Hänninen T, Hallikainen M, Tuomainen S, Vanhanen M, Soininen H
Department of Neuroscience and Neurology, University of Kuopio, Finland.
Acta Neurol Scand. 2002 Sep;106(3):148-54. doi: 10.1034/j.1600-0404.2002.01225.x.
Mild cognitive impairment (MCI) has been suggested as a term for a boundary area between normal aging and dementia, especially Alzheimer's disease (AD). In follow-up studies, more than 50% of MCI subjects have been converted to dementia in 3-4 years. However, the epidemiology of MCI is not well known. This study was designed to determine the prevalence of MCI in an elderly population.
A total of 806 subjects (60-76 years of age) from a population-based random sample of 1150 subjects living in the city of Kuopio in eastern Finland were evaluated. Neuropsychological tests and a structured interview including the modified Clinical Dementia Rating (CDR) were used to apply the diagnostic criteria of MCI as proposed by Mayo Clinic Alzheimer's Disease Research Centre. Thus, subjects having a test score more than 1.5 SDs below the age appropriate mean in memory tests and a CDR score of 0.5 but no dementia, were diagnosed as having MCI.
A total of 43 subjects, 5.3%, met the MCI criteria. MCI was more prevalent in older and less-educated subjects, but no difference was found between men and women. The CDR appeared to be the most important part of the criteria. The memory tests had less impact on prevalence variables.
The low prevalence of MCI indicate that in a population-based study design its criteria may identify a more homogeneous group of subjects at the lower end of the cognitive continuum as contrasted with various other criteria of cognitive impairment in the elderly population. This is compatible with follow-up studies showing a high probability of dementia in the MCI group. Thus, probable candidates for trials of preventive intervention for dementia can be screened from the elderly population using these diagnostic criteria.
轻度认知障碍(MCI)被认为是正常衰老与痴呆,尤其是阿尔茨海默病(AD)之间边界区域的一个术语。在随访研究中,超过50%的MCI受试者在3至4年内转变为痴呆。然而,MCI的流行病学情况尚不为人所知。本研究旨在确定老年人群中MCI的患病率。
对来自芬兰东部库奥皮奥市1150名居民的基于人群的随机样本中的806名受试者(60 - 76岁)进行了评估。采用神经心理学测试和包括改良临床痴呆评定量表(CDR)在内的结构化访谈,以应用梅奥诊所阿尔茨海默病研究中心提出的MCI诊断标准。因此,在记忆测试中得分比相应年龄均值低超过1.5个标准差且CDR评分为0.5但无痴呆的受试者被诊断为患有MCI。
共有43名受试者(5.3%)符合MCI标准。MCI在年龄较大和受教育程度较低的受试者中更为普遍,但在男性和女性之间未发现差异。CDR似乎是标准中最重要的部分。记忆测试对患病率变量的影响较小。
MCI的低患病率表明,在基于人群的研究设计中,其标准可能识别出认知连续体较低端的一组更为同质的受试者,这与老年人群中其他各种认知障碍标准形成对比。这与随访研究显示MCI组患痴呆的高概率相符。因此,可使用这些诊断标准从老年人群中筛选出可能适合痴呆预防性干预试验的受试者。