Madureira Sofia, Verdelho Ana, Ferro José, Basile Anna-Maria, Chabriat Hugues, Erkinjuntti Timo, Fazekas Franz, Hennerici Michael, O'brien John, Pantoni Leonardo, Salvadori Emilia, Scheltens Philip, Visser Marieke C, Wahlund Lars-Olof, Waldemar Gunhild, Wallin Anders, Inzitari Domenico
Serviço de Neurologia, Centro de Estudos Egas Moniz, Hospital de Santa Maria, Lisboa, Portugal.
Neuroepidemiology. 2006;27(2):101-16. doi: 10.1159/000095381.
The relationship between age-related white matter changes and cognitive performance in independent elderly people is still not clear. The Leukoaraiosis and Disability in the Elderly study (LADIS) involves 11 European centers. It aims to assess the role of the age-related white matter changes as an independent factor in the transition to disability, and in cognitive performance of an independent elderly population. A comprehensive neuropsychological battery was constructed in order to harmonize the cognitive assessment across countries. Patients were evaluated at baseline and during the 3-year follow-up with the Mini-Mental State Examination, a modified version of the VADAS-Cog (Alzheimer's Dementia Assessment Scale plus tests of Delayed recall, Symbol digit, Digit span, Maze, Digit cancellation and Verbal fluency), Trail making and Stroop test. Six hundred thirty-eight patients (mean age 74 +/- 5 years; mean educational level 10 +/- 4, F/M: 351/287) were included in this study. Neuropsychological data were analyzed test by test and also grouped in three compound measures (executive, memory and speed/motor control domains). Older subjects (>74 years) performed significantly worse than younger subjects on the ADAS-Mod and on the tests of memory (t(631) = 3.25; p = 0.001), executive functions (t(581) = 4.68; p = 0.001) and speed/motor control (t(587) = 4.01; p = 0.001). Participants with higher educational level (>8 years of school) showed better performances on the compound measures for memory (t(631) = 3.25; p = 0.001), executive functions (t(581) = 4.68; p = 0.001) and speed/motor control (t(587) = 4.01; p = 0.001). Using multiple regression analysis models to study the influence of demographic variables on cognitive performance, age and education remained important variables influencing test performance. In the LADIS population baseline data, older age and lower educational levels negatively influence neuropsychological performance.
在独立生活的老年人中，与年龄相关的白质变化和认知表现之间的关系仍不明确。老年脑白质疏松症与残疾研究（LADIS）涉及11个欧洲中心。其目的是评估与年龄相关的白质变化作为向残疾转变以及独立老年人群认知表现的独立因素所起的作用。为了统一各国的认知评估，构建了一套全面的神经心理测试组合。患者在基线时以及3年随访期间接受简易精神状态检查、VADAS - Cog（阿尔茨海默病痴呆评估量表加上延迟回忆、符号数字、数字广度、迷宫、数字划消和语言流畅性测试）的修订版、连线测验和斯特鲁普测验的评估。本研究纳入了638名患者（平均年龄74±5岁；平均教育水平10±4，女性/男性：351/287）。对神经心理数据进行了逐个测试分析，并将其归为三个复合指标（执行功能、记忆和速度/运动控制领域）。年龄较大的受试者（>74岁）在ADAS修订版以及记忆测试（t(631) = 3.25；p = 0.001）、执行功能测试（t(581) = 4.68；p = 0.001）和速度/运动控制测试（t(587) = 4.01；p = 0.001）中的表现明显比年龄较小的受试者差。教育水平较高（>8年学校教育）的参与者在记忆复合指标（t(631) = 3.25；p = 0.001）、执行功能复合指标（t(581) = 4.68；p = 0.001）和速度/运动控制复合指标（t(587) = 4.01；p = 0.001）上表现更好。使用多元回归分析模型研究人口统计学变量对认知表现的影响时，年龄和教育仍然是影响测试表现的重要变量。在LADIS人群的基线数据中，年龄较大和教育水平较低对神经心理表现有负面影响。
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