Profile of hippocampal volumes and stroke risk varies by neuropsychological definition of mild cognitive impairment.
Profile of hippocampal volumes and stroke risk varies by neuropsychological definition of mild cognitive impairment.
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DOI：
10.1017/s1355617709090638
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发表时间：
2009-11
期刊：
影响因子：
--
通讯作者：
Bondi MW
中科院分区：
文献类型：
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作者：
Jak AJ;Urban S;McCauley A;Bangen KJ;Delano-Wood L;Corey-Bloom J;Bondi MW
定义轻度认知障碍（MCI）的广泛概念和诊断方法导致了高度可变的患病率和进展率。我们试图研究是否双侧海马体积和脑血管危险因素的特点是两种不同的神经心理学定义的MCI亚型的个体也会有所不同。参与者是65名非痴呆，社区居住，老年人，年龄62-91岁，从一个更大的群体的个人参加了一项纵向研究的正常老化。一个全面的神经心理学定义的MCI，需要存在一个以上的认知领域受损的分数导致预期的解剖结果;海马体积显着较小的aMCI组相比，认知正常或nonamnestic MCI参与者。然而，一个典型的定义方案分类MCI的基础上存在的一个受损的分数在认知域并没有导致组间的海马差异。尽管中风风险变量与神经心理学表现之间的关系确实因诊断方法而异，但两种定义方案之间的总体中风风险因素没有差异。综合方法证明了中风风险和认知之间的关联，而典型方法则没有。使用更复杂的临床决策和诊断方法，包括全面的神经心理学评估技术的支持，这种收敛的神经心理学，神经病理学，中风风险的结果。
Wide-ranging conceptual and diagnostic approaches to defining mild cognitive impairment (MCI) have led to highly variable prevalence and progression rates. We sought to examine whether bilateral hippocampal volumes and cerebrovascular risk factors in individuals characterized by two different neuropsychological definitions of MCI subtypes would also differ. Participants were 65 nondemented, community-dwelling, older adults, ages 62–91 years, drawn from a larger group of individuals enrolled in a longitudinal study of normal aging. A comprehensive neuropsychological definition of MCI that required the presence of more than one impaired score in a cognitive domain resulted in expected anatomical results; hippocampal volumes were significantly smaller in the aMCI group as compared to cognitively normal or nonamnestic MCI participants. However, a typical definitional scheme for classifying MCI based only on the presence of one impaired score within a cognitive domain did not result in hippocampal differences between groups. Global stroke risk factors did not differ between the two definitional schemes, although the relationship between stroke risk variables and neuropsychological performance did vary by diagnostic approach. The comprehensive approach demonstrated associations between stroke risk and cognition, whereas the typical approach did not. Use of more sophisticated clinical decision-making and diagnostic approaches that incorporate comprehensive neuropsychological assessment techniques is supported by this convergence of neuropsychological, neuropathological, and stroke risk findings.