Rush AD Center, Rush University Medical Center, 600 South Paulina Avenue, Suite 1038, Chicago, IL 60612, USA.
Neurology. 2010 Mar 23;74(12):951-5. doi: 10.1212/WNL.0b013e3181d64786.
To measure the cognitive consequences of incident Alzheimer disease (AD) in older African American and white subjects.
Data are from the Chicago Health and Aging Project, a longitudinal cohort study of older white and black persons residing in a geographically defined community. At 3-year intervals, the entire study population completed 4 brief cognitive tests, from which a previously established composite measure of global cognition was derived, and a subset underwent detailed clinical evaluation that supported clinical classification of mild cognitive impairment, dementia, and AD. We used mixed-effects models to examine change in cognitive function following the diagnostic evaluation.
On clinical evaluation, 614 persons were found to have no cognitive impairment, 395 had mild cognitive impairment, and 149 had AD (88.5% mild); 10 persons with other dementias were excluded from analyses. During up to 11 years of observation following the clinical evaluation (mean = 5.5, SD = 2.5), the composite measure of global cognition declined a mean of 0.042 unit per year (SE = 0.008, p < 0.001) in those with no cognitive impairment. In comparison to the no cognitive impairment group, the annual rate of decline was increased more than twofold in mild cognitive impairment (estimate = 0.086, SE = 0.011, p < 0.001) and more than fourfold in AD (estimate = 0.173, SE = 0.020, p < 0.001). Results did not reliably vary by race, sex, or age.
Alzheimer disease has a devastating impact on cognition, even in its prodromal stages, with comparable effects in African American and white persons.
衡量老年非裔美国人和白人受试者中偶发阿尔茨海默病（AD）的认知后果。
数据来自芝加哥健康与老龄化项目，这是一项针对居住在地理定义明确社区的老年白人和黑人的纵向队列研究。每 3 年，整个研究人群完成 4 项简短认知测试，从中得出先前建立的整体认知综合衡量标准，以及一部分人接受详细的临床评估，以支持轻度认知障碍、痴呆和 AD 的临床分类。我们使用混合效应模型来检查诊断评估后认知功能的变化。
在临床评估中，发现 614 人无认知障碍，395 人有轻度认知障碍，149 人患有 AD（88.5%为轻度）；10 名患有其他类型痴呆症的患者被排除在分析之外。在临床评估后的长达 11 年的观察期间（平均=5.5，SD=2.5），无认知障碍者的整体认知综合衡量标准每年平均下降 0.042 个单位（SE=0.008，p<0.001）。与无认知障碍组相比，轻度认知障碍者的年下降率增加了两倍多（估计值=0.086，SE=0.011，p<0.001），AD 患者的年下降率增加了四倍多（估计值=0.173，SE=0.020，p<0.001）。结果在种族、性别或年龄方面没有可靠差异。
阿尔茨海默病对认知能力具有破坏性影响，即使在其前驱阶段也是如此，对非裔美国人和白人的影响相当。
