Longitudinal study of the transition from healthy aging to Alzheimer disease.
Longitudinal study of the transition from healthy aging to Alzheimer disease.
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DOI：
10.1001/archneurol.2009.158
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发表时间：
2009-10
影响因子：
--
通讯作者：
Galvin, James E.
中科院分区：
文献类型：
--
作者：
Johnson, David K.;Storandt, Martha;Morris, John C.;Galvin, James E.
检测表明阿尔茨海默病的最早认知变化很困难。模拟临床前阿尔茨海默病的认知能力下降。纵向档案研究比较了在随访期间变得痴呆的人和保持非痴呆的人在 4 个认知因素上的每一个：整体、言语记忆、视觉空间和工作记忆。华盛顿大学医学院阿尔茨海默病研究中心，密苏里州圣路易斯。 134 人在随访期间变得痴呆，310 人保持非痴呆状态。纵向认知表现的拐点。稳定组中 4 个因素的最佳拟合模型都是线性的，除了视觉空间因素外，所有因素都有轻微的下降趋势。相比之下，在急剧拐点之后具有加速斜率的分段模型为进展的组提供了最佳拟合。所有 4 个因素的最佳拐点是在痴呆症诊断之前：全球，2 年；语言和工作记忆，1年；和视觉空间，3年。当数据仅限于尸检证实的阿尔茨海默病的子集（n = 44）时，也获得了这些结果。在阿尔茨海默病的临床前阶段，当认知能力下降不足以保证使用传统标准进行临床诊断时，会出现一个急剧的拐点，随后多个认知领域（而不仅仅是记忆）加速下降。早期的变化出现在视觉空间能力测试中，其中大部分都是加速的。仅使用情景记忆任务来早期检测认知障碍的研究可能对疾病的所有早期表现不敏感。
Detection of the earliest cognitive changes signifying Alzheimer disease is difficult. To model the cognitive decline in preclinical Alzheimer disease. Longitudinal archival study comparing individuals who became demented during follow-up and people who remained nondemented on each of 4 cognitive factors: global, verbal memory, visuospatial, and working memory. Alzheimer Disease Research Center, Washington University School of Medicine, St Louis, Missouri. One hundred thirty-four individuals who became demented during follow-up and 310 who remained nondemented. Inflection point in longitudinal cognitive performance. The best-fitting model for each of the 4 factors in the stable group was linear, with a very slight downward trend on all but the Visuospatial factor. In contrast, a piecewise model with accelerated slope after a sharp inflection point provided the best fit for the group that progressed. The optimal inflection point for all 4 factors was prior to diagnosis of dementia: Global, 2 years; Verbal and Working Memory, 1 year; and Visuospatial, 3 years. These results were also obtained when data were limited to the subset (n=44) with autopsy-confirmed Alzheimer disease. There is a sharp inflection point followed by accelerating decline in multiple domains of cognition, not just memory, in the preclinical period in Alzheimer disease when there is insufficient cognitive decline to warrant clinical diagnosis using conventional criteria. Early change was seen in tests of visuospatial ability, most of which were speeded. Research into early detection of cognitive disorders using only episodic memory tasks may not be sensitive to all of the early manifestations of disease.
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影响因子：
4.2
作者：
Ball, M;Braak, H;Khachaturian, Z
通讯作者：
Khachaturian, Z
影响因子：
9.9
作者：
Storandt, M;Grant, EA;Morris, JC
通讯作者：
Morris, JC
影响因子：
--
作者：
Chen, PJ;Ratcliff, G;Ganguli, M
通讯作者：
Ganguli, M
影响因子：
11.1
作者：
Winblad, B;Palmer, K;Petersen, RC
通讯作者：
Petersen, RC
DOI：
10.1111/j.1532-5415.1997.tb03091.x
发表时间：
1997-05-01
影响因子：
6.3
作者：
Howieson, DB;Dame, A;Kaye, JA
通讯作者：
Kaye, JA