Cognitive discrepancies versus APOE genotype as predictors of cognitive decline in normal-functioning elderly individuals: A longitudinal study
Cognitive discrepancies versus APOE genotype as predictors of cognitive decline in normal-functioning elderly individuals: A longitudinal study
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DOI：
10.1097/jgp.0b013e3181629957
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发表时间：
2008-05-01
影响因子：
7.2
通讯作者：
Bondi, Mark W.
中科院分区：
文献类型：
--
作者：
Fine, Eric M.;Delis, Dean C.;Bondi, Mark W.
目的：认知差异分析已被证明是一种有用的技术，用于检测具有阿尔茨海默病（AD）遗传风险的正常功能老年人的细微认知缺陷。然而，迄今为止，使用认知差异测量的研究都采用了回顾性或横断面设计，并且这种方法在预测认知衰退方面的效用尚未在前瞻性调查中得到检验。设计：纵向研究。地点：圣地亚哥，加州，退伍军人管理医院。参与者：24名功能正常的老年人参与了这项研究，其中16名受试者在1年内痴呆评分量表（DRS）评分没有变化（稳定组），8名受试者在1年内DRS评分下降（下降组）。测量方法：计算了一个孤立认知转换的认知差异测量方法，将执行功能的新高级任务（Stroop/ switching测量方法）的表现与低水平Stroop条件的复合测量方法进行对比。结果：a)与对照组（稳定组）相比，衰退组在认知变化前一年表现出显著较大的认知差异（Stroop/Switching与较低水平Stroop条件）得分；b)认知差异测量在预测DRS下降方面优于APOE基因型。结论：分离执行功能能力的认知差异分析不仅是识别有认知缺陷风险的个体的有用工具，而且在预测随着时间的推移可能出现细微认知衰退的个体方面也显示出希望。
Objectives: Cognitive-discrepancy analysis has been shown to be a useful technique for detecting subtle cognitive deficits in normal-functioning elderly individuals who are genetically at-risk for Alzheimer disease ( AD). However, studies that have used cognitive-discrepancy measures to date have used retrospective or cross-sectional designs, and the utility of this approach to predict cognitive decline has not been examined in a prospective investigation. Design: Longitudinal study. Setting: San Diego, CA, Veterans Administration Hospital. Participants: Twenty-four normal-functioning elderly individuals participated in the study, with 16 subjects exhibiting no change in their Dementia Rating Scale ( DRS) scores over an 1-year period ( Stable Group), and 8 subjects exhibiting a decline in DRS scores over the 1-year period ( Decline group). Measurements: A cognitive-discrepancy measure isolating cognitive switching was computed that contrasted performance on a new higher-level task of executive functioning ( a Stroop/Switching measure) relative to a composite measure of lower-level Stroop conditions. Results: a) In the year before their cognitive changes, the Decline group exhibited a significantly larger cognitive-discrepancy ( Stroop/Switching versus lower-level Stroop conditions) score compared with a control ( Stable) group; and b) the cognitive-discrepancy measure was superior to APOE genotype in predicting DRS decline. Conclusion: Cognitive-discrepancy analysis isolating a component executive function ability not only seems to be a useful tool for identifying individuals at risk for cognitive deficits, but also shows promise in predicting individuals who may show subtle cognitive decline over time.