The diagnosis and management of mild cognitive impairment: a clinical review.
The diagnosis and management of mild cognitive impairment: a clinical review.
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DOI：
10.1001/jama.2014.13806
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发表时间：
2014-12-17
影响因子：
120.7
通讯作者：
Levine, Deborah A.
中科院分区：
文献类型：
--
作者：
Langa, Kenneth M.;Levine, Deborah A.
认知能力下降是衰老过程中常见且令人畏惧的一个方面。轻度认知损害(MCI)被定义为认知功能下降连续体上的“症状性痴呆前期”，其特征是认知的客观损害不够严重，不足以在日常生活活动中需要帮助。提供有关MCI的诊断、治疗和预后的证据，并为医生提供一个以循证为基础的框架，以照顾老年MCI患者及其照顾者。我们在PubMed上搜索同行评议期刊和Cochrane图书馆数据库中的英文文章，直到2014年7月。还对检索到的文章的相关参考文献进行了评估。≥65岁的成年人患病率为10-20%；风险随着年龄的增长而增加，男性的风险似乎比女性更高。对于年长的MCI患者，临床医生应该考虑抑郁、多药联用和无法控制的心血管危险因素，所有这些都可能增加认知损害和其他负面后果的风险。目前，还没有药物被证明对MCI有效；治疗和干预的目的应该是减少心血管危险因素和预防中风。有氧运动、脑力活动和社交活动可能有助于降低认知能力进一步下降的风险。尽管与普通人群相比，MCI患者患痴呆症的风险更大，但目前风险估计(从5%到20%的年转换率)存在很大差异，这取决于所研究的人群。目前的研究旨在改善MCI的早期发现和治疗，特别是在发展为痴呆症的高风险患者。认知衰退和MCI对患者及其家人具有重要影响，并将要求初级保健临床医生在未来几十年随着老年人数量的增加而熟练地识别和管理这一常见疾病。目前的证据支持有氧运动、精神活动和心血管危险因素在MCI患者中的控制。
Cognitive decline is a common and feared aspect of aging. Mild Cognitive Impairment (MCI) is defined as the “symptomatic pre-dementia stage” on the continuum of cognitive decline, characterized by objective impairment in cognition that is not severe enough to require help with usual activities of daily living. To present evidence on the diagnosis,treatment, and prognosis of MCI, and to provide physicians with an evidence-based framework for caring for older MCI patients and their caregivers. We searched PubMed for English-language articles in peer-reviewed journals and the Cochrane Library database through July 2014. Relevant references from retrieved articles were also evaluated. The prevalence of MCI in adults aged ≥65 years is 10- 20%; risk increases with age, and men appear to be at higher risk than women. In older MCI patients, clinicians shouldconsider depression, polypharmacy, and uncontrolled cardiovascular risk factors, all of which may increase risk for cognitive impairment and other negative outcomes. Currently, no medications have proven effective for MCI; treatments and interventions should be aimed at reducing cardiovascular risk factors and prevention of stroke. Aerobic exercise, mental activity, and social engagement may help decrease risk of further cognitive decline. Although patients with MCI are at greater risk of developing dementia compared withthe general population, there is currently substantial variation in risk estimates (from <5% to 20% annual conversion rates), depending on the population studied.Current research is aimed at improving early detection and treatment of MCI, particularly in patients at high risk for progression to dementia. Cognitive decline and MCI have important implications for patients and their families, and will require that primary care clinicians be skilled in identifying and managing this common disorder as the number of older adults increases in coming decades. Current evidence supports aerobic exercise, mental activity, and cardiovascular risk factor control in patients with MCI.
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影响因子：
2.1
作者：
Barnes DE;Yaffe K;Belfor N;Jagust WJ;DeCarli C;Reed BR;Kramer JH
通讯作者：
Kramer JH
影响因子：
12.7
作者：
Ertel, Karen A.;Glymour, M. Maria;Berkman, Lisa F.
通讯作者：
Berkman, Lisa F.
DOI：
10.1177/1533317513481093
发表时间：
2013-05-01
影响因子：
3.4
作者：
Banningh, Liesbeth W. A. Joosten-Weyn;Vernooij-Dassen, Myrra J. F. J.;Kessels, Roy P. C.
通讯作者：
Kessels, Roy P. C.
DOI：
10.1016/j.jalz.2012.02.005
发表时间：
2013-07
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
Cai X;Campbell N;Khan B;Callahan C;Boustani M
通讯作者：
Boustani M
DOI：
10.1001/jama.2010.2008
发表时间：
2011-01-19
期刊：
JAMA
影响因子：
--
作者：
Clark CM;Schneider JA;Bedell BJ;Beach TG;Bilker WB;Mintun MA;Pontecorvo MJ;Hefti F;Carpenter AP;Flitter ML;Krautkramer MJ;Kung HF;Coleman RE;Doraiswamy PM;Fleisher AS;Sabbagh MN;Sadowsky CH;Reiman EP;Zehntner SP;Skovronsky DM;AV45-A07 Study Group
通讯作者：
AV45-A07 Study Group