Patterns of cognitive decline in presymptomatic Alzheimer disease - A prospective community study
Patterns of cognitive decline in presymptomatic Alzheimer disease - A prospective community study
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DOI：
10.1001/archpsyc.58.9.853
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发表时间：
2001-09-01
影响因子：
--
通讯作者：
Ganguli, M
中科院分区：
文献类型：
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作者：
Chen, PJ;Ratcliff, G;Ganguli, M
背景：在一项基于社区的前瞻性研究中，对症状前阿尔茨海默病(AD)患者的一系列认知指标随时间推移的具体模式进行了评估。方法：在一项基于社区的前瞻性研究中，共有551名个体完成了一系列标准认知测试，分别在结果前3.5年和1.5年(AD临床发病与持续非痴呆状态)。在15项认知测试中，68名患者(随后发展为症状性阿尔茨海默病)和483名对照组(仍为非痴呆者)的测试分数变化被转换为根据年龄、性别和教育调整后的z分数。结果：在无症状AD患者中，A、B两项测验中认知功能减退、词表延迟再认和第三次即刻学习测验中认知功能减退的比率最高，均大于3.0(P<；.01)。紧随其后的是单词列表对箔片的延迟识别和延迟回忆，建立阿尔茨海默病实践登记表的联盟，钟表绘制，波士顿命名测试和定向，比率在1.7到3.0之间(P<；0.05)。结论：在1.5年后临床表现为AD的个体中，随着时间的推移，记忆力和执行功能障碍的下降最大。这些发现可能有助于我们理解早期神经退化过程的潜在进化。它们强调了在疾病过程中早期执行功能障碍的重要性，并可能有助于AD的早期发现。
Background: Specific patterns of decline over time were evaluated across a spectrum of cognitive measures in presymptomatic Alzheimer disease (AD) within a community sample.Methods: A total of 551 individuals completed a battery of standard cognitive tests 3.5 and 1.5 years before outcome (clinical onset of AD vs continued nondemented status) within a prospective community-based study of AD. Test score changes in 68 cases (who subsequently developed symptomatic AD) and 483 controls (who remained nondemented) on each of 15 cognitive measures were transformed into z scores adjusted for age, sex, and education. A case-control rate ratio of the proportions of individuals who showed "cognitive decline" on each test was calculated, representing the relative magnitude of cognitive decline on each test in presymptomatic AD compared with normal aging.Results: Declines in Trail-Making Tests A and B and Word List delayed recognition of originals and third immediate learning trial had the highest rate ratios, larger than 3.0 (P < .01). These were followed by Word List delayed recognition of foils and delayed recall, Consortium to Establish a Registry for Alzheimer's Disease Praxis, Clock Drawing, the Boston Naming Test, and Orientation, with rate ratios between 1.7 and 3.0 (P < .05).Conclusions: Memory and executive dysfunction showed the greatest decline over time in individuals who would clinically manifest AD 1.5 years later. These findings might help us understand the underlying evolution of the early neurodegenerative process. They highlight the importance of executive dysfunction early in the disease process and might facilitate early detection of AD.