Predictors of Alzheimers Disease in Mild Cognitive Impairment

描述(由申请人提供)：心血管健康研究-认知研究(CHS-CS)，“轻度认知障碍中阿尔茨海默病(AD)的预测因素”(AG 20098)在过去4年中仔细跟踪了532名CHS-CS参与者。这是最初于1992-94年建立的CHS匹兹堡记忆研究的924名合格参与者中的83%。参与者接受了年度神经心理评估、告密者提供的信息和详细的临床信息。自1988年启动母体社区卫生服务以来，已有关于风险因素的数据。到2005年，32%的正常人(每年约6%)和63%的MCL(每年约16%)患有痴呆症；2006年有359人活着，平均年龄为86岁。这项研究表明，大多数MCI转变为痴呆症，许多正常人非常迅速地转变为痴呆症，MRI表现对于了解风险至关重要，包括脑血管疾病、全局性脑萎缩和局灶性脑异常。拟议的4年续展包括对存活队列进行3年的随访和重复磁共振成像，以评估无痴呆生存的个人的特征，确定风险因素与924名参与者在大约18-20年的随访中MRI变化的关系，分析生活方式、遗传和MRI属性与痴呆症风险、MCI和保持正常的关系。这一拟议后续行动的大部分资源专门用于对核磁共振成像的详细评价、对剩余幸存者的仔细评价和详细的最终分析。从这个项目前三年收集的数据中，我们开发了一个中心假设来指导我们的研究问题。具体地说，阿尔茨海默病的病理状态早于痴呆综合征的临床体征/症状发展数年。我们认为MCI是正常认知和坦率痴呆之间的过渡状态，在没有其他共病的情况下，MCI就是AD。在这种背景下，我们对指示神经病变存在的变量(例如，结构和灌注MRI、血浆β-淀粉样蛋白)以及修改风险以表达临床综合征的因素的研究具有额外的重要性。

DESCRIPTION (provided by applicant): The Cardiovascular Health Study-Cognition Study (CHS-CS), "Predictors of Alzheimer's disease (AD) in mild cognitive impairment (MCI)" (AG 20098) has carefully followed 532 CHS-CS participants over the past 4 years. These were 83% of the 924 eligible participants from the original CHS Pittsburgh Memory Study initially established in 1992-94. The participants have been followed with annual neuropsychological evaluations, information from informants and detailed clinical information. Data on risk factors are available since1988, when the parent CHS was initiated. By 2005, 32% of the normals (approximately 6% per year) and 63% of the MCls (approximately 16% per year) were demented; and 359 are alive in 2006, with a mean age of 86. This study has shown that most MCI convert to dementia, that many normals convert to dementia very rapidly, that the MRI findings are crucial for understanding risk, including vascular disease in the brain, global brain atrophy and focal brain abnormalities. The proposed 4-year renewal includes 3 years of follow up and repeat MRIs for the surviving cohort in order to evaluate the characteristics of individuals who survive free of dementia to determine the relationship of risk factors and MRI changes over an approximate 18-20 year follow up for the 924 participants, to analyze the relationship of lifestyles, genetic and MRI attributes to the risk of dementia, MCI and remaining normal. Most of the resources in this proposed follow up are dedicated to the detailed evaluation of the MRIs, to careful evaluation of the remaining survivors and for detailed final analysis. From the data gathered in the first 3 years of this project, we have developed a central hypothesis to guide our research questions. Specifically, that the pathological state of AD exists years prior to the development of the clinical signs/symptoms of the dementia syndrome. We view MCI as the transitional state between normal cognition and frank dementia, and that in the absence of other comorbid conditions, MCI is AD. In this context, our study of the variables that indicate the presence of neuropathological change (e.g., structural and perfusion MRI, plasma beta-amyloid) and the factors that modify the risk to express the clinical syndrome takes on an added importance.