Prencipe Massimiliano, Santini Manuela, Casini Anna Rosa, Pezzella Francesca Romana, Scaldaferri Nicola, Culasso Franco
J Neurol. 2003 Aug;250(8):907-12. doi: 10.1007/s00415-003-1094-0.
To assess the prevalence of "Cognitive Impairment No Dementia" (CIND) and circumscribed memory impairment (CMI) and to evaluate their association with vascular risk factors and stroke, we examined all people aged 65 years or over living in three rural Italian villages. The survey was conducted by means of a doorto-door 2-phase procedure. As phase 1 screening tests, we used the Mini-Mental State Examination (MMSE), or the Mental Status Questionnaire (MSQ) for people with < 3 years of schooling. In phase 2, four neurologists examined people with MMSE scores < 28 or MSQ scores < 10. The diagnostic study consisted of a clinical and neuropsychological examination which included a structured interview with a close respondent. Dementia was diagnosed by means of DSM III-R criteria. The study protocol was completed by 968 (84.4%) of the 1147 eligible people. Of the 968 participants, 690 (71.3 %) had no cognitive abnormalities, 78 (8.1%) were demented and 200 (20.6 %) suffered from CIND. The CIND group included 59 people (6.1% of the study population) with CMI. At the multiple logistic regression analysis, CIND was associated with age >or= 75 years (OR 1.6, 95 % CI 1.1.-2.2), < 5 years of schooling (OR 3.7, 95% CI 2.5.-5.5), stroke (OR 3.3, 95% CI 1.8.-6.1) and hypertension (OR 2.3, 95% CI 1.5.-3.5),while CMI was associated with < 5 years of schooling (OR 3.8, 95 % CI 1.9.-7.7), stroke (OR 3.1, 95% CI 1.2.-7.9) and hypertension (OR 3.7, 95% CI 1.7.-8.0). Using normotensive people as a reference group and adjusting for age, sex, education and stroke, the ORs for CIND were 1.9 (95 % CI 1.2.-3.0) for treated and 2.9 (95 % CI 1.8.-4.6) for untreated hypertensive patients. In conclusion, hypertension is significantly and independently associated with both CIND and CMI, and the risk of CIND is higher in untreated than treated hypertensive patients.
为评估“非痴呆性认知障碍”（CIND）和局限性记忆障碍（CMI）的患病率，并评估它们与血管危险因素及中风的关联，我们对居住在意大利三个乡村的所有65岁及以上老人进行了调查。该调查通过挨家挨户的两阶段程序进行。作为第一阶段的筛查测试，我们对受教育年限不足3年的人群使用简易精神状态检查表（MMSE）或精神状态问卷（MSQ）。在第二阶段，四位神经科医生对MMSE得分低于28或MSQ得分低于10的人群进行检查。诊断研究包括临床和神经心理学检查，其中包括与一位关系密切的受访者进行结构化访谈。根据《精神疾病诊断与统计手册》第三版修订本（DSM III-R）标准诊断痴呆症。1147名符合条件的人中，968人（84.4%）完成了研究方案。在968名参与者中，690人（71.3%）无认知异常，78人（8.1%）患有痴呆症，200人（20.6%）患有CIND。CIND组包括59名患有CMI的人（占研究人群的6.1%）。在多因素逻辑回归分析中，CIND与年龄≥75岁（比值比1.6，95%可信区间1.1 - 2.2）、受教育年限不足5年（比值比3.7，95%可信区间2.5 - 5.5）、中风（比值比3.3，95%可信区间1.8 - 6.1）和高血压（比值比2.3，95%可信区间1.5 - 3.5）相关，而CMI与受教育年限不足5年（比值比3.8，95%可信区间1.9 - 7.7）、中风（比值比3.1，95%可信区间1.2 - 7.9）和高血压（比值比3.7，95%可信区间1.7 - 8.0）相关。以血压正常的人群作为参照组，并对年龄、性别、教育程度和中风进行校正后，接受治疗的高血压患者发生CIND的比值比为1.9（95%可信区间1.2 - 3.0），未接受治疗的高血压患者为2.9（95%可信区间1.8 - 4.6）。总之，高血压与CIND和CMI均显著且独立相关，未接受治疗的高血压患者发生CIND的风险高于接受治疗的患者。
