Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
J Int Neuropsychol Soc. 2011 Mar;17(2):277-88. doi: 10.1017/S1355617710001621. Epub 2010 Dec 21.
Impairments in executive cognition (EC) may be predictive of incident dementia in patients with mild cognitive impairment (MCI). The present study examined whether specific EC tests could predict which MCI individuals progress from a Clinical Dementia Rating (CDR) score of 0.5 to a score ≥1 over a 2-year period. Eighteen clinical and experimental EC measures were administered at baseline to 104 MCI patients (amnestic and non-amnestic, single- and multiple-domain) recruited from clinical and research settings. Demographic characteristics, screening cognitive measures and measures of everyday functioning at baseline were also considered as potential predictors. Over the 2-year period, 18% of the MCI individuals progressed to CDR ≥ 1, 73.1% remained stable (CDR = 0.5), and 4.5% reverted to normal (CDR = 0). Multiple-domain MCI participants had higher rates of progression to dementia than single-domain, but amnestic and non-amnestic MCIs had similar rates of conversion. Only three EC measures were predictive of subsequent cognitive and functional decline at the univariate level, but they failed to independently predict progression to dementia after adjusting for demographic, other cognitive characteristics, and measures of everyday functioning. Decline over 2 years was best predicted by informant ratings of subtle functional impairments and lower baseline scores on memory, category fluency, and constructional praxis.
执行认知功能障碍 (EC) 可能是预测轻度认知障碍 (MCI) 患者发生痴呆的指标。本研究旨在探讨特定的 EC 测试是否可以预测哪些 MCI 患者在 2 年内从临床痴呆评定量表 (CDR) 评分为 0.5 进展为评分≥1。从临床和研究环境中招募的 104 名 MCI 患者（遗忘型和非遗忘型、单域和多域）在基线时接受了 18 项临床和实验 EC 测试。还考虑了基线时的人口统计学特征、筛选认知测试和日常功能测试，作为潜在的预测因素。在 2 年内，18%的 MCI 患者进展为 CDR≥1，73.1%保持稳定（CDR=0.5），4.5%恢复正常（CDR=0）。多域 MCI 患者向痴呆进展的比率高于单域，但遗忘型和非遗忘型 MCI 患者的转化率相似。只有三项 EC 测试在单变量水平上预测随后的认知和功能下降，但在调整人口统计学、其他认知特征和日常功能测试后，它们未能独立预测向痴呆的进展。2 年内的下降情况最好由知情人对轻微功能障碍的评分以及记忆、类别流畅性和结构操作性测试的基线分数较低来预测。
