Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, Alzheimer Centre Limburg, NL-6200 MD Maastricht, The Netherlands.
Psychol Med. 2010 Jul;40(7):1193-201. doi: 10.1017/S0033291709991577. Epub 2009 Nov 11.
Affective symptoms are common in subjects with mild cognitive impairment (MCI), but there is disagreement whether these symptoms are predictive for Alzheimer's disease (AD). We investigated the predictive accuracy of affective symptoms for AD during a follow-up study in subjects with MCI, and whether the predictive accuracy was modified by age, the presence of amnestic MCI or the length of follow-up.
Newly referred subjects (n=263) with MCI older than 55 years were selected from a memory clinic and followed up after 2, 5 and 10 years. Predictors investigated were: symptoms of depression, anxiety, apathy and sleeping problems.
Affective symptoms were present in 50-70% of the subjects. The average follow-up period was 5.4 years and 79 subjects (29%) developed AD. Sleeping problems were associated with a decreased risk for AD [odds ratio (OR) 0.35, p<0.001]. Symptoms of depression (OR 0.61, p=0.059) and anxiety (OR 0.58, p=0.051) showed a trend in the same direction. The OR of apathy for AD was 0.67 (p=0.14). Depression was associated with a decreased risk for AD only in subjects without amnestic MCI, but not in subjects with amnestic MCI. Moreover, anxiety was related to the risk for AD differently between subjects diagnosed with AD at the 5-year follow-up (OR 0.23) and subjects diagnosed with AD at the 10-year follow-up (OR 1.7).
Affective symptoms are associated with a decreased risk for AD. The risk may be dependent on MCI subtype or length of follow-up, but it does not depend on age.
情感症状在轻度认知障碍（MCI）患者中很常见，但这些症状是否对阿尔茨海默病（AD）具有预测性存在争议。我们在 MCI 患者的随访研究中，调查了情感症状对 AD 的预测准确性，以及这种预测准确性是否会因年龄、是否存在遗忘型 MCI 或随访时间长短而改变。
从记忆诊所新转诊的年龄在 55 岁以上的 MCI 患者（n=263）中选择研究对象，并在 2、5 和 10 年后进行随访。研究的预测因子包括：抑郁、焦虑、淡漠和睡眠问题的症状。
50-70%的患者存在情感症状。平均随访时间为 5.4 年，79 例（29%）患者发展为 AD。睡眠问题与 AD 风险降低相关[比值比（OR）0.35，p<0.001]。抑郁症状（OR 0.61，p=0.059）和焦虑症状（OR 0.58，p=0.051）呈下降趋势。淡漠对 AD 的 OR 为 0.67（p=0.14）。抑郁与 AD 的风险降低相关，仅在无遗忘型 MCI 的患者中，而在有遗忘型 MCI 的患者中则无此关联。此外，焦虑与 AD 的风险关系在诊断为 AD 的患者中（5 年随访时的 OR 0.23）和在诊断为 AD 的患者中（10 年随访时的 OR 1.7）有所不同。
情感症状与 AD 的风险降低相关。这种风险可能取决于 MCI 亚型或随访时间长短，但不取决于年龄。
