Risk factors for mild cognitive impairment in the Cardiovascular Health Study cognition study part 2
Risk factors for mild cognitive impairment in the Cardiovascular Health Study cognition study part 2
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DOI：
10.1001/archneur.60.10.1394
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发表时间：
2003-10-01
影响因子：
--
通讯作者：
Kuller, LH
中科院分区：
文献类型：
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作者：
Lopez, OL;Jagust, WJ;Kuller, LH
目的：在一项纵向人群研究——心血管健康研究认知研究中检查轻度认知障碍（MCI）的危险因素。设计：我们检查了 1991 年至 1994 年期间所有心血管健康研究认知研究参与者中预测 MCI 发展的因素。在宾夕法尼亚州匹兹堡队列 (n = 927) 中进行了进一步检查，其中 MCI 参与者被分类为 MCI 遗忘型或 MCI 多重认知缺陷型。设置：多中心人群研究。患者：本研究包括接受磁共振成像 (MRI) 的心血管健康研究认知研究 (n = 3608) 的所有参与者 1991 年至 1994 年间进行的脑部扫描，以及详细的神经心理学、神经学和医学评估，以确定 1998 年至 1999 年间是否存在 MCI 或痴呆。心血管健康研究认知研究队列中最接近的 MRI 临床检查与认知障碍诊断评估之间的平均时间为 5.8 年，匹兹堡队列为 6.0 年。 主要结果 测量：使用逻辑回归确定 MRI 时 MCI 的危险因素，控制年龄、种族、教育水平、基线改良简易精神状态检查和数字符号测试分数、抑郁测量、MRI 结果（萎缩、心室体积、白质病变和梗死）、载脂蛋白 E (APOE) epsilon4 等位基因的存在、高血压、糖尿病 结果：轻度认知障碍 (n=577) 与种族（非洲裔美国人）、教育水平低、改良简易精神状态检查和数字符号测试分数低、皮质萎缩、MRI 识别的梗塞和抑郁症测量结果相关。 MCI 遗忘型与 MRI 识别的梗塞、APOE E4 等位基因的存在以及改良简易精神状态检查分数低相关。 MCI 多重认知缺陷型与改良简易精神状态检查和数字符号测试分数低相关。结论：MCI 的发展与认知和抑郁、种族和体质因素以及脑血管疾病的测量有关。早期认知缺陷似乎是两种形式的 MCI 的共同点：脑血管疾病和 APOE epsilon4 等位基因的存在与遗忘型 MCI 相关。
Objective: To examine the risk factors for mild cognitive impairment (MCI) in a longitudinal population study-the Cardiovascular Health Study Cognition Study.Design: We examined the factors that in the period 1991 through 1994 predicted the development of MCI in all participants of the Cardiovascular Health Study Cognition Study. Further examination was conducted in the Pittsburgh, Pa, cohort (n = 927), where participants with MCI were classified as having either the MCI amnestic-type or the MCI multiple cognitive deficits-type.Setting: Multicenter population study.Patients: This study includes all participants of the Cardiovascular Health Study Cognition Study (n = 3608) who had a magnetic resonance imaging (MRI) scan of the brain between 1991 and 1994, and detailed neuropsychological, neurological, and medical evaluations to identify the presence of MCI or dementia in the period 1998 to 1999. The mean time between the closest clinical examination to the MRI and the diagnostic evaluation for cognitive disorders was 5.8 years for the Cardiovascular Health Study Cognition Study cohort and 6.0 years for the Pittsburgh cohort.Main Outcome Measures: Risk factors for MCI at the time of the MRI were identified using logistic regression, controlling for age, race, educational level, baseline Modified Mini-Mental State Examination and Digit Symbol Test scores, measurements of depression, MRI findings (atrophy, ventricular volume, white matter lesions, and infarcts), the presence of the apolipoprotein E (APOE) epsilon4 allele, hypertension, diabetes mellitus, and heart disease.Results: Mild cognitive impairment (n=577) was associated with race (African American), low educational level, low Modified Mini-Mental State Examination and Digit Symbol Test scores, cortical atrophy, MRI-identified infarcts, and measurements of depression. The MCI amnestic-type was associated with MRI-identified infarcts, the presence of the APOE E4 allele, and low Modified Mini-Mental State Examination scores. The MCI multiple cognitive deficits-type was associated with low Modified Mini-Mental State Examination and Digit Symbol Test scores.Conclusions: The development of MCI is associated with measurements of cognition and depression, racial and constitutional factors, and cerebrovascular disease. Early cognitive deficits seem to be a common denominator for the 2 forms of MCI; the presence of cerebrovascular disease and the APOE epsilon4 allele is associated with the amnestic type of MCI.