EARLY MARKERS OF ALZHEIMER DISEASE

工作摘要：阿尔茨海默病(AD)是几种神经退行性疾病(痴呆症)中最常见的，主要发生在晚年，偶尔在60岁之前，但更常见的是70岁以后。这项研究调查了巴尔的摩老龄化纵向研究(BLSA)参与者的预期心理、神经和神经心理变化。对60岁及以上的参与者进行神经学和神经心理学检查，重复许多在年龄较小时对这些受试者进行的测试。疑似阿尔茨海默病的诊断遵循NINCDS-ADRDA标准。在最近的一份出版物中，我们表明，巴尔的摩纵向研究的阿尔茨海默病发病率与已发表的发病率一致，尽管它缺乏代表性。在这项研究中，有1236名参与者(802名男性，434名女性)在1985年1月至1998年5月期间进行了纵向随访。平均随访时间为7.5年，参与者每两年进行一次身体、神经学和神经心理学检查。我们根据《精神疾病诊断和统计手册》和美国国家神经与沟通障碍研究所和中风-阿尔茨海默病及相关疾病协会的标准诊断了155例痴呆症和阿尔茨海默病。在155例痴呆症患者中，有114例(74%)患有阿尔茨海默病。阿尔茨海默病的发病率随着年龄的增长而增加，从60到65岁年龄组的估计每年0.08%(95%可信区间0.00到0.43)增加到85岁以上年龄组的估计每年6.48%(95%可信区间5.01到8.38)。发病率倍增的时间约为4.4年。有一种趋势是，妇女的发病率高于男子，受教育年限越少，发病率越高；但这些影响并不显著。从轻度认知障碍到阿尔茨海默病诊断的中位时间为4.4年。这些结果表明，巴尔的摩纵向研究中阿尔茨海默病的发病率与其他研究中公布的发病率一致。

Summary of work: Alzheimer's disease (AD) is the most widespread among several neurological degenerative diseases (dementias) that occur principally at later ages, occasionally before 60, but more frequently after age 70. This study examines prospective psychological, neurological, and neuropsychological changes in participants from the Baltimore Longitudinal Study of Aging (BLSA). Neurological and neuropsychological examinations are administered to participants aged 60 and older, repeating many of the tests that were administered to these subjects at earlier ages. Diagnoses of probable Alzheimer's disease follow the NINCDS-ADRDA criteria. In a recent publication, we showed that incidence rates of Alzheimer's disease from the Baltimore Longitudinal Study are consistent with published incidence rates despite its lack of representativeness. In this study, there were 1,236 participants (802 men, 434 women) with longitudinal follow-ups between January 1985 and May 1998. The average length of follow-up was 7.5 years, with participants evaluated every 2 years by physical, neurologic, and neuropsychological examinations. We diagnosed 155 cases of dementia and Alzheimer's disease based on criteria from the Diagnostic and Statistical Manual of Mental Disorders and National Institute of Neurological and Communicative Disorders and Stroke-Alzheimer's Disease and Related Disorders Association. Of the 155 cases of dementia, there were 114 (74%) cases of Alzheimer's disease. Incidence rates of Alzheimer's disease increased with age from an estimated 0.08% per year (95% CI 0.00 to 0.43) in the 60 to 65 age group to an estimated 6.48% per year (95% CI 5.01 to 8.38) in the 85+ age group for men and women combined. The doubling time of incidence rates was approximately 4.4 years. There was a trend for women to have higher incidence rates than men and for an association of fewer years of education with higher incidence rates; but these effects were not significant. The median time of conversion from mild cognitive impairment to diagnosis of Alzheimer's disease was 4.4 years. These results suggest that the incidence rates for Alzheimer's disease in the Baltimore Longitudinal Study are consistent with published rates in other studies.