Low Prevalence of Mixed Dementia in a Cohort of 2,000 Elderly Patients in a Memory Clinic Setting
Low Prevalence of Mixed Dementia in a Cohort of 2,000 Elderly Patients in a Memory Clinic Setting
复制标题
DOI：
10.3233/jad-150796
复制
发表时间：
2016-01-01
影响因子：
4
通讯作者：
Scheltens, Philip
中科院分区：
文献类型：
--
作者：
Claus, Jules J.;Staekenborg, Salka S.;Scheltens, Philip
背景：一般认为，随着年龄的增长，临床诊断的阿尔茨海默病（AD）的病理变得更加混合，即淀粉样斑块和脑血管病理并存。目的：验证在单中心记忆临床人群中迟发性临床诊断阿尔茨海默病（AD）混合性痴呆患病率增加的假设。方法：诊断为AD（832例）、主观认知障碍（SCI， 333例）、轻度认知障碍（MCI， 492例）、血管性痴呆（VaD， 57例）、其他痴呆（53例）或其他诊断（233例）的患者。重度白质病变（WML）的患病率定义为脑计算机断层扫描fazekass评分为2分或更高，将AD患者分类为混合性痴呆。我们使用多元线性回归分析检验了年龄对WML的影响，并将AD患者与SCI患者进行比较，以确定疾病对WML的影响。结果：AD患者（混合性痴呆）重度WML患病率为33.6%，SCI为11.4%，MCI为22.7%，VaD为75.4%，其他痴呆为3.8%，其他诊断为15.5%。随着年龄的增长，WML评分在SCI、MCI、AD、其他痴呆和其他诊断中的增加幅度相似，表明AD没有改变效果。AD患者和SCI患者在WML评分上的平均差异为0.16，在所有年龄段中，AD和SCI患者之间严重WML百分比的差异为15%。结论：我们发现混合性痴呆的患病率较低。此外，AD患者严重的WML很大程度上是由年龄而不是疾病的影响来解释的。
Background: It is generally assumed that with increasing age, pathology in clinically diagnosed Alzheimer's disease (AD) becomes more mixed, i. e., co-existence of amyloid plaques and cerebrovascular pathology.Objective: To test the hypothesis of increasing prevalence of mixed dementia in late-onset clinically diagnosed Alzheimer's disease (AD) in a single-center memory clinic population.Methods: Patients included had diagnoses of AD (n = 832), subjective cognitive impairment (SCI, n = 333), mild cognitive impairment (MCI, n = 492), vascular dementia (VaD, n = 57), other dementia (n = 53), or other diagnosis (n = 233). Prevalence of severe white matter lesions (WML) was defined as a score of 2 or higher on the Fazekas-scale on brain computed tomography to classify AD patients as having mixed dementia. We examined the effect of age on WML using multiple linear regression analysis, and AD patients were compared to SCI to determine the effect of disease on WML.Results: Prevalence of severe WML was 33.6% in AD patients (mixed dementia), 11.4% in SCI, 22.7% in MCI, 75.4% in VaD, 3.8% in other dementia, and 15.5% in other diagnosis. With increasing age there was a significant and similar increase of WML scores in SCI, MCI, AD, other dementia, and other diagnosis, indicating no effect modification by AD. The difference between AD patients and SCI averaged 0.16 on the WML score and difference in percentage severe WML between AD and SCI patients was 15% across all ages.Conclusion: We found a low prevalence of mixed dementia. Furthermore, severe WML in AD was largely explained by age rather than effect of disease.