Kryscio R J, Schmitt F A, Salazar J C, Mendiondo M S, Markesbery W R
Sanders-Brown Center on Aging, University of Kentucky, KY, USA.
Neurology. 2006 Mar 28;66(6):828-32. doi: 10.1212/01.wnl.0000203264.71880.45.
To identify risk factors associated with transitions from cognitively normal to various forms of mild cognitive impairment (MCI) and then from MCI into early dementia with death as a competing state.
Cognitive assessments from 554 subjects participating in a longitudinal study at the University of Kentucky AD Center were used to classify individuals into one of three transient states at any visit: cognitively normal, amnestic MCI, or mixed MCI. Between visits subjects could die or become demented. A series of polytomous logistic models were used to model transitions among these states over time and to determine how the log odds of these transitions vary with age, education, sex, family history of dementia, and APOE status.
Age affects all transitions among transient states as well as those to dementia or death. Presence of at least one apolipoprotein 4 allele affects transitions from cognitively normal into amnestic MCI or into dementia. At most 12 years of education affects transitions into mixed MCI. Transitions do not vary with sex or family history.
Aside from age, the usual risk factors associated with conversion from cognitively normal into dementia are likely risk factors for transitions into mild cognitive impairment.
确定与从认知正常转变为各种形式的轻度认知障碍（MCI），然后从MCI转变为早期痴呆且将死亡作为竞争状态相关的风险因素。
来自肯塔基大学阿尔茨海默病中心参与一项纵向研究的554名受试者的认知评估结果，被用于在每次访视时将个体分类为三种短暂状态之一：认知正常、遗忘型MCI或混合型MCI。在访视期间，受试者可能死亡或发展为痴呆。一系列多分类逻辑模型被用于对这些状态随时间的转变进行建模，并确定这些转变的对数几率如何随年龄、教育程度、性别、痴呆家族史和载脂蛋白E（APOE）状态而变化。
年龄影响短暂状态之间的所有转变以及向痴呆或死亡的转变。至少存在一个载脂蛋白E4等位基因影响从认知正常向遗忘型MCI或向痴呆的转变。最多12年的教育程度影响向混合型MCI的转变。转变不随性别或家族史而变化。
除年龄外，通常与从认知正常转变为痴呆相关的风险因素可能也是转变为轻度认知障碍的风险因素。
