遗忘型轻度认知障碍患者队列中阿尔茨海默病的高转化率
High rate of conversion to Alzheimer's disease in a cohort of amnestic MCI patients.
作者信息
Schmidtke Klaus, Hermeneit Sonja
机构信息
Center for Geriatric Medicine and Gerontology, University Hospital Freiburg, Germany.
出版信息
Int Psychogeriatr. 2008 Feb;20(1):96-108. doi: 10.1017/S1041610207005509. Epub 2007 May 16.
BACKGROUND
A large proportion of patients with amnestic mild cognitive impairment (MCI) progress to Alzheimer's disease (AD), but the rate of conversion is highly variable, depending on selection and inclusion criteria. In the present prospective study, amnestic MCI criteria were applied in order to enrich the study population with prodromal AD patients.
METHODS
A composite CERAD word list learning z-score of -1 was applied as a cut-off for memory performance at baseline. Competing causes of memory impairment other than prodromal AD were actively excluded. A cohort of 88 amnestic MCI patients was included; 75 were available for follow-up.
RESULTS
After a mean delay of 19 months, 44% were found to have converted to AD, corresponding to an annualized conversion rate of 28%. The rate of new diagnoses other than stable MCI or AD was 6%. Baseline neuropsychological variables were not instrumental to predict progression.
CONCLUSION
Amnestic MCI patients, as identified by the present set of criteria, carry a high risk of median-term progression to AD.
背景
很大一部分遗忘型轻度认知障碍（MCI）患者会进展为阿尔茨海默病（AD），但其转化率高度可变，这取决于选择和纳入标准。在本前瞻性研究中，应用遗忘型MCI标准以增加前驱期AD患者的研究人群。
方法
采用综合CERAD单词表学习z分数-1作为基线记忆表现的临界值。积极排除前驱期AD以外的记忆损害的其他竞争原因。纳入了88例遗忘型MCI患者队列；75例可供随访。
结果
平均延迟19个月后，发现44%已转化为AD，相当于年化转化率为28%。除稳定型MCI或AD以外的新诊断率为6%。基线神经心理学变量无助于预测病情进展。
结论
根据本套标准确定的遗忘型MCI患者中期进展为AD的风险很高。
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