An analysis of systems of classifying mild cognitive impairment in older people
An analysis of systems of classifying mild cognitive impairment in older people
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DOI：
10.1046/j.1440-1614.2002.00972.x
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发表时间：
2002-02-01
影响因子：
4.6
通讯作者：
Maruff, P
中科院分区：
文献类型：
--
作者：
Collie, A;Maruff, P
目的：在过去的二十年中，已经开发了许多用于老年人认知和行为异常分类的系统，以便可以在疾病临床表现之前识别出患有神经退行性疾病（特别是阿尔茨海默病）的高危个体。本文批判性地考察了许多此类分类系统的纳入和排除标准，以确定标准的变化可能对轻度认知障碍老年人报告的临床、行为和神经影像学结果的影响。方法：定性回顾描述轻度认知障碍分类系统的文献，以及老年轻度认知障碍患者的临床、行为、神经影像学和遗传学研究的结果。结果：这些分类系统的排除和纳入标准差异很大，评估这些系统有效性的研究设计也是如此。个体排除/纳入标准的微小变化可能导致对轻度认知障碍患病率和临床结果的估计发生重大变化，而不适当的实验设计可能会混淆对结果的解释。结论：由于这些因素，对其他方面健康的老年人轻度认知障碍的结果尚未得到准确和一致的估计。在此文献分析的基础上，提出了未来可以对轻度认知障碍进行准确分类的最佳标准。
Objective: Over the past two decades, a number of systems have been developed for the classification of cognitive and behavioural abnormalities in older people, in order that individuals at high risk of developing neurodegenerative disease, particularly Alzheimer's disease, may be identified well before the disease manifests clinically. This article critically examines the inclusion and exclusion criteria of a number of such classification systems, to determine the effect that variations in criterion may have on clinical, behavioural and neuroimaging outcomes reported from older people with mild cognitive impairment.Method: Qualitative review of the literature describing systems of classifying mild cognitive impairment, and outcomes from clinical, behavioural, neuroimaging and genetic studies of older people with mild cognitive impairment.Results: The exclusion and inclusion criteria for these classification systems vary markedly, as do the design of studies upon which the validity of these systems has been assessed. Minor changes to individual exclusion/inclusion criterion may result in substantial changes to estimates of the prevalence and clinical outcome of mild cognitive impairment, while inadequate experimental design may act to confound the interpretation of results.Conclusions: As a result of these factors, accurate and consistent estimates of the outcome of mild cognitive impairments in otherwise healthy older people are yet to be obtained. On the basis of this analysis of the literature, optimal criteria via which accurate classifications of mild cognitive impairment can be made in future are proposed.