Cognitive markers preceding Alzheimer's dementia in the healthy oldest old
Cognitive markers preceding Alzheimer's dementia in the healthy oldest old
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DOI：
10.1111/j.1532-5415.1997.tb03091.x
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发表时间：
1997-05-01
影响因子：
6.3
通讯作者：
Kaye, JA
中科院分区：
文献类型：
--
作者：
Howieson, DB;Dame, A;Kaye, JA
目的：在健康的、年龄最大的老年人样本中寻找阿尔茨海默氏痴呆症的临床前标志物。设计：前瞻性的、纵向的研究，对每隔一年进行一次的神经心理学测试，选择对痴呆症早期检测敏感的个体进行检查。139个社区居住，功能独立，年龄在65至106岁之间的健康个体，其在进入时符合无痴呆症的严格标准。在平均2.8年的随访间隔期间，16名80岁或以上的老年痴呆症患者和31名80岁或以上的老年痴呆症患者均未出现痴呆症。当没有志愿者表现出痴呆的临床证据时，对10项神经心理学指标的评分进行了初步分析，结果：随后发展为痴呆的个体在其初次检查时显示出言语记忆障碍的证据，这是痴呆临床证据之前的平均2.8年。80岁以上老年痴呆症的年平均发病率为12%。没有发展成痴呆的个人的性能保持相对稳定，在后续长达5 years.CONCLUSION：阿尔茨海默病有一个临床前阶段，其中文字记忆下降是最早的迹象。老年痴呆症与年龄相关的认知能力下降是有区别的。
OBJECTIVE: To look for preclinical markers of Alzheimer's dementia in a sample of healthy, oldest old individuals.DESIGN: Prospective, longitudinal study of individuals examined at yearly intervals with neuropsychological tests selected to be sensitive to the early detection of dementia.PARTICIPANTS: One hundred and thirty-nine community-dwelling, functionally independent, healthy individuals 65 to 106 years of age who met strict criteria for lack of dementia at entry. Incident dementia cases consisted of 16 volunteers all 80 years old or older who developed dementia of the Alzheimer's type and 31 volunteers 80 years old and older showing no evidence of dementia during a mean 2.8-year follow-up interval.MEASUREMENTS: Scores on 10 neuropsychological measures were analyzed for the initial examination when none of the volunteers showed clinical evidence of dementia and for the two subsequent yearly examinations.RESULTS: Individuals who subsequently developed dementia showed evidence of verbal memory impairment at their initial examination, which was a mean of 2.8 years before clinical evidence of dementia. The average yearly incidence rate for dementia in those 80 years of age and older was 12%. Performance of individuals who did not development dementia remained relatively stable during follow-up for up to 5 years.CONCLUSION: Alzheimer's disease has a preclinical stage in which verbal memory decline is the earliest sign. Dementia in the oldest old is distinguishable from age-related cognitive decline.