Conceptualization of mild cognitive impairment: a review
Conceptualization of mild cognitive impairment: a review
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DOI：
10.1002/gps.1049
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发表时间：
2004-04-01
影响因子：
4
通讯作者：
Rockwood, K
中科院分区：
文献类型：
--
作者：
Davis, HS;Rockwood, K
几个因素促使人们重新关注与衰老有关的认知功能下降的概念，特别是在正常认知和痴呆之间的领域。我们回顾了被称为轻度认知障碍（MCI）的不断变化的概念，以努力确定最近的发展和突出的争议领域。方法用标准MEDLINE检索有关轻度认知障碍及其相关术语的相关英文出版物，并手工检索相关参考文献。结果许多情况导致认知障碍，不符合目前痴呆的标准。在这个被称为“认知障碍，无痴呆”（CIND）的异质性组中，存在与痴呆进展风险增加相关的疾病。尽管如此，后一种疾病的概念化仍然在不断变化，围绕着衰老、损伤与疾病之间的关系以及如何分类伴随功能损伤的假设存在差异。在MCI患者中，特别是其遗忘形式，许多人会发展为阿尔茨海默病（AD）。与基于临床的研究相反，基于人群的研究表明，在这种情况下，MCI的分类是不稳定的。除了遗忘性轻度认知障碍（AMCI）之外，还存在其他综合征，并可能发展为痴呆。例如，有血管性认知障碍但没有痴呆的可识别组显示出发展为血管性痴呆、阿尔茨海默病和混合性痴呆的更高风险。最近对痴呆症风险增加的患者进行的分析表明，这可以由熟练的人来完成，特别是对那些症状促使他们寻求医疗照顾的人。这些人是否真的患有早期阿尔茨海默病还有待确定。更狭义的MCI概况需要在CIND的人口背景下理解。版权所有：John Wiley Sons， Ltd. 2004
Background Several factors have prompted renewed interest in the concept of declines in cognitive function that occur in association with aging, in particular the area between normal cognition and dementia. We review the changing conceptualization of what has come to be known as mild cognitive impairment (MCI) in an effort to identify recent developments and highlight areas of controversy.Methods Standard MEDLINE search for relevant English-language publications on mild cognitive impairment and its associated terms, supplemented by hand searches of pertinent reference lists.Results Many conditions cause cognitive impairment which does not meet current criteria for dementia. Within this heterogenous group, termed 'Cognitive Impairment, No Dementia' (CIND), there are disorders associated with an increased risk of progression to dementia. Still, the conceptualization of these latter disorders remains in flux, with variability around assumptions about aging, the relationship between impairment and disease, and how concomitant functional impairment is classified. Amongst patients with MCI, especially its amnestic form, many will progress to Alzheimer's disease (AD). In contrast with clinic-based studies, where progression is more uniform, population-based studies suggest that the MCI classification is unstable in that context. In addition to Amnestic Mild Cognitive Impairment (AMCI), other syndromes exist and can progress to dementia. For example, an identifiable group with vascular cognitive impairment without dementia shows a higher risk of progression to vascular dementia, Alzheimer's disease and mixed dementia.Conclusions Recent attempts to profile patients at an increased risk of dementia suggest that this can be done in skilled hands, especially in people whose symptoms prompt them to seek medical attention. Whether these people actually have early AD remains to be determined. The more narrowly defined MCI profiles need to be understood in a population context of CIND. Copyright (C) 2004 John Wiley Sons, Ltd.