Variations in case definition affect prevalence but not outcomes of mild cognitive impairment
Variations in case definition affect prevalence but not outcomes of mild cognitive impairment
复制标题
DOI：
10.1212/01.wnl.0000089238.07771.c7
复制
发表时间：
2003-11-11
期刊：
影响因子：
9.9
通讯作者：
Rockwood, K
中科院分区：
文献类型：
--
作者：
Fisk, JD;Merry, HR;Rockwood, K
目的：研究轻度认知功能障碍(MCI)不同病例定义的患病率估计和5年预后。方法：作者检查了1790名65岁或65岁以上的成年人，他们在加拿大健康和老龄化研究中完成了神经心理学和临床评估，这是一项为期5年的具有代表性的前瞻性队列研究。结果：最常用的MCI病例定义得出人群患病率估计为1.03%(95%可信区间为0.66~1.40)。排除主观记忆主诉和日常生活工具活动(IADL)的要求，患病率增加到3.02%(CI 2.40~3.64)。五年的结果，包括死亡、住院和痴呆的风险，在不同的MCI病例定义中没有明显的差异，但都增加了住院(RR 2.3到5.2)和痴呆(RR 9.3到19.7)的风险。无论病例定义如何，大多数MCI患者都会患上痴呆症，主要是阿尔茨海默病(AD)。尽管如此，对于每个病例定义，近三分之一的人被认为在5年后没有认知障碍。结论：记忆障碍和完整的IADL对于人群样本中MCI的病例定义可能是不必要的要求。MCI标准确定了AD风险增加的人，但需要承认相当大比例的MCI患者的改善潜力。
Objective: To examine the prevalence estimates and 5-year outcomes of various case definitions of mild cognitive impairment (MCI). Methods: The authors examined 1,790 adults 65 years of age or older who completed neuropsychological and clinical assessments in the Canadian Study of Health and Aging, a 5-year, representative, prospective cohort study. Results: The most commonly used case definition of MCI yielded a population prevalence estimate of 1.03% (95% CI 0.66 to 1.40). Eliminating the requirements for subjective memory complaints and intact instrumental activities of daily living (IADL) increased the prevalence to 3.02% (CI 2.40 to 3.64). Five-year outcomes, including the risk of death, institutionalization, and dementia, were not distinctly different for various case definitions of MCI, but all were at increased risk of institutionalization (RR 2.3 to 5.2) and dementia (RR 9.3 to 19.7). Regardless of the case definition, most people with MCI developed dementia, chiefly Alzheimer disease (AD). Still, for each case definition, almost one third were considered to have no cognitive impairment after 5 years. Conclusions: Memory complaints and intact IADL may be unnecessary requirements for a case definition of MCI in population-based samples. The MCI criteria identify people at increased risk of AD, but the potential for improvement of a substantial proportion of those with MCI needs to be acknowledged.