The source of cognitive complaints predicts diagnostic conversion differentially among nondemented older adults.
The source of cognitive complaints predicts diagnostic conversion differentially among nondemented older adults.
复制标题
DOI：
10.1016/j.jalz.2013.02.007
复制
发表时间：
2014-05
期刊：
影响因子：
--
通讯作者：
Jefferson AL
中科院分区：
文献类型：
--
作者：
Gifford KA;Liu D;Lu Z;Tripodis Y;Cantwell NG;Palmisano J;Kowall N;Jefferson AL
本研究的目的是比较不同来源的认知抱怨（即，主观和知情者）预测非痴呆老年人诊断转换。来自国家阿尔茨海默病协调中心的参与者具有正常认知（NC; n=4414，73±8岁，69%女性）或轻度认知障碍（MCI; n=1843，74±8岁，52%女性）的基线诊断。将基线认知主诉（无主诉、仅自我、仅告知者或自我和告知者）与诊断结果（逆转、稳定或转换）进行多项logistic回归。随访时，14%的NC参与者转化为MCI/痴呆（3.5±1.8年），41%的MCI参与者转化为痴呆（3.0±1.6年）。在NC参与者中，与无投诉相比，仅自我投诉（OR=2.1; 99%CI=1.5-2.9，p<0.001），仅举报投诉（OR=2.2; 99%CI=1.2-3.9，p<0.001）以及自我和举报投诉（OR=4.2; 99%CI=2.9-6.0，p<0.001）与诊断转换相关。在MCI参与者中-与无投诉相比，仅举报投诉（OR，2.2; 99%CI，1.2-4.3，P = .002），以及自我和举报投诉（OR，2.9; 99%CI，1.8-4.8; P < .001）-与转换相关。认知主诉与非痴呆老年人的转换有关。投诉从这两个（即相互投诉）来源是最预测的诊断结果，其次是举报投诉，强调需要获得举报佐证，以提高预后和区分潜在的病理过程从正常的认知老化。自我抱怨与诊断结果不一致。
The objective of this study was to compare whether different sources of cognitive complaint (i.e., subjective and informant) predict diagnostic conversion in nondemented older adults. Participants from the National Alzheimer’s Coordinating Center had a baseline diagnosis of normal cognition (NC; n=4414, 73±8 years, 69% female) or mild cognitive impairment (MCI; n=1843, 74±8 years, 52% female). Multinomial logistic regression related baseline cognitive complaint (no-complaint, self only, informant only, or both self-and informant) to diagnostic outcome (reversion, stable or conversion). At follow-up, 14% of NC participants converted to MCI/dementia (3.5±1.8 years), and 41% of MCI participants converted to dementia (3.0±1.6 years). Among NC participants, self-complaint only (OR=2.1; 99%CI=1.5–2.9, p<0.001), informant-complaint only (OR=2.2; 99%CI=1.2–3.9, p<0.001), and both self-and informant-complaint (OR=4.2; 99%CI=2.9–6.0, p<0.001) were associated with diagnostic conversion, compared to no-complaint. Among participants with MCI—compared with no-complaint, informant-complaint only (OR, 2.2; 99% CI, 1.2–4.3, P = .002), and both self- and informant-complaint (OR, 2.9; 99% CI, 1.8–4.8; P < .001)—were associated with conversion. Cognitive complaints are related to conversion among non-demented older adults. Complaint from both (i.e. mutual complaint) sources was most predictive of diagnostic outcome, followed by informant complaint, highlighting the need for obtaining informant corroboration to enhance prognosis and distinguish underlying pathological processes from normal cognitive aging. Self-complaint was inconsistently related to diagnostic outcome.
登录
查看更多内容
影响因子：
--
作者：
Laurin, D;Verreault, R;Rockwood, K
通讯作者：
Rockwood, K
DOI：
10.1093/geronb/58.2.s74
发表时间：
2003-03-01
影响因子：
6.2
作者：
Menec, VH
通讯作者：
Menec, VH
DOI：
10.1016/j.jalz.2011.03.008
发表时间：
2011-05
期刊：
Alzheimer's & dementia : the journal of the Alzheimer's Association
影响因子：
--
作者：
Albert MS;DeKosky ST;Dickson D;Dubois B;Feldman HH;Fox NC;Gamst A;Holtzman DM;Jagust WJ;Petersen RC;Snyder PJ;Carrillo MC;Thies B;Phelps CH
通讯作者：
Phelps CH
DOI：
10.1007/s00259-003-1194-1
发表时间：
2003-08-01
影响因子：
9.1
作者：
Drzezga, A;Lautenschlager, N;Kurz, A
通讯作者：
Kurz, A
影响因子：
9.9
作者：
MCKHANN, G;DRACHMAN, D;STADLAN, EM
通讯作者：
STADLAN, EM