The Risk of Incident Mild Cognitive Impairment and Progression to Dementia Considering Mild Cognitive Impairment Subtypes.
The Risk of Incident Mild Cognitive Impairment and Progression to Dementia Considering Mild Cognitive Impairment Subtypes.
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DOI：
10.1159/000452486
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发表时间：
2017-01
影响因子：
2.3
通讯作者：
Murman DL
中科院分区：
文献类型：
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作者：
Michaud TL;Su D;Siahpush M;Murman DL
目前尚不清楚人口统计学和临床特征如何与其亚型的轻度认知障碍（MCI）事件的风险相关。此外，MCI亚型对痴呆进展的贡献仍然令人困惑。我们使用了国家阿尔茨海默病协调中心收集的数据。我们的分析样本包括基线时认知正常的受试者。使用竞争风险生存回归模型和考克斯比例风险模型来检验相关性。约16.3%的受试者发生了偶发MCI，其中15.8%进展为阿尔茨海默病（总体平均随访4.3年）。与无ε4等位基因的受试者相比，携带1个（亚危险比[SHR]：1.23; 95% CI：1.00-1.50）或2个（SHR：2.14; 95% CI：1.49-3.05）APOE ε4等位基因的受试者发生偶发性遗忘型MCI（aMCI）的风险更大。多领域aMCI患者比单领域aMCI患者更可能进展为痴呆（风险比：2.14; 95% CI：1.28-3.58）。具有APOE ε4等位基因的认知正常受试者患aMCI的可能性更高，并且MCI亚型与痴呆亚型相关。我们的研究结果为预测认知能力下降的实用指标提供了重要信息。
It remains unclear how demographic and clinical characteristics are related to the risk of incident mild cognitive impairment (MCI) by its subtypes. Moreover, the contribution of the subtypes of incident MCI to the progression to dementia remains puzzling. We used data collected by the National Alzheimer Coordinating Center. Our analysis sample included cognitively normal subjects at baseline. The associations were examined using competing-risks survival regression models and Cox proportional hazards models. About 16.3% of subjects developed incident MCI of whom 15.8% progressed to Alzheimer disease (overall mean follow-up of 4.3 years). The risk of incident amnestic MCI (aMCI) was greater in subjects with 1 copy (subhazard ratio [SHR]: 1.23; 95% CI: 1.00–1.50) or 2 copies (SHR: 2.14; 95% CI: 1.49–3.05) of the APOE ε4 allele than in those who had no ε4 allele. Multiple-domain aMCI patients were more likely to progress to dementia than single-domain aMCI patients (hazard ratio: 2.14; 95% CI: 1.28–3.58). Cognitively normal subjects with an APOE ε4 allele had a higher likelihood of developing aMCI and the MCI subtype was associated with the dementia subtype. Our findings provide important information about practical indicators for the prediction of cognitive decline.