Teng Edmond, Tingus Kathleen D, Lu Po H, Cummings Jeffrey L
Department of Neurology, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, Calif., USA.
Dement Geriatr Cogn Disord. 2009;28(2):168-78. doi: 10.1159/000235732. Epub 2009 Aug 26.
The significant variability across studies of mild cognitive impairment (MCI) in rates of progression to Alzheimer's disease (AD) and reversion to normal cognition may be due to differences in specific neuropsychological tests and thresholds used to define MCI.
We assessed 115 subjects with amnestic (AMN) or non-amnestic (NON) MCI on a standardized neuropsychological battery at baseline and after a mean follow-up of 16.4 months to determine the prevalence and persistence of deficits identified with specific tests.
The prevalence of impaired performance varied widely across tests. Deficits were more persistent in the AMN group than in the NON group. Baseline deficits in Visual Reproduction II and the California Verbal Learning Test were the best predictors of persistent memory impairment. Subjects who at baseline were impaired on multiple memory tests or had poorer overall memory performance were more likely to exhibit persistent memory deficits.
The use of different neuropsychological tests and thresholds to diagnose MCI identified subsets of subjects with different rates of persistence of cognitive impairment. Standardization of the operational definition of cognitive impairment in MCI may result in more consistent predictions of progression to AD.
在轻度认知障碍(MCI)进展为阿尔茨海默病(AD)以及恢复正常认知的研究中,不同研究之间存在显著差异,这可能是由于用于定义MCI的特定神经心理学测试和阈值不同所致。
我们在基线时以及平均随访16.4个月后,使用标准化神经心理学测试组合对115名遗忘型(AMN)或非遗忘型(NON)MCI患者进行评估,以确定特定测试所发现缺陷的患病率和持续性。
不同测试中表现受损的患病率差异很大。遗忘型组的缺陷比非遗忘型组更具持续性。视觉再现II和加利福尼亚言语学习测试中的基线缺陷是持续性记忆损害的最佳预测指标。在基线时多项记忆测试受损或总体记忆表现较差的受试者更有可能出现持续性记忆缺陷。
使用不同的神经心理学测试和阈值来诊断MCI,确定了认知障碍持续性发生率不同的受试者亚组。MCI中认知障碍操作定义的标准化可能会使AD进展的预测更加一致。