Early symptoms and signs of cognitive deficits might not always be detectable in persons who develop Alzheimer's disease
Early symptoms and signs of cognitive deficits might not always be detectable in persons who develop Alzheimer's disease
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DOI：
10.1017/s1041610207006564
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发表时间：
2008-04-01
影响因子：
7
通讯作者：
Fratiglioni, Laura
中科院分区：
文献类型：
--
作者：
Palmer, Katie;Backman, Lars;Fratiglioni, Laura
目的：临床综合征，如遗忘性轻度认知障碍（MCI）是高度预测阿尔茨海默病（AD）的未来发展，但目前还不知道有多少发展这种疾病的个人可以确定与这些综合征。本研究的目的是确定有多少个人与AD显示可检测的症状或临床体征的认知功能障碍三年前diagnosis.Methods：152事件AD病例中确定了一个无痴呆症队列的1417人，年龄在75-95岁，经过三年的随访，从一个前瞻性的人口为基础的研究，Kungsholmen项目。认知功能障碍的症状，包括记忆问题的主观报告和认知缺陷，在基线时用广泛的神经心理学测试组合进行客观测量。事件AD的临床诊断，根据DSM-IIIR标准在三年follow-up.Results：只有一半的未来AD病例报告的主观记忆问题三年前诊断。超过三分之一的事件AD病例在任何调查的特定认知领域都没有表现出可检测的缺陷。只有38.3%的人都有主观的投诉和特定领域的认知defictions.Conclusions：症状和体征目前用于定义MCI并不总是存在于谁开发AD的人。增加潜在可识别和可治疗的临床前AD病例的数量是不可行的，除非确定更敏感的主观和客观标志物。此外，由于只有一半的未来AD病例在诊断前三年报告主观记忆问题，因此引起医疗注意的人数有限。
Objective: Clinical syndromes such as amnestic mild cognitive impairment (MCI) are highly predictive of future development of Alzheimer's disease (AD), but it is not known how many of the individuals that develop the disease can be identified with these syndromes. This study aims to determine how many individuals with AD show detectable symptoms or clinical signs of cognitive deficits three years before diagnosis.Methods: 152 incident AD cases were identified in a dementia-free cohort of 1417 persons aged 75-95, after three-year follow-up from a prospective population-based study, the Kungsholmen Project. Symptoms of cognitive impairment including the subjective report of memory problems, and cognitive deficits were objectively measured with an extensive neuropsychological test battery at baseline. Incident AD was clinically diagnosed according to DSM-IIIR criteria at three-year follow-up.Results: Only half of future AD cases reported subjective memory problems three years before diagnosis. More than one-third of incident AD cases did not exhibit detectable deficits in any of the investigated specific cognitive domains. Only 38.3% had both subjective complaints and domain-specific cognitive deficits.Conclusions: Symptoms and signs currently used to define MCI are not always present in persons who develop AD. Increasing the number of potentially identifiable and treatable preclinical AD cases is unfeasible unless more sensitive subjective and objective markers are identified. Furthermore, as only half of future AD cases report subjective memory problems three years before diagnosis, the number of persons coming to the attention of medical care is limited.