Incidence and outcome of mild cognitive impairment in a population-based prospective cohort
Incidence and outcome of mild cognitive impairment in a population-based prospective cohort
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DOI：
10.1212/01.wnl.0000034176.07159.f8
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发表时间：
2002-11-26
期刊：
影响因子：
9.9
通讯作者：
Dartigues, JF
中科院分区：
文献类型：
--
作者：
Larrieu, S;Letenneur, L;Dartigues, JF
目的：在以人群为基础的队列中，根据性别和教育水平估计轻度认知障碍（MCI）的年龄特异性发病率，并探讨MCI的病程，特别是其向AD的进展。方法：以社区为基础的非痴呆老年人队列（Personnes Agees QUID [PAQUID]）纵向随访5年。MCI被定义为伴有客观记忆障碍的记忆抱怨，没有痴呆、一般认知功能障碍或日常生活活动障碍。发病率采用人年法计算。对不同随访时间进行描述性分析，研究轻度认知损伤的病程。结果：基线时，有58例MCI流行病例（占样本的2.8%）。在5年的随访中，1265名高危受试者中发生了40例轻度认知损伤。MCI的全球发病率为9.9/ 1000人年。MCI是AD的一个很好的预测指标，年转化率为8.3%，具有很好的特异性，但随着时间的推移，它非常不稳定：在2到3年内，只有6%的受试者继续患有MCI，而bb0 40%的受试者恢复正常。结论：常规定义的MCI对AD具有合理的预测价值和特异性。然而，在本研究中，MCI在时间上是非常不稳定的。此外，MCI的定义似乎过于严格，可能应该扩展到其他类别的个体，这些个体也有患AD的高风险。
Objective: To estimate the age-specific incidence rate of mild cognitive impairment (MCI) according to sex and educational level and to explore the course of MCI, particularly its progression to AD, in a population-based cohort. Methods: A comniunity-based cohort of nondemented elderly people (Personnes Agees QUID [PAQUID]) was followed longitudinally for 5 years. MCI was defined as memory complaints with objective memory impairment, without dementia, impairment of general cognitive functioning, or disability in activities of daily living. Incidence rates were calculated using the person-years method. A descriptive analysis at the different follow-up times was performed to study the course of MCI. Results: At baseline, there were 58 prevalent cases of MCI (2.8% of the sample). During a 5-year follow-up, 40 incident cases of MCI occurred in 1,265 subjects at risk. The global incidence rate of MCI was 9.9/1,000 person-years. MCI was a good predictor of AD with an annual conversion rate of 8.3% and a good specificity, but it was very unstable over time: Within 2 to 3 years, only 6% of the subjects continued to have MCI, whereas >40% reverted to normal. Conclusions: Conventionally defined MCI has reasonable predictive value and specificity for AD. However, MCI was very unstable across time in this study. Furthermore, the definition of MCI seems to be too restrictive and should probably be extended to other categories of individuals also at high risk of developing AD.