Down Syndrome and Dementia: Seizures and Cognitive Decline
Down Syndrome and Dementia: Seizures and Cognitive Decline
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DOI：
10.3233/jad-2012-111613
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发表时间：
2012-01-01
影响因子：
4
通讯作者：
Gillen, Daniel L.
中科院分区：
文献类型：
--
作者：
Lott, Ira T.;Doran, Eric;Gillen, Daniel L.
本研究的目的是确定唐氏综合征（DS）和阿尔茨海默氏型痴呆的成人癫痫发作和认知能力下降之间的关系。一项回顾性数据分析进行了一项对照研究的抗氧化剂补充剂的痴呆症在DS。在基线和每6个月进行一次观察，持续2年。从研究记录中获得癫痫发作史。主要结局指标包括基于表现的严重损害成套测验（SIB）和简明实践测验（BPT）。次要结果测量包括基于信息提供者的智力迟钝者痴呆问卷和Vineland适应行为量表。由于大部分癫痫发作患者的认知功能严重下降，无法进行测试，因此测量了至“首次无法测试”的时间。对年龄、性别、APOE 4状态、基线认知损害、基线痴呆发作后的年数和治疗分配等潜在混杂协变量进行了调整。在SIB上，有癫痫发作的患者与无癫痫发作的患者相比，至“首次无法测试”的时间的估计比值比为11.02（95% CI：1.59，76.27），该比值与1有显著差异（p=0.015）。同样，我们估计BPT的比值比为9.02（95% CI：1.90，42.85），该比值也显著不同于1（p=0.006）。对举报人措施的二次分析结果显示，缉获量大幅下降。我们的结论是，有一个很强的关联性癫痫发作与认知功能下降的痴呆患者与DS。指出了探索DS中这种关系的前瞻性研究。
The objective of this study was to determine the association of seizures and cognitive decline in adults with Down syndrome (DS) and Alzheimer's-type dementia. A retrospective data analysis was carried out following a controlled study of antioxidant supplementation for dementia in DS. Observations were made at baseline and every 6 months for 2 years. Seizure history was obtained from study records. The primary outcome measures comprised the performance-based Severe Impairment Battery (SIB) and Brief Praxis Test (BPT). Secondary outcome measures comprised the informant-based Dementia Questionnaire for Mentally Retarded Persons and Vineland Adaptive Behavior Scales. Because a large proportion of patients with seizures had such severe cognitive decline as to become untestable on the performance measures, time to "first inability to test" was measured. Adjustments were made for the potentially confounding co-variates of age, gender, APOE4 status, baseline cognitive impairment, years since dementia onset at baseline, and treatment assignment. The estimated odds ratio for the time to "first inability to test" on the SIB comparing those with seizures to those without is 11.02 (95% CI: 1.59, 76.27), a ratio that is significantly different from 1 (p=0.015). Similarly, we estimated an odds ratio of 9.02 (95% CI: 1.90, 42.85) on the BPT, a ratio also significantly different than 1 (p=0.006). Results from a secondary analysis of the informant measures showed significant decline related to seizures. We conclude that there is a strong association of seizures with cognitive decline in demented individuals with DS. Prospective studies exploring this relationship in DS are indicated.