Hodges John R, Erzinçlioğlu Sharon, Patterson Karalyn
MRC Cognition and Brain Sciences Unit, Addenbrooke's Hospital, Cambridge, UK.
Dement Geriatr Cogn Disord. 2006;21(5-6):380-91. doi: 10.1159/000092534. Epub 2006 Apr 4.
Ten patients with mild cognitive impairment (MCI) underwent extensive neuropsychological evaluation at 12-monthly intervals for a minimum of 6 years. All 10 patients declined and 5 have now died. The onset of dementia, as defined by a fall in global cognitive function (MMSE <24) or activities of daily living (Clinical Dementia Rating Scale; CDR) ranged from 1 to 8 years with generally good concordance between these measures. The rate of decline on the MMSE was highly variable ranging from 0.86 to 2.83 points per year. Other than a consistent impairment on tests of episodic memory and category fluency (8 out of 10), other early cognitive deficits were difficult to define and tended to be unstable in the early stages. Impairment of semantic memory, visuo-spatial and attentional abilities eventually developed but the sequence of deficit acquisition was heterogeneous. These findings are discussed in the light of current views of MCI. Amnestic MCI may not be an accurate concept unless semantic memory impairment is also considered as an integral core deficit. Full-blown dementia may take many years to develop in patients with MCI but was a universal feature in this study.
10名轻度认知障碍（MCI）患者每隔12个月接受一次全面的神经心理学评估，至少持续6年。所有10名患者病情均出现恶化，其中5人现已死亡。根据整体认知功能下降（简易精神状态检查表<24分）或日常生活活动能力（临床痴呆评定量表；CDR）定义的痴呆症发病时间为1至8年，这些指标之间通常具有良好的一致性。简易精神状态检查表（MMSE）的下降速度差异很大，每年从0.86分到2.83分不等。除了情景记忆测试和类别流畅性测试持续受损（10人中有8人）外，其他早期认知缺陷难以界定，且在早期往往不稳定。语义记忆、视觉空间和注意力能力最终出现受损，但缺陷出现的顺序各不相同。结合当前对MCI的看法对这些发现进行了讨论。除非将语义记忆损害也视为一个不可或缺的核心缺陷，否则遗忘型MCI可能不是一个准确的概念。MCI患者可能需要很多年才会发展为全面性痴呆症，但这是本研究中的一个普遍特征。
