Department of Old Age Psychiatry, Castle Peak Hospital, Tuen Mun, Hong Kong SAR.
Am J Geriatr Psychiatry. 2010 Oct;18(10):948-54. doi: 10.1097/JGP.0b013e3181d69467.
To estimate the point prevalence and correlates of neuropsychiatric (NP) symptoms among older adults with mild cognitive impairment (MCI) and normal cognition (NC) in a Chinese community.
Cross-sectional study derived from a population-based prevalence study of MCI and dementia.
This survey was conducted in Hong Kong from 2005 to 2006. Seven hundred eighty-eight community-dwelling older adults (450 NC and 338 MCI) were recruited. Cognitive and NP data were obtained.
The point prevalence of at least one NP symptom in NC and MCI were 29% and 36.7%, respectively (logistic regression controlled for age and education, odds ratio = 1.38, 95% confidence interval [CI]: 1.01-1.89, Wald χ = 4.10, df = 1, p = 0.04). Agitation (1.8% versus 5.1%), apathy (7.6% versus 15.2%), and irritability (4.2% versus 8%) were more prevalent in subjects with MCI (p <0.05). Logistic regression analyses showed that apathy score was a significant factor associated with the status of NC or MCI (logistic regression, apathy, p = 0.031, Exp(B) = 1.23, 95% CI: 1.02-1.47; Hosmer and Lemeshow test, χ = 8.6, df = 8, p = 0.38, R = 0.23).
The authors reported the findings of one of the first population-based studies estimating the point prevalence of NP symptoms in Asian older adults with MCI. Taking into account of its prevalence and magnitude of effects, apathy is a clinically significant symptom in MCI. Its predictive value for conversion to dementia warrants further evaluation.
评估轻度认知障碍(MCI)和认知正常(NC)的老年人群中神经精神(NP)症状的现患率及其相关因素。
来源于 MCI 和痴呆人群的基于人群的患病率研究的横断面研究。
这项调查于 2005 年至 2006 年在香港进行。共招募了 788 名居住在社区的老年人(450 名 NC 和 338 名 MCI)。获取认知和 NP 数据。
NC 和 MCI 中至少有一种 NP 症状的现患率分别为 29%和 36.7%(经年龄和教育调整的 logistic 回归,比值比=1.38,95%置信区间[CI]:1.01-1.89,Wald χ=4.10,df=1,p=0.04)。与 NC 相比,MCI 患者中更常见激越(1.8%比 5.1%)、淡漠(7.6%比 15.2%)和易激惹(4.2%比 8%)(p<0.05)。logistic 回归分析显示,淡漠评分是与 NC 或 MCI 状态相关的显著因素(logistic 回归,淡漠,p=0.031,Exp(B)=1.23,95%CI:1.02-1.47;Hosmer 和 Lemeshow 检验,χ=8.6,df=8,p=0.38,R=0.23)。
作者报告了亚洲认知正常老年人 MCI 人群中 NP 症状现患率的首次基于人群的研究结果之一。考虑到其普遍性和影响程度,淡漠是 MCI 中具有临床意义的症状。其向痴呆转化的预测价值需要进一步评估。