Rates of progression in mild cognitive impairment and early Alzheimer's disease
Rates of progression in mild cognitive impairment and early Alzheimer's disease
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DOI：
10.1212/wnl.59.7.1034
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发表时间：
2002-10-08
期刊：
影响因子：
9.9
通讯作者：
Morris, JC
中科院分区：
文献类型：
--
作者：
Storandt, M;Grant, EA;Morris, JC
目的：比较AD最轻度阶段（包括目前确定为轻度认知障碍（MCI）的阶段）的进展率，并确定这些进展率的预测因素。研究方法：痴呆（n = 289）和非痴呆（n = 230）的人参加了纵向研究在阿尔茨海默病研究中心接受年度临床和心理测试长达20年。按照痴呆严重程度的增加顺序，痴呆患者被诊断为初期、非常轻度或轻度痴呆;初期阶段相当于MCI。结果测量包括死亡，疗养院安置，心理评分。结果：进展率随着痴呆严重程度的增加而增加，如在进入研究时通过临床痴呆评级进行分期。关于二分结局，老年痴呆症严重程度的增加在进入疗养院的终点比在死亡的终点更显著。随着痴呆严重程度的增加，认知能力下降的比率也增加了心理测量分数。其他进展预测因素的证据有限。结论：缺乏痴呆症进展速度的有效预测因素延伸到疾病的最早阶段，包括通常称为MCI的疾病。需要一种新的方法来识别进展率的相关性。
Objective: To compare rates of progression in the very mildest stages of AD, including the stage currently identified as mild cognitive impairment (MCI), and to identify predictors of those rates. Methods: Demented (n = 289) and nondemented (n = 230) individuals enrolled in longitudinal studies at an Alzheimer Disease Research Center received annual clinical and psychometric examinations for up to 20 years. In order of increasing dementia severity, demented individuals were diagnosed with incipient, very mild, or mild dementia; the incipient stage is equivalent to MCI. Outcome measures included death, nursing home placement, and psychometric scores. Results: Rate of progression increased with dementia severity as staged by the Clinical Dementia Rating at entry into the study. With respect to the dichotomous outcomes, the increase with dementia severity was more dramatic for the endpoint of nursing home entry than it was for the endpoint of death. Increased rates of cognitive decline with increased dementia severity were also obtained for psychometric scores. There was limited evidence of other predictors of progression. Conclusions: The lack of effective predictors of the rate of dementia progression extends to the very earliest stages of the disease, including what is often called MCI. A new approach to the identification of correlates of rates of progression is needed.