Mild cognitive impairment with subcortical vascular features - Clinical characteristics and outcome
Mild cognitive impairment with subcortical vascular features - Clinical characteristics and outcome
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DOI：
10.1007/s00415-002-0861-7
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发表时间：
2002-10-01
影响因子：
6
通讯作者：
Geroldi, C
中科院分区：
文献类型：
--
作者：
Frisoni, GB;Galluzzi, S;Geroldi, C
目标.在前来接受记忆诊所观察的患者中，识别因脑血管病因导致认知障碍的非痴呆患者，并描述其临床特征和结局。方法.患者参加了在记忆诊所进行的早期认知障碍的前瞻性研究。血管型轻度认知损害（MCI-V）是根据Erkin-juntti及其同事修改的皮质下血管性痴呆（SVD）标准定义的。根据马约诊所标准（年龄72 +/- 9，MMSE 25 +/- 2），将29例MCI-V患者（年龄78 +/- 7，简易精神状态检查（MMSE）24 +/- 3）与14例退行性病因（MCI）轻度认知障碍患者和21例明确SVD患者（年龄80 +/- 6，MMSE 21 +/- 3）进行了比较。患者随时间随访32 +/- 8个月。结果MCI-V患者的神经心理学特征表现为额叶测试（威斯康星州卡片分类和文字流畅性）表现不佳，以及无震颤的帕金森综合征神经学特征（平衡和步态受损）。在随访至少40个月的患者中，50%的MCI-V和SVD患者死亡，而所有MCI患者仍然存活（P = 0.03）。在存活的患者中，68%的MCI-V、52%的SVD和17%的MCI患者在40个月时达到以下结局之一：疗养院安置、功能丧失和认知恶化（P = 0.02）。结论. MCI-V患者具有独特的临床表现，可以在临床环境中识别。由于不良结果的发生率很高，需要制定非常早期的预防措施。
Objectives. To identify non-demented individuals with cognitive impairment due to a cerebrovascular etiology among those coming to observation of a memory clinic and to describe their clinical features and outcome. Methods. Patients were enrolled in a prospective study on early cognitive impairment carried out in a Memory Clinic. Mild cognitive impairment of the vascular type (MCI-V) was defined based on modified criteria for subcortical vascular dementia (SVD) by Erkin-juntti and colleagues. Twenty-nine patients with MCI-V (age 78 +/- 7, Mini Mental State Exam (MMSE) 24 +/- 3) were compared with 14 with mild cognitive impairment of degenerative etiology (MCI) based on the Mayo Clinic criteria (age 72 +/- 9, MMSE 25 +/- 2), and to 21 patients with frank SVD (age 80 +/- 6, MMSE 21 +/- 3). Patients were followed over time for 32 +/- 8 months. Results. MCI-V patients had a neuropsychological profile characterized by poor performance on frontal tests (Wisconsin card sorting and word fluency) and neurological features of parkinsonism without tremor (impairment of balance and gait). Of those followed for at least 40 months, 50% of patients with MCI-V and SVD had died, while all MCI patients were still alive (P = 0.03). Of those alive, 68% of the MCI-V, 52% of the SVD, and 17% of the MCI patients had reached one of the following outcomes at 40 months: nursing home placement, functional loss, and cognitive deterioration (P = 0.02). Conclusions. Patients with MCI-V have a distinctive clinical picture and can be identified in a clinical setting. Because of the high frequency of adverse outcomes, very early preventive measures need to be devised.