National Institute of Neurology and Neurosurgery, Autonomous National University of Mexico, Mexico City, Mexico.
PLoS Med. 2012 Feb;9(2):e1001170. doi: 10.1371/journal.pmed.1001170. Epub 2012 Feb 7.
Rapid demographic ageing is a growing public health issue in many low- and middle-income countries (LAMICs). Mild cognitive impairment (MCI) is a construct frequently used to define groups of people who may be at risk of developing dementia, crucial for targeting preventative interventions. However, little is known about the prevalence or impact of MCI in LAMIC settings.
Data were analysed from cross-sectional surveys established by the 10/66 Dementia Research Group and carried out in Cuba, Dominican Republic, Peru, Mexico, Venezuela, Puerto Rico, China, and India on 15,376 individuals aged 65+ without dementia. Standardised assessments of mental and physical health, and cognitive function were carried out including informant interviews. An algorithm was developed to define Mayo Clinic amnestic MCI (aMCI). Disability (12-item World Health Organization disability assessment schedule [WHODAS]) and informant-reported neuropsychiatric symptoms (neuropsychiatric inventory [NPI-Q]) were measured. After adjustment, aMCI was associated with disability, anxiety, apathy, and irritability (but not depression); between-country heterogeneity in these associations was only significant for disability. The crude prevalence of aMCI ranged from 0.8% in China to 4.3% in India. Country differences changed little (range 0.6%-4.6%) after standardization for age, gender, and education level. In pooled estimates, aMCI was modestly associated with male gender and fewer assets but was not associated with age or education. There was no significant between-country variation in these demographic associations.
An algorithm-derived diagnosis of aMCI showed few sociodemographic associations but was consistently associated with higher disability and neuropsychiatric symptoms in addition to showing substantial variation in prevalence across LAMIC populations. Longitudinal data are needed to confirm findings-in particular, to investigate the predictive validity of aMCI in these settings and risk/protective factors for progression to dementia; however, the large number affected has important implications in these rapidly ageing settings.
快速的人口老龄化是许多低收入和中等收入国家（LMICs）日益严重的公共卫生问题。轻度认知障碍（MCI）是一种常用于定义可能患有痴呆症风险人群的结构，对于确定预防干预措施至关重要。然而，在 LMIC 环境中，MCI 的患病率或影响知之甚少。
对 10/66 痴呆症研究小组建立的横断面调查数据进行了分析，该调查在古巴、多米尼加共和国、秘鲁、墨西哥、委内瑞拉、波多黎各、中国和印度进行，涉及 15376 名无痴呆症的 65 岁以上个体。进行了包括知情者访谈在内的心理健康和身体健康以及认知功能的标准化评估。开发了一种算法来定义 Mayo 诊所遗忘型 MCI（aMCI）。测量了残疾（12 项世界卫生组织残疾评估表[WHODAS]）和知情者报告的神经精神症状（神经精神障碍问卷[NPI-Q]）。调整后，aMCI 与残疾、焦虑、淡漠和易怒（但与抑郁无关）有关；这些关联在国家之间存在异质性，仅在残疾方面具有统计学意义。未经标准化时，aMCI 的粗患病率在中国为 0.8%，在印度为 4.3%。标准化后，aMCI 的患病率范围为 0.6%-4.6%，变化不大。在汇总估计中，aMCI 与男性性别和较少资产适度相关，但与年龄或教育程度无关。这些人口统计学关联在国家之间没有显著差异。
基于算法的 aMCI 诊断与社会人口统计学因素的关联很少，但与较高的残疾和神经精神症状相关，并且在 LMIC 人群中患病率存在很大差异。需要纵向数据来证实这些发现，特别是要在这些环境中调查 aMCI 的预测有效性以及向痴呆症进展的风险/保护因素；然而，受影响的人数众多，这在这些快速老龄化的环境中具有重要意义。
