Trajectories of decline on instrumental activities of daily living prior to dementia in persons with mild cognitive impairment.
Trajectories of decline on instrumental activities of daily living prior to dementia in persons with mild cognitive impairment.
复制标题
轻度认知障碍患者痴呆前工具性日常生活活动能力的下降轨迹。
DOI：
10.1002/gps.5426
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发表时间：
2021-03
影响因子：
4
通讯作者：
Belleville S
中科院分区：
文献类型：
--
作者：
Cloutier S;Chertkow H;Kergoat MJ;Gélinas I;Gauthier S;Belleville S
主要目的是确定进展为痴呆的轻度认知障碍 (MCI) 患者相对于保持稳定的 MCI 患者工具性日常生活活动 (iADL) 下降的轨迹。进入研究时，121 名参与者符合 MCI 标准。根据随访结果，47 名参与者后来转变为痴呆症并被确定为进展者。被确定为衰退者的 16 名参与者表现出显着的认知衰退，但在研究时间内并未达到痴呆症的标准。稳定的 MCI 在 5 年随访期间保持认知稳定； n = 58。参与者使用临床测试/问卷、神经心理学测量和功能自主评估完成了年度评估，直到符合痴呆症标准。平均随访月数为 34 个月。观察到进展者的复杂活动表现多年稳定，随后在诊断前加速下降。稳定的 MCI 没有发现任何变化，下降者的特征是逐渐线性下降。与家务相关的活动成分在进展者中呈线性下降，而在稳定和下降的 MCI 中没有变化。我们发现了一个预测模型，其中包括痴呆症转化的重要预测因素，并且在接下来的一年具有较高的诊断准确性（曲线下面积 = 0.94 [95% 置信水平；下限：0.87，上限：1]）。评估 iADL 至关重要，因为 iADL 反映了 MCI 个体评估中的复杂活动，因为他们的损伤加上认知标志物的变化，表明 1 或 2 年后痴呆进展的风险较高。
The main objective was to determine the trajectory of instrumental activities of daily living (iADL) decline in persons with mild cognitive impairment (MCI) who progressed towards dementia relative to persons with MCI who remained stable. At study entry, 121 participants met criteria for MCI. Based on the follow‐up, 47 participants later converted to dementia and were identified as progressors. Sixteen participants, identified as decliners, presented a significant cognitive decline but did not reach the criteria for dementia within the study timeframe. Stable MCI remained cognitively stable during the 5‐year follow‐up; n = 58. Participants completed a yearly assessment using clinical tests/questionnaires, neuropsychological measures, and functional autonomy assessment until they met criteria for dementia. The average number of months for the follow‐up was 34. Many years of stable performance followed by an accelerated decline just prior to diagnosis, was observed for complex activities for progressors. No change was found for stable MCI and a gradual linear decline characterized decliners. The housekeeping‐related activities component showed a linear decline in progressors and did not change in stable and decliner MCI. We found a predictive model that includes significant predictors of dementia conversion with a high diagnostic accuracy the following year (area under the curve = 0.94 [95% confidence level; lower bound: 0.87, upper bound: 1]). It is critical to assess iADL that reflect complex activities in the evaluation of MCI individuals as their impairment, combined with change on cognitive markers, indicates a higher risk of dementia progression 1 or 2 years later.
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影响因子：
6.9
作者：
Luck, T.;Luppa, M.;Riedel-Heller, S. G.
通讯作者：
Riedel-Heller, S. G.
DOI：
10.3233/jad-150852
发表时间：
2016
期刊：
Journal of Alzheimer's disease : JAD
影响因子：
--
作者：
Henneges C;Reed C;Chen YF;Dell'Agnello G;Lebrec J
通讯作者：
Lebrec J
影响因子：
6.7
作者：
HEBERT, R;CARRIER, R;BILODEAU, A
通讯作者：
BILODEAU, A
DOI：
10.1111/j.1532-5415.1999.tb07239.x
发表时间：
1999-04-01
影响因子：
6.3
作者：
Barberger-Gateau, P;Fabrigoule, C;Dartigues, JF
通讯作者：
Dartigues, JF
影响因子：
6.7
作者：
DESROSIERS, J;BRAVO, G;DUBUC, N
通讯作者：
DUBUC, N