Neurology Service, IFIMAV and CIBERNED, Marqués de Valdecilla University Hospital (University of Cantabria), Avda Valdecilla s/n, 39008-Santander, Spain.
BMC Neurol. 2011 Jun 24;11:78. doi: 10.1186/1471-2377-11-78.
Mild cognitive impairment (MCI) is a heterogeneous clinical entity that comprises the prodromal phase of Alzheimer's disease (Pr-AD). New biomarkers are useful in detecting Pr-AD, but they are not universally available. We aimed to investigate baseline clinical and neuropsychological variables that might predict progression from MCI to AD dementia.
All patients underwent a complete clinical and neuropsychological evaluation at baseline and every 6 months during a two-year follow-up period, with 54 out of 109 MCI patients progressing to dementia (50 of them progressed to AD dementia), and 55 remaining as stable MCI (S-MCI).
A combination of MMSE and California Verbal Learning Test Long Delayed Total Recall (CVLT-LDTR) constituted the best predictive model: subjects scoring above 26/30 on MMSE and 4/16 on CVLT-LDTR had a negative predictive value of 93.93% at 2 years, whereas those subjects scoring below both of these cut-off scores had a positive predictive value of 80.95%.
Pr-AD might be distinguished from S-MCI at baseline using the combination of MMSE and CVLT-LDTR. These two neuropsychological predictors are relatively brief and may be readily completed in non-specialist clinical settings.
轻度认知障碍（MCI）是一种异质性的临床实体，包含阿尔茨海默病（AD）的前驱期（Pr-AD）。新的生物标志物有助于发现 Pr-AD，但它们并非普遍可用。我们旨在研究基线临床和神经心理学变量，这些变量可能预测从 MCI 向 AD 痴呆的进展。
所有患者在基线时接受了完整的临床和神经心理学评估，并在两年的随访期间每 6 个月进行一次评估，其中 109 名 MCI 患者中有 54 名进展为痴呆（其中 50 名进展为 AD 痴呆），55 名仍为稳定 MCI（S-MCI）。
MMSE 和加利福尼亚语言学习测试长延迟总回忆（CVLT-LDTR）的组合构成了最佳预测模型：MMSE 得分高于 26/30 且 CVLT-LDTR 得分高于 4/16 的受试者在 2 年内的阴性预测值为 93.93%，而得分低于这两个临界值的受试者的阳性预测值为 80.95%。
基线时可以使用 MMSE 和 CVLT-LDTR 的组合来区分 Pr-AD 和 S-MCI。这两个神经心理学预测因子相对较短，并且可能在非专业临床环境中容易完成。
