Conversion from subtypes of mild cognitive impairment to Alzheimer dementia
Conversion from subtypes of mild cognitive impairment to Alzheimer dementia
复制标题
DOI：
10.1212/01.wnl.0000252358.03285.9d
复制
发表时间：
2007-01-23
期刊：
影响因子：
9.9
通讯作者：
Tragl, K. H.
中科院分区：
文献类型：
--
作者：
Fischer, P.;Jungwirth, S.;Tragl, K. H.
目的：比较社区出生队列中轻度认知障碍（MCI）亚型向阿尔茨海默氏痴呆（AD）的转化率，研究对象为75岁时的MCI，并在30个月后随访。研究方法：维也纳跨多瑙河老龄化研究调查了多瑙河左岸海岸地区1925年5月至1926年6月出生的每一位居民。通过使用官方投票登记，联系了1505名受试者，697名参与。数据涉及581名在基线时完成广泛神经心理学检查的非痴呆个体的队列。30个月后随访476例先证者（35例死亡）。结果：141例MCI患者分为两种亚型。随访时，这些MCI患者中有41例被诊断为AD。遗忘型MCI的AD转化率为48.7%（CI：32.4至65.2），非遗忘型MCI的AD转化率为26.8%（CI：17.6至37.8）。另外49例AD病例在基线时源于认知健康（12.6%; CI：9.4 - 16.3）。结论：轻度认知功能障碍（MCI）患者在30个月后被诊断为Alzheimer痴呆（AD）的可能性较高。MCI的亚型在定义各种类型痴呆的早期阶段中没有用：不仅遗忘型MCI，而且非遗忘型MCI也经常转化为AD，并且转化为血管性痴呆和路易体痴呆并不限于非遗忘型MCI。
Objective: To compare the rates of conversion to Alzheimer dementia (AD) between subtypes of mild cognitive impairment (MCI) in a community- based birth cohort investigated at age 75 and followed up after 30 months. Methods: The Vienna Trans-Danube Aging Study investigated every inhabitant of the area on the left shore of the river Danube who was born between May 1925 and June 1926. With use of the official voting registry, 1505 subjects were contacted and 697 participated. Data refer to the cohort of 581 nondemented individuals who completed extensive neuropsychological examination at baseline. Follow-up after 30 months was possible in 476 probands (35 deceased). Results: The 141 patients with MCI at baseline were classified into two subtypes. At follow-up, 41 of these patients with MCI were diagnosed with AD. Conversion rates to AD were 48.7% (CI: 32.4 to 65.2) for amnestic MCI and 26.8% (CI: 17.6 to 37.8) for nonamnestic MCI. Another 49 AD cases originated from cognitive health at baseline (12.6%; CI: 9.4 to 16.3). Conclusions: Patients with mild cognitive impairment (MCI) showed a high probability to be diagnosed with Alzheimer dementia (AD) after 30 months. Subtypes of MCI were not useful in defining early stages of various types of dementia: Not only amnestic MCI but also nonamnestic MCI converted frequently to AD, and conversion to vascular dementia and dementia with Lewy bodies was not restricted to nonamnestic MCI.