Early Markers Of Alzheimer Disease

阿尔茨海默病（AD）是主要发生在较晚年龄的几种神经退行性疾病（痴呆）中最普遍的，偶尔在60岁之前，但更频繁地在70岁之后。本研究探讨了前瞻性的心理，神经和神经心理学的变化，参与者从巴尔的摩纵向研究老化（BLSA）。对60岁及以上的参与者进行神经学和神经心理学检查，重复在早期对这些受试者进行的许多测试。可能的阿尔茨海默病的诊断遵循NINCDS-ADRDA标准。 部分研究人员检查了与抑郁症症状相关的痴呆症和阿尔茨海默病（AD）的风险增加，尽管尚不清楚抑郁症是否代表实际的风险因素或前驱症状。为了确定发病前抑郁性痴呆症对痴呆和AD发展的相对危险性，我们研究了1,357名社区居民中参与40年前瞻性巴尔的摩老龄化纵向研究的男性和女性在14年内发生痴呆和AD的风险。每2年前瞻性收集抑郁症状筛查、综合医学和神经心理学评估。分别计算男性和女性AD或痴呆发展的时间依赖性比例风险，在痴呆症状发作前2年、4年和6年检测抑郁症状。血管风险因素作为协变量进行分析。病前抑郁症状显著增加痴呆症的风险，尤其是男性AD，但女性则不然。风险比大约是没有抑郁症状史的个体的两倍，这种影响与血管疾病无关。我们的结论是，抑郁症状对痴呆和AD风险的影响可能因性别而异。 部分研究人员开发了一种计算机化的方法来帮助预测个体患阿尔茨海默病（AD）的风险。这种方法将是一个有价值的工具，临床医生在制定治疗计划，为潜在的AD患者。使用视觉记忆表现的初始水平和变化率，这种方法可以快速和廉价的方式预测潜在的AD患者。一项纵向病例对照研究，52名女性和145名男性参与者进行了在老年学研究中心使用视觉记忆和神经系统检查的病前测试，以确定个人与非痴呆和AD。每个个体的分类方法从第二次检查开始，并根据其余个体的所有随访信息，一次一次地进行一次检查，以计算该人的AD风险。通过进行交叉验证研究，从受试者工作特征（ROC）曲线得出的灵敏度和特异性的最佳组合显示，65%的阿尔茨海默病病例和75%的非病例被正确分类为女性，而65%和60%的病例和非病例，分别被正确分类为男性。认知的纵向测量可用于检测AD的存在。

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. Section investigators examined the increased risk for dementia and Alzheimer's disease (AD) associated with symptoms of depression, although it is unclear whether depression represents an actual risk factor or a prodrome. To determine the relative hazard of premorbid depressive symptomatology for development of dementia and AD, we studied risk for incident dementia and AD over a 14-year period in 1,357 community-dwelling men and women participating in the 40-year prospective Baltimore Longitudinal Study of Aging. Screening for depressive symptoms, comprehensive medical and neuropsychological evaluations were prospectively collected every 2 years. Time-dependent proportional hazards of development of AD or dementia were calculated separately for men and women, with symptoms of depression detected at 2-, 4-, and 6-year intervals before onset of dementia symptoms. Vascular risk factors were analyzed as covariates. Premorbid depressive symptoms significantly increased risk for dementia, particularly AD in men but not in women. Hazard ratios were approximately two times greater than for individuals without history of depressive symptoms, an effect independent of vascular disease. We concluded that the impact of depressive symptoms on risk for dementia and AD may vary with sex. Section investigators developed a computerized method to help predict individuals at risk for developing Alzheimer's disease (AD). This method would be a valuable tool for clinicians in developing treatment plans for potential AD patients. Using the initial level and rates of change in visual memory performance, such a method could predict potential AD patients in a fast and inexpensive manner. A longitudinal case-control study of 52 female and 145 male participants was performed in a gerontology research center using premorbid tests of visual memory and neurologic examinations to identify individuals with and without dementia and AD. The classification method for each individual starts on the second examination and proceeds to compute that person's risk of AD one examination at a time based on all the follow-up information of the remaining individuals. By performing a crossvalidation study, the optimal combination of sensitivity and specificity derived from a receiver operating characteristic (ROC) curve showed 65% of the Alzheimer cases and 75% of the noncases were correctly classified for females, while 65 and 60% of cases and noncases, respectively, were correctly classified for males. Longitudinal measurements of cognition can be useful in detecting the presence of AD.