Risk of Conversion to Dementia in a Mild Behavioral Impairment Group Compared to a Psychiatric Group and to a Mild Cognitive Impairment Group
Risk of Conversion to Dementia in a Mild Behavioral Impairment Group Compared to a Psychiatric Group and to a Mild Cognitive Impairment Group
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DOI：
10.3233/jad-170632
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发表时间：
2018-01-01
影响因子：
4
通讯作者：
Dillon, Carol
中科院分区：
文献类型：
--
作者：
Taragano, Fernando E.;Allegri, Ricardo F.;Dillon, Carol
工作背景：目的：观察分析轻度行为障碍（MBI）、轻度认知障碍（MCI）和精神病组（PG）患者进展为痴呆的危险性。从最初评估的677名≥ 60岁的患者中，对348名患者进行了为期5年的研究，直到删失或转化为痴呆：96名MBI患者，87名MCI患者和165名一般精神障碍患者，包括4个亚组：焦虑、抑郁、精神病及其他。结果：348例患者中，126例（36.2%）发展为痴呆。与PG组（13.9%）相比，MBI组（71.5%）、MCI-MBI重叠组（59.6%）和MCI组（37.8%）的转化率显著更高（对数秩p < 0.001）。MCI患者多转为Alzheimer痴呆，MBI患者多转为额颞叶痴呆和Lewy体痴呆。结论：有神经精神症状的PG患者中，痴呆的发生率明显增高。MBI概念在神经退行性疾病诊断的改进和创建神经精神病学特征的可能性方面产生了新的里程碑。它的早期识别将为治疗干预提供新的可能性。
Background: There is insufficient available information on behavioral changes in the absence of cognitive impairment as factors increasing the risk of conversion to dementia.Objective: To observe and analyze patients with mild behavioral impairment (MBI), mild cognitive impairment (MCI), and a psychiatry group (PG) to compare the risk of progression to dementia.Methods: From 677 initially assessed >= 60-year-old patients, a series of 348 patients was studied for a five-year period until censoring or conversion to dementia: 96 with MBI, 87 with MCI, and 165 with general psychiatry disorders, including 4 subgroups: Anxiety, Depression, Psychosis and Others. All patients were assessed with clinical, psychiatric, neurological, neuropsychological, and neuroimaging studies.Results: From 348 patients, 126 evolved to dementia (36.2%). Conversion was significantly higher in MBI (71.5%), followed by the MCI-MBI overlap (59.6%) and MCI (37.8%) groups, compared to PG (13.9%) (Log-rank p < 0.001). MCI patients mostly converted to Alzheimer's dementia, while MBI converted to frontotemporal dementia and Lewy body dementia. Patients in PG converted to Lewy body dementia and frontotemporal dementia.Conclusion: Conversion to dementia is significantly higher in patients with neuropsychiatric symptoms. The MBI concept generates a new milestone in the refining of diagnosis of neurodegenerative diseases and the possibility of creating neuropsychiatric profiles. Its earlier identification will allow new possibilities for therapeutic intervention.