Taragano Fernando E, Allegri Ricardo F, Krupitzki Hugo, Sarasola Diego R, Serrano Cecilia M, Loñ Leandro, Lyketsos Constantine G
University Institute Center for Medical Education and Clinical Research, School of Medicine & Research Institute, Buenos Aires, Argentina.
J Clin Psychiatry. 2009 Apr;70(4):584-92. doi: 10.4088/jcp.08m04181. Epub 2009 Mar 24.
Mild cognitive impairment (MCI) is a transitional state between normal aging and dementia, at least for some patients. Behavioral symptoms in MCI are associated with a higher risk of dementia, but their association with dementia risk in patients without MCI is unknown. Mild behavioral impairment (MBI) refers to a late-life syndrome with prominent psychiatric and related behavioral symptoms in the absence of prominent cognitive symptoms that may also be a dementia prodrome. This study sought to compare MCI and MBI patients and to estimate the risk of dementia development in these 2 groups.
Between January 2001 and January 2006, a consecutive series of 358 elderly (>or= 65 years old) patients (239 with MCI and 119 with MBI) presenting to an outpatient general hospital specialty clinic were followed for up to 5 years until conversion to dementia or censoring.
Thirty-four percent of MCI patients and over 70% of patients with MBI developed dementia (log-rank p = .011). MBI patients without cognitive symptoms were more likely to develop dementia (log-rank p < .001). MBI patients were more likely to develop frontotemporal dementia (FTD) than dementia of the Alzheimer's type (DAT).
MBI appears to be a transitional state between normal aging and dementia. MBI (specifically in those without cognitive symptoms) may confer a higher risk for dementia than MCI, and it is very likely an FTD prodrome in many cases. These findings have implications for the early detection, prevention, and treatment of patients with dementia in late life, by focusing the attention of researchers on the emergence of new behavioral symptoms.
轻度认知障碍（MCI）至少对部分患者而言是正常衰老与痴呆之间的过渡状态。MCI中的行为症状与痴呆风险较高相关，但它们与无MCI患者的痴呆风险之间的关联尚不清楚。轻度行为障碍（MBI）指的是一种晚年综合征，其具有突出的精神及相关行为症状，而无突出的认知症状，这也可能是痴呆的前驱症状。本研究旨在比较MCI和MBI患者，并评估这两组患者发生痴呆的风险。
在2001年1月至2006年1月期间，对连续358例（年龄≥65岁）到门诊综合医院专科诊所就诊的患者（239例MCI患者和119例MBI患者）进行了长达5年的随访，直至其转变为痴呆或失访。
34%的MCI患者和超过70%的MBI患者发生了痴呆（对数秩检验p = 0.011）。无认知症状的MBI患者更易发生痴呆（对数秩检验p < 0.001）。MBI患者比阿尔茨海默病型痴呆（DAT）患者更易发生额颞叶痴呆（FTD）。
MBI似乎是正常衰老与痴呆之间的过渡状态。MBI（特别是那些无认知症状的患者）可能比MCI具有更高的痴呆风险，并且在许多情况下很可能是FTD的前驱症状。这些发现通过将研究人员的注意力集中于新行为症状的出现，对晚年痴呆患者的早期检测、预防和治疗具有启示意义。
