Cohort study for a cognitive decline in elderly people living in a Japanese community.

基于体素的阿尔茨海默病特异性区域分析（VSRAD）是一个免费的软件，用于检测包括内holinal皮质在内的内侧颞区萎缩，使用基于体素的形态测量法进行阿尔茨海默病的早期诊断。方法：对居住在日本农村社区的182名年龄在65 ~ 91岁，平均年龄78岁（SD 6.4）的非痴呆老年受试者（男53名，女129名）进行脑磁共振成像（VSRAD），并于2004 ~ 2006年（时间a）进行了Mini-Mental State Examination （MMSE）、Frontal Assessment Battery （FAB）和Clinical Dementia Rating （CDR）的测量。3年后进行第二次认知功能评估，以评估VSRAD参数与受试者认知缺陷之间的关系。年龄、性别、受教育程度、饮酒、高血压和糖尿病对认知能力下降的影响也进行了调查。结果：代表VSRAD内侧颞区萎缩的时间B的z -评分与3年MMSE评分变化呈负相关（r=- 0.360， P<0.001），与FAB评分变化无显著相关性（r=.342， P<0.001），与CDR评分变化呈正相关（r=.342， P<0.001）。与CDR为0的受试者相比，在时间B时CDR升高至0.5的受试者在时间a时显示出更大的VSRAD内侧颞区萎缩指数。这些数据表明，在社区痴呆患病率研究中，VSRAD可以为预测随后的认知缺陷提供有用的信息。

The Voxel-based Specific Regional Analysis for Alzheimer's Disease (VSRAD) is a freely available software to detect the atrophy of medial temporal areas including the entorholinal cortex using voxel-based morphometry for early diagnosis of Alzheimer's disease. Methods : Cranial MRI with VSRAD was performed on 182 non-demented elderly subjects (male n=53 ; female n=129) aged from 65 to 91 years of age, with a mean age of 78 (SD 6.4) who resided in a Japanese rural community, followed by measurement of Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB) and Clinical Dementia Rating (CDR) in 2004 to 2006 (Time A). The second assessment of the cognitive functions was performed 3 years later to assess the relationship between the parameters of VSRAD and consequent cognitive deficits in the subjects. Effects of age, sex, education, alcohol intake, hypertension and diabetes on consequent cognitive decline were also investigated. Results : The Z-score of medial temporal areas of VSRAD at Time B which represents the atrophy of the area was negatively correlated with the changes in the score of MMSE during 3 years (r=-.360, P<0.001), but not in the score of FAB and positively correlated with the changes in the score of CDR (r=.342, P<0.001). The subjects with a consequent cognitive decline assessed by increased CDR to 0.5 at Time B showed a greater atrophy index of medial temporal areas of VSRAD at Time A, compared with the subjects with CDR 0 at Time B. These data indicate that VSRAD could provide an useful information to predict consequent cognitive deficits in a community prevalence study of dementia.