Reversion from mild cognitive impairment to normal or near-normal cognition
Reversion from mild cognitive impairment to normal or near-normal cognition
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DOI：
10.1212/wnl.0b013e31826e26b7
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发表时间：
2012-10-01
期刊：
影响因子：
9.9
通讯作者：
Monsell, Sarah E.
中科院分区：
文献类型：
--
作者：
Koepsell, Thomas D.;Monsell, Sarah E.
目的：我们试图找出与恢复正常认知的相对较高概率相关的轻度认知障碍 (MCI) 个体的特征，并估计恢复正常认知的患者未来认知能力下降的风险。 方法：我们首先研究了 3,020 名在美国阿尔茨海默病中心至少就诊过 1 次的 3,020 名被诊断患有 MCI 的个体。所有患者在第一次就诊时均接受了标准化统一数据集评估，诊断为 MCI，并在大约一年后的后续就诊中重新评估了认知状态。多元逻辑回归用于确定从 MCI 恢复到正常认知的预测因素。然后，我们估计了那些已经恢复的患者在未来 3 年内患 MCI 或痴呆的风险，与那些没有接受 MCI 研究访问的个体相比。结果：大约 16% 的诊断为 MCI 的受试者在大约 1 年后恢复到正常或接近正常认知。第一次 MCI 就诊时评估的五个特征对预测恢复正常认知的模型有显着贡献：简易精神状态检查 (MMSE) 评分、临床痴呆评级 (CDR) 评分、MCI 类型、功能活动问卷 (FAQ) 评分和 APOE（是）4 状态的一个要素。生存分析显示，与没有 MCI 病史的个体相比，患有 MCI 的患者在未来 3 年内重新转变为 MCI 或痴呆的风险急剧升高，然后有所改善。结论：即使在痴呆研究中心的一组患者中，MCI 的逆转也相当常见。尽管如此，那些恢复的人未来认知能力下降的风险仍然增加。神经病学（R）2012；79：1591-1598
Objectives: We sought to identify characteristics of individuals with mild cognitive impairment (MCI) that are associated with a relatively high probability of reverting back to normal cognition, and to estimate the risk of future cognitive decline among those who revert.Methods: We first studied 3,020 individuals diagnosed with MCI on at least 1 visit to an Alzheimer's Disease Center in the United States. All underwent standardized Uniform Data Set evaluations at their first visit with an MCI diagnosis and on a subsequent visit, about 1 year later, at which cognitive status was reassessed. Multiple logistic regression was used to identify predictors of reverting from MCI back to normal cognition. We then estimated the risk of developing MCI or dementia over the next 3 years among those who had reverted, compared with individuals who had not had a study visit with MCI.Results: About 16% of subjects diagnosed with MCI reverted back to normal or near-normal cognition approximately 1 year later. Five characteristics assessed at the first MCI visit contributed significantly to a model predicting a return to normal cognition: Mini-Mental State Examination (MMSE) score, Clinical Dementia Rating (CDR) score, MCI type, Functional Activities Questionnaire (FAQ) score, and APOE (is an element of)4 status. Survival analysis showed that the risk of retransitioning to MCI or dementia over the next 3 years was sharply elevated among those who had MCI and then improved, compared with individuals with no history of MCI.Conclusions: Even in a cohort of patients seen at dementia research centers, reversion from MCI was fairly common. Nonetheless, those who reverted remained at increased risk for future cognitive decline. Neurology (R) 2012;79:1591-1598