The dawn of robust individualised risk models for dementia
The dawn of robust individualised risk models for dementia
复制标题
痴呆症稳健个体化风险模型的曙光
DOI：
10.1016/s1474-4422(19)30353-9
复制
发表时间：
2019
期刊：
影响因子：
--
通讯作者：
C. Masters
中科院分区：
文献类型：
--
作者：
S. Burnham;S. Loi;J. Doecke;V. Fedyashov;V. Doré;V. Villemagne;C. Masters
轻度认知障碍（MCI）通常是指那些生活多年却不知道其长期预后的个体的一种持有模式。这种改善或保持稳定与进展到痴呆诊断之间的不确定性是令人不满意的。具体信息或建议的缺乏加剧了这个问题。轻度认知障碍患者无法获得诸如胆碱酯酶抑制剂或缩短治疗时间之类的治疗，他们通常不能参加治疗试验，而且缺乏前进的道路会增加他们和家庭成员的焦虑。在《柳叶刀神经病学》杂志上，英格丽德·范·莫里克和他的同事试图澄清这种情况。他们提供了一种个性化预后的方法，通过指出在他们的研究中，哪些MCI参与者最有可能在1年、3年和5年的时间框架内发展为痴呆。他们评估了四种独立的预后模型：第一种模型包含年龄、性别和简易精神状态检查（MMSE）；其次，建立年龄、MMSE和海马体积的模型；第三，建立MMSE、脑脊液β淀粉样蛋白（1-42）和脑脊液总tau的模型；3和4，脑脊液β淀粉样蛋白（1-42）、脑脊液磷酸化tau和海马体积的ATN模型4。这些模型应用于欧洲阿尔茨海默病医学信息框架（EMIF）、阿尔茨海默病神经影像学倡议（ADNI）、阿姆斯特丹痴呆队列（ADC）和瑞典BioFINDER研究的2611名MCI参与者。在这2611名MCI参与者中，1007名（39%）在平均3年的随访期间（SD 2）进展为痴呆。808名（80%）参与者因阿尔茨海默病进展为痴呆。范·莫里克和他的同事们必须克服许多困难，才能协调这么多参与者的数据，并确保进行可靠和适当的分析
Mild cognitive impairment (MCI) typically represents a hold ing pattern for individuals who live for many years without knowing their long-term prognosis. Such uncertainty between improvement or remaining stable versus progressing to a diagnosis of dementia is unsatis fying. Scarcity of specific information or advice com pounds this issue. People with MCI do not have access to treatments such as cholinesterase inhibitors or meman tine, they usually cannot partake in therapeutic trials, and the absence of a path forward can add to their anxiety and that of family members. 1 In The Lancet Neurology, Ingrid van Maurik and colleagues2 attempt to clarify this situation. They provide a method for individualised prognosis by indicating which of the participants with MCI in their study were most likely to progress to dementia over 1, 3, and 5 year timeframes. They assessed four separate prognostic models: first, a model incorporating age, sex, and the Mini-Mental State Examination (MMSE); second, a model of age, MMSE, and hippocampal volume; third, a model of MMSE, CSF amyloid β (1–42), and CSF total tau; 3 and fourth, the ATN model4 of CSF amyloid β (1–42), CSF phosphorylated tau, and hippocampal volume. These models were applied to 2611 MCI participants across the European Medical Information Framework for Alzheimer’s disease (EMIF), the Alzheimer’s Disease Neuroimaging Initiative (ADNI), the Amsterdam Dementia Cohort (ADC), and the Swedish BioFINDER studies. Of these 2611 MCI participants, 1007 (39%) progressed to dementia within a mean follow-up period of 3 years (SD 2). 808 (80%) participants progressed to dementia due to Alzheimer’s disease. Van Maurik and colleagues had to overcome many difficulties in harmonising the data from so many participants and to ensure that robust and appropriate analyses
DOI：
--
发表时间：
2017
期刊：
--
影响因子：
--
作者：
C. Jack;D. Bennett;K. Blennow;B. Dunn;C. Elliott;S. Haeberlein;D. Holtzman;M. Jagust;F. Jessen-F.
通讯作者：
C. Jack;D. Bennett;K. Blennow;B. Dunn;C. Elliott;S. Haeberlein;D. Holtzman;M. Jagust;F. Jessen-F.