Impact of impairment in instrumental activities of daily living and mild cognitive impairment on time to incident dementia: results of the Leipzig Longitudinal Study of the Aged
Impact of impairment in instrumental activities of daily living and mild cognitive impairment on time to incident dementia: results of the Leipzig Longitudinal Study of the Aged
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DOI：
10.1017/s003329171000142x
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发表时间：
2011-05-01
影响因子：
6.9
通讯作者：
Riedel-Heller, S. G.
中科院分区：
文献类型：
--
作者：
Luck, T.;Luppa, M.;Riedel-Heller, S. G.
背景痴呆症的早期诊断需要了解相关的预测因素。本研究的目的是确定轻度认知功能障碍（MCI）和工具性日常生活活动能力（IADL）障碍对痴呆诊断时间的影响。数据来自莱比锡老年人纵向研究（LEILA 75+），这是一项针对75岁以上人群的研究。Kaplan-Meier生存分析用于确定发生痴呆的时间。应用考克斯比例风险模型来确定MCI和IADL损伤对痴呆发病前Lie时间的影响。在819名最初无痴呆症的受试者中，共有180名（22.0%）在研究结束时发展为痴呆症。平均痴呆发生时间为6.7年[95%置信区间（CI）6.5-6.9]。MCI合并IADL损害与更高的痴呆转化率、更短的临床表现诊断时间和更低的恢复认知正常的机会相关。发现遗忘型MCI合并IADL损害的患者发生痴呆的时间较短，风险最高。发生痴呆的平均时间为3.7年（95%CI 2.9-4.4），因此是没有MCI和IADL损伤的受试者的一半。MCI和IADL受损的受试者构成未来痴呆的高危人群。MCI和IADL损伤的考虑可能有助于改善痴呆的预测。
Background. Early diagnosis of dementia requires knowledge about associated predictors. The aim of this study was to determine the impact of mild cognitive impairment (MCI) and impairment in instrumental activities of daily living (IADL) on the time to an incident dementia diagnosis.Method. Data were derived from the Leipzig Longitudinal Study of the Aged (LEILA75+), a population-based study of individuals aged 75 years. Kaplan-Meier survival analysis was used to determine time to incident dementia. Cox proportional hazards models were applied to determine the impact of MCI and IADL impairment on Lie time to incident dementia.Results. In total, 180 (22.0%) of 819 initially dementia-free subjects developed dementia by the end of the study. Mean time to incident dementia was 6.7 years [95% confidence interval (CI) 6.5-6.9]. MCI combined with IADL impairment was associated with a higher conversion rate to dementia, a shorter time to clinically manifest diagnosis and a lower chance of reversibility to cognitive normal. The highest risk for a shorter time to incident dementia was found for amnestic MCI combined with IADL impairment. The mean time to incident dementia was 3.7 years (95% CI 2.9-4.4) and thus half as long as in subjects without MCI and IADL impairment.Conclusions. Subjects with MCI and IADL impairment constitute a high-risk population for future dementia. The consideration of both - MCI and IADL impairment - might help to improve the prediction of dementia.