Early Markers Of Alzheimer Disease

阿尔茨海默病(AD)是几种神经退行性疾病(痴呆症)中最普遍的，主要发生在晚年，偶尔发生在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。 该部门的研究人员研究了与抑郁症状相关的痴呆症和阿尔茨海默病(AD)风险的增加，尽管尚不清楚抑郁是实际的风险因素还是前驱症状。为了确定发病前抑郁症状对痴呆症和AD发展的相对风险，我们研究了14年期间1357名社区居住的男性和女性患痴呆症和AD的风险，这些男性和女性参与了为期40年的巴尔的摩前瞻性老龄化纵向研究。每两年前瞻性收集抑郁症状筛查、综合医学和神经心理学评估。分别计算了男性和女性患阿尔茨海默病或痴呆症的随时间变化的比例风险，在痴呆症症状出现之前的2年、4年和6年检测到抑郁症状。将血管危险因素作为协变量进行分析。病前抑郁症状显著增加了患痴呆症的风险，尤其是在男性中，但在女性中不是。风险比大约是没有抑郁症状病史的个体的两倍，这种影响与血管疾病无关。我们得出结论，抑郁症状对痴呆症和AD风险的影响可能因性别而异。 该部门的研究人员开发了一种计算机化的方法，以帮助预测有患阿尔茨海默病(AD)风险的个人。这种方法将是临床医生为潜在的AD患者制定治疗计划的一个有价值的工具。利用视觉记忆表现的初始水平和变化率，这种方法可以快速、廉价地预测潜在的AD患者。在老年学研究中心对52名女性和145名男性参与者进行了一项纵向病例对照研究，使用病前视觉记忆测试和神经学检查来确定是否患有痴呆症和阿尔茨海默病。每个人的分类方法从第二次检查开始，并根据其余个人的所有后续信息，一次一次地计算该人患AD的风险。通过进行交叉验证研究，根据接收器工作特征(ROC)曲线得出的灵敏度和特异度的最佳组合显示，65%的阿尔茨海默病病例和75%的非阿尔茨海默病病例被正确归类为女性，而65%的病例和60%的非病例被正确归类为男性。认知的纵向测量在检测AD的存在方面是有用的。

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.