Dumont C, Voisin T, Nourhashemi F, Andrieu S, Koning M, Vellas B
Department of Internal Medicine and Geriatrics, Hopitaux St Joseph-Ste Therese-IMTR, Gilly, Belgium.
J Nutr Health Aging. 2005;9(3):163-7.
To seek predictors of rapid loss of cognition and to evaluate their frequency in a prospective study of patients suffering from Alzheimer's disease (AD).
A one-year prospective study.
312 AD patients from the memory clinic at Toulouse University Hospital, participants in the ELSA study, were enrolled. Rapid cognitive decline was defined as a 4-point or greater loss on the Mini-Mental State Examination (MMSE) in 6 months. Comprehensive geriatric and neuropsychological assessment was conducted at baseline, 6 months and one year.
Seventy-nine (24.8%) patients presented rapid cognitive loss over 6 months. The majority were stable at one year whereas 15 experienced continued rapid cognitive loss. Multivariate analysis showed that only the Mini Nutritional Assessment score (MNA) was correlated with rate of decline. Patients with rapid cognitive decline were also significantly more dependent at 6 months.
Our findings demonstrate that rapid cognitive loss is frequent in AD patients, probably indicating underlying frailty. Future studies should lead to a practical approach to detecting these frail patients and to increasing preventive interventions.
在一项针对阿尔茨海默病（AD）患者的前瞻性研究中寻找认知快速丧失的预测因素，并评估其出现频率。
为期一年的前瞻性研究。
招募了来自图卢兹大学医院记忆门诊的312名AD患者，他们均为ELSA研究的参与者。认知快速衰退被定义为在6个月内简易精神状态检查表（MMSE）得分下降4分或更多。在基线、6个月和1年时进行了全面的老年医学和神经心理学评估。
79名（24.8%）患者在6个月内出现认知快速丧失。大多数患者在1年时病情稳定，而15名患者持续出现认知快速丧失。多变量分析显示，只有微型营养评定量表（MNA）得分与衰退率相关。认知快速衰退的患者在6个月时也明显更依赖他人。
我们的研究结果表明，认知快速丧失在AD患者中很常见，这可能表明存在潜在的虚弱状况。未来的研究应能找到一种切实可行的方法来检测这些虚弱患者，并增加预防性干预措施。
