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轻度认知障碍向痴呆症的转化率:抑郁的预测作用。

The rate of conversion of mild cognitive impairment to dementia: predictive role of depression.

作者信息

Gabryelewicz T, Styczynska M, Luczywek E, Barczak A, Pfeffer A, Androsiuk W, Chodakowska-Zebrowska M, Wasiak B, Peplonska B, Barcikowska M

机构信息

Department of Neurodegenerative Disorders, Medical Research Centre Polish Academy of Sciences, Warsaw, Poland.

出版信息

Int J Geriatr Psychiatry. 2007 Jun;22(6):563-7. doi: 10.1002/gps.1716.

Abstract

BACKGROUND

Mild cognitive impairment (MCI) is a condition referring to the persons with cognitive deficits measurable in some form or another, but not meeting criteria for dementia, and who have an increased risk of becoming demented.

OBJECTIVE

To establish the rate of progression to dementia in MCI, to investigate the risk of conversion for amnestic vs multiple-domains subtypes, and to identify the predictors of progression.

METHODS

MCI (n = 105) individuals enrolled in a longitudinal study received annual clinical and psychometric examinations for up to a mean of 3 years. The diagnosis of MCI according to Mayo Clinic Petersen's Criteria was conducted by a panel of specialists.

RESULTS

After 3 years of follow-up, 23 of 105 subjects with MCI were diagnosed with dementia. 40 showed cognitive decline not dementia, 34 were stable and showed no cognitive decline or improvement, while eight showed cognitive improvement.

CONCLUSIONS

We conclude that conversion rate from MCI to DSM-IIIR dementia was 21.9% over a period of 3 years. The occurrence of depressive symptoms may constitute a predictor for those who are more likely to progress to dementia. The risk of conversion to dementia was higher among the subjects with an evidence of impairment extending beyond memory than with those who suffered only from memory deficits, and the subjects who converted to dementia in this subtype had significantly higher baseline plasma total homocysteine levels than non-converters.

摘要

背景

轻度认知障碍(MCI)是指那些存在以某种形式可测量的认知缺陷,但不符合痴呆症标准且患痴呆症风险增加的人群。

目的

确定MCI进展为痴呆症的发生率,研究遗忘型与多领域亚型的转化风险,并确定进展的预测因素。

方法

纳入一项纵向研究的105名MCI个体接受了平均长达3年的年度临床和心理测量检查。由一组专家根据梅奥诊所彼得森标准进行MCI诊断。

结果

经过3年随访,105名MCI受试者中有23人被诊断为痴呆症。40人出现认知衰退但非痴呆,34人病情稳定,未出现认知衰退或改善,8人出现认知改善。

结论

我们得出结论,在3年时间里,MCI转化为DSM-IIIR痴呆症的转化率为21.9%。抑郁症状的出现可能是那些更易进展为痴呆症患者的一个预测因素。与仅存在记忆缺陷的受试者相比,存在超出记忆范围损害证据的受试者转化为痴呆症的风险更高,且该亚型中转化为痴呆症的受试者基线血浆总同型半胱氨酸水平显著高于未转化者。

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