Mild cognitive impairment -: Long-term course of four clinical subtypes
Mild cognitive impairment -: Long-term course of four clinical subtypes
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DOI：
10.1212/01.wnl.0000249117.23318.e1
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发表时间：
2006-12-26
期刊：
影响因子：
9.9
通讯作者：
Riedel-Heller, S. G.
中科院分区：
文献类型：
--
作者：
Busse, A.;Hensel, A.;Riedel-Heller, S. G.
目的：实证验证轻度认知障碍（MCI）的扩展概念，该概念区分了四种临床亚型-遗忘型MCI -单域、遗忘型MCI -多域、非遗忘型MCI单域和非遗忘型MCI -多域-并研究了这四种临床亚型的患病率、病程和预后。方法：我们研究了980名参加莱比锡老年人纵向研究（LEILA 75+）的75岁及以上无痴呆个体的社区样本。所有参与者在6年的观察基础上进行了神经心理测试。四种临床MCI亚型的诊断是根据Petersen等人（2001）的原始标准和稍作修改的标准进行的（截断值分别为1.0 SD和1.5 SD）。对所有亚型的结局类型（痴呆、死亡、改善、稳定诊断、不稳定诊断）进行了完整的描述。确定了稳定MCI对痴呆发病的相对预测能力。结果：MCI -单域比MCI -多域发生频率高，非遗忘型MCI与遗忘型MCI发生频率相同。“MCI修正，1.0 SD”标准对痴呆的发展具有最高的相对预测能力（敏感性= 74%，特异性= 73%）。在所有MCI亚型中，阿尔茨海默病（AD）是最常见的痴呆类型。患有非遗忘型MCI -多域的参与者更有可能发展为非AD痴呆。结论：人们一直认为，每一种轻度认知障碍亚型都与一种特定类型痴呆的风险增加有关。我们只能部分同意这一点。
Objective: To empirically validate the expanded concept of mild cognitive impairment (MCI), which differentiates between four clinical subtypes - amnestic MCI - single domain, amnestic MCI - multiple domains, nonamnestic MCI single domain, and nonamnestic MCI - multiple domains - and to examine the prevalence, course, and outcome of these four clinical MCI subtypes. Methods: We studied a community sample of 980 dementia- free individuals aged 75 years or older who participated in the Leipzig Longitudinal Study of the Aged (LEILA 75+). All participants were examined by neuropsychological testing based on 6 years of observation. The diagnoses of the four clinical MCI subtypes were made according to the original and to slightly modified criteria by Petersen et al. (2001) (both with a cutoff of 1.0 SD and with a cutoff of 1.5 SD). The complete range of outcome types (dementia, death, improvement, stable diagnosis, unstable diagnosis) was described for all subtypes. The relative predictive power of stable MCI for dementia onset was determined. Results: MCI - single domain is more frequent than MCI - multiple domains, and the nonamnestic MCI type is as frequent as the amnestic MCI type. The "MCI modified, 1.0 SD" criteria have the highest relative predictive power for the development of dementia (sensitivity = 74%, specificity = 73%). Alzheimer disease (AD) was the most common type of dementia at follow- up in all but one MCI subtype. Participants with nonamnestic MCI - multiple domains were more likely to progress to a non- AD dementia. Conclusions: It has been assumed that each MCI subtype is associated with an increased risk for a particular type of dementia. We can only partially agree with this.