005) and 14 longitudinal (N = 2584) samples. Aβ-related cognitive impairment was observed for global cognition (d = 0.32), visuospatial function (d = 0.25), processing speed (d = 0.18), episodic memory, and executive function (both d's = 0.15), with decline observed for global cognition (d = 0.30), semantic memory (d = 0.28), visuospatial function (d = 0.25), and episodic memory (d = 0.24). Aβ-related impairment was moderated by age, amyloid measure, type of analysis, and inclusion of control variables and decline moderated by amyloid measure, type of analysis, inclusion of control variables, and exclusion criteria used. CN older adults with high Aβ show a small general cognitive impairment and small to moderate decline in episodic memory, visuospatial function, semantic memory, and global cognition.