Implementing diagnostic criteria and estimating frequency of mild cognitive impairment in an urban community
Implementing diagnostic criteria and estimating frequency of mild cognitive impairment in an urban community
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DOI：
10.1001/archneur.62.11.1739
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发表时间：
2005-11-01
影响因子：
--
通讯作者：
Mayeux, R
中科院分区：
文献类型：
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作者：
Manly, JJ;Bell-McGinty, S;Mayeux, R
背景：报告的轻度认知障碍（MCI）发生率差异很大，这取决于方法的差异，包括特定样本特征、使用的认知测量、用于神经心理学测试的规范样本和诊断标准。目的：建立MCI的诊断标准，并检查不同种族和语言的老年人（65岁以上的个体）MCI的发病率。设计：前瞻性、基于社区的纵向队列研究。地点：纽约曼哈顿北部参与者：1315名无痴呆症状的老年参与者。主要结局指标：在综合神经心理学、功能学和神经学评估的基础上，回顾性诊断MCI。健忘性轻度认知障碍，以及具有其他认知特征的轻度损伤形式，被分类。结果：遗忘型轻度认知损伤发生率为5.0%（95%可信区间3.8 ~ 6.2）。其他亚型MCI的发生率从2.1%到6.2%不等。与65 - 75岁的人相比，轻度认知障碍在75岁以上的人中更为常见。受教育时间少于9年的人更有可能符合MCI标准。载脂蛋白（APOE） E4等位基因在遗忘型轻度认知损伤患者中更为常见。结论：当使用适当的规范值时，只有年龄和教育程度，而不是种族或民族，与MCI的高频率相关。非痴呆老年人有孤立记忆缺陷的比例小于有多个认知领域缺陷的比例。APOE E4等位基因与遗忘型轻度认知损伤的强相关性表明，在轻度认知损伤的认知亚型中，可能存在多种导致认知损伤的原因以及转化为阿尔茨海默病的不同比率。
Background: Reported rates of mild cognitive impairment (MCI) range widely depending on methodologic differences, including specific sample characteristics, cognitive measures used, normative samples used for neuropsychological tests, and diagnostic criteria.Objectives: To operationalize diagnostic criteria for MCI and examine the frequency of MCI in ethnically and linguistically diverse elders (individuals older than 65 years).Design: Prospective, community-based longitudinal cohort study.Setting: Northern Manhattan, New York, NY.Participants: A cohort of 1315 nondemented elderly participants.Main Outcome Measure: A diagnosis of MCI was assigned retrospectively on the basis of comprehensive neuropsycho logical, functional, and neurologic assessments. Amnestic MCI, as well as forms of mild impairment with other cognitive characteristics, were classified.Results: The frequency of amnestic MCI was 5.0% (95% confidence interval, 3.8-6.2). Other subtypes of MCI ranged in frequency from 2.1% to 6.2%. Mild cognitive impairment was more common among those older than 75 years compared with those aged 65 to 75 years. Individuals with fewer than 9 years of schooling were more likely to meet MCI criteria. Apolipoprotein (APOE) E4 allele was more frequent among those with amnestic MCI.Conclusions: When proper normative values are used, only age and education, and not race or ethnicity, are associated with higher frequency of MCI. The proportion of nondemented elders with isolated memory deficits is smaller than the proportion with deficits in multiple cognitive domains. The strong association of the APOE E4 allele with only amnestic MCI suggests that there are likely to be multiple causes of cognitive impairment and differential rates of conversion to Alzheimer disease within the cognitive subtypes of MCI.