Department of Neuropsychiatry, University of Tsukuba, Tsukuba City, Japan.
Int J Geriatr Psychiatry. 2009 Oct;24(10):1119-26. doi: 10.1002/gps.2234.
The results of previous reports estimating the prevalence of mild cognitive impairment (MCI) have varied widely according to the criteria used to define MCI.
We assessed the cognitive function of Japanese community-dwelling individuals >or=65 years old and attempted to estimate the prevalence of four MCI subtypes (amnestic single, amnestic multiple, nonamnestic single, and nonamnestic multiple) using two cutoffs (1 and 1.5 SD) below normative standard. Presence of apolipoprotein E4 allele (APOE4), which is known as a strong risk factor for AD, is reportedly associated with high risk of conversion from MCI to AD. We therefore calculated the frequency of APOE4 carriers for each MCI subtype.
Initially 1888 (70%) of 2698 baseline samples participated, and 1433 (53%) subjects who had complete clinical data including APOE typing remained for the final analysis. The prevalence of MCI subtypes varied within the range of 1.7-16.6%, depending on the criteria applied. Prevalence of MCI was higher using a cutoff at -1.0 SD than at -1.5 SD, and prevalence of amnestic MCI single at -1.5 SD was lowest among all subtypes of MCI. Frequency of APOE4 was higher for amnestic MCI than for non-amnestic MCI or the cognitively normal group.
The prevalence of MCI was highly dependent on the diagnostic criteria applied. A higher frequency of APOE4 in participants with amnestic MCI subtype suggested a greater risk of future AD. For future interventions to delay the onset of dementia, targeting individuals with amnestic MCI multiple at -1 SD might be desirable.
根据用于定义轻度认知障碍(MCI)的标准不同,先前报告的 MCI 患病率结果差异很大。
我们评估了日本社区居住的>65 岁老年人的认知功能,并尝试使用两个低于正常标准的截断值(1 和 1.5 个标准差)来估计四种 MCI 亚型(单纯遗忘型、遗忘型多种、非遗忘型单一和非遗忘型多种)的患病率。载脂蛋白 E4 等位基因(APOE4)被认为是 AD 的一个强烈危险因素,与从 MCI 向 AD 转化的高风险相关。因此,我们计算了每个 MCI 亚型的 APOE4 携带者频率。
最初有 1888 名(70%)2698 名基线样本参加,1433 名(53%)有完整临床数据(包括 APOE 分型)的受试者进入最终分析。根据应用的标准,MCI 亚型的患病率在 1.7-16.6%之间变化。使用 -1.0 SD 截断值的 MCI 患病率高于使用-1.5 SD 截断值,而在所有 MCI 亚型中,-1.5 SD 时遗忘型单一 MCI 的患病率最低。在遗忘型 MCI 中,APOE4 的频率高于非遗忘型 MCI 或认知正常组。
MCI 的患病率高度依赖于应用的诊断标准。在遗忘型 MCI 亚型患者中 APOE4 频率较高,表明未来发生 AD 的风险更大。为了延迟痴呆的发病,针对 -1 SD 时的遗忘型多种 MCI 个体进行干预可能是可取的。