Awareness of Cognitive Decline in Patients With Alzheimer's Disease: A Systematic Review and Meta-Analysis.
Awareness of Cognitive Decline in Patients With Alzheimer's Disease: A Systematic Review and Meta-Analysis.
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阿尔茨海默氏病患者认知能力下降的认识：系统评价和荟萃分析。
DOI：
10.3389/fnagi.2021.697234
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发表时间：
2021
影响因子：
4.8
通讯作者：
Epelbaum S
中科院分区：
文献类型：
--
作者：
Cacciamani F;Houot M;Gagliardi G;Dubois B;Sikkes S;Sánchez-Benavides G;Denicolò E;Molinuevo JL;Vannini P;Epelbaum S
背景：识别认知能力下降（ACD）的意识程度差可能是阿尔茨海默病（AD）的早期指标。目的：（1）了解是否有证据表明在AD的痴呆前阶段ACD较差;（2）总结研究AD中ACD获得的主要结果;（3）提出一个概念框架。数据来源：我们检索了Scopus、Pubmed和截至2020年8月发表的研究参考文献列表。原始研究文章必须报告ACD的测量结果，并包括AD痴呆或前驱AD（或MCI）或有AD风险的个体。数据综合：对所有涉及临床前、前驱期和AD痴呆的研究进行了系统综述。我们打算对临床前AD或前驱AD（或MCI）的经验研究进行荟萃分析，以比较临床组之间的ACD。由于临床前AD的文献缺乏，仅可能对前驱AD（或MCI）研究进行荟萃分析。结果如下：我们系统地回顾了283篇文献，并对18篇关于前驱AD（或MCI）的文献进行了荟萃分析，结果表明，遗忘型和非遗忘型MCI患者的ACD无显著差异（SMD = 0.09，p = 0.574）;遗忘型轻度认知障碍患者的ACD明显较差（SMD =-0.56，p = 0.001）和轻度AD（SMD =-1.39，p < 0.001）;轻度AD患者的ACD也明显低于遗忘型MCI患者（SMD =-0.75，p < 0.001），并且比非遗忘型MCI差（SMD =-1.00，p < 0.001）。我们还讨论了AD中ACD的关键发现，例如其神经和认知相关性。结论和影响：我们认为，患者可能会抱怨他们最初的微妙认知变化，但ACD很快就会开始减少。个体在MCI阶段会表现出轻度的病感失认，而在痴呆阶段会表现出严重的病感失认。ACD的评估（将自我报告与认知评分或线人报告进行比较）可能有助于指导临床医生及时诊断，并用于针对早期AD的试验。
Background: Identifying a poor degree of awareness of cognitive decline (ACD) could represent an early indicator of Alzheimer's disease (AD). Objectives: (1) to understand whether there is evidence of poor ACD in the pre-dementia stages of AD; (2) to summarize the main findings obtained investigating ACD in AD; (3) to propose a conceptual framework. Data Sources: We searched Scopus, Pubmed, and the reference lists for studies published up to August 2020. Original research articles must report a measure of ACD and included individuals with AD dementia, or prodromal AD (or MCI), or being at risk for AD. Data Synthesis: All studies covering preclinical, prodromal, and AD dementia were systematically reviewed. We intended to perform a meta-analysis of empirical studies on preclinical AD or prodromal AD (or MCI), to compare ACD between clinical groups. Due to the paucity of literature on preclinical AD, meta-analysis was only possible for prodromal AD (or MCI) studies. Results: We systematically reviewed 283 articles, and conducted a meta-analysis of 18 articles on prodromal AD (or MCI), showing that ACD was not significantly different between patients with amnestic and non-amnestic MCI (SMD = 0.09, p = 0.574); ACD was significantly poorer in amnestic MCI (SMD = −0.56, p = 0.001) and mild AD (SMD = −1.39, p < 0.001) than in controls; ACD was also significantly poorer in mild AD than in amnestic MCI (SMD = −0.75, p < 0.001), as well as poorer than in non-amnestic MCI (SMD = −1.00, p < 0.001). We also discuss key findings on ACD in AD, such as its neural and cognitive correlates. Conclusions and Implications: We propose that patients may be complaining of their initial subtle cognitive changes, but ACD would soon start to decrease. The individual would show mild anosognosia in the MCI stage, and severe anosognosia in dementia. The evaluation of ACD (comparing self-report to cognitive scores or to informant-report) could be useful to guide the clinician toward a timely diagnosis, and in trials targeting early-stage AD.
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影响因子：
4
作者：
Dourado, Marcia C. N.;Mograbi, Daniel C.;Laks, Jerson
通讯作者：
Laks, Jerson
影响因子：
6.6
作者：
Comijs, HC;Deeg, DJH;Jonker, C
通讯作者：
Jonker, C
影响因子：
2.3
作者：
Maki Y;Yamaguchi T;Yamaguchi H
通讯作者：
Yamaguchi H
DOI：
10.1186/s13195-020-00700-8
发表时间：
2020-10-14
期刊：
Alzheimer's research & therapy
影响因子：
--
作者：
Cacciamani F;Sambati L;Houot M;Habert MO;Dubois B;Epelbaum S;INSIGHT-PreAD study group
通讯作者：
INSIGHT-PreAD study group
影响因子：
3.7
作者：
Cations M;Radisic G;Crotty M;Laver KE
通讯作者：
Laver KE