Department of Psychology, Brooklyn College and The Graduate Center, City University of New York, Brooklyn, New York 11210, USA.
J Am Geriatr Soc. 2012 Jun;60(6):1128-34. doi: 10.1111/j.1532-5415.2012.03956.x.
To investigate the independent and combined contributions to the risk of Alzheimer's disease (AD) of three important domains of cognitive assessment: neuropsychological measurement, self-reports, and informant reports.
Longitudinal, community-based sample.
Einstein Aging Study.
Six hundred twenty-seven individuals without dementia aged 70 and older systematically recruited from the Bronx, New York.
Comprehensive assessment included neurological examination, behavioral questions, and neuropsychological testing. AD diagnoses were based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria assigned at a multidisciplinary consensus case conference. The major statistical analyses used Cox proportional hazards models (with age as the time scale) adjusted for sex, education, and depressive symptoms.
Forty-eight participants developed incident AD during a median of 3.3 years of follow-up. Self- and informant reports of cognitive status and baseline scores on tests of episodic memory and psychomotor speed predicted the onset of AD, but in models examining all the variables simultaneously, only the episodic memory tests and informant reports were associated with risk of AD. A likelihood ratio test confirmed the incremental effect of informant reports in addition to the neuropsychological test scores (P = .03).
Informant ratings improved the prediction of AD conversion in addition to objective memory impairment in older adults without dementia. Combining these cognitive measures may provide a useful, empirical method for identifying individuals at high risk of future AD.
探究认知评估的三个重要领域（神经心理学测量、自我报告和知情者报告）对阿尔茨海默病（AD）风险的独立和综合贡献。
纵向、社区为基础的样本。
爱因斯坦衰老研究。
627 名无痴呆症、年龄在 70 岁及以上的个体，从纽约布朗克斯有系统地招募。
全面评估包括神经学检查、行为问题和神经心理学测试。AD 的诊断基于《精神障碍诊断与统计手册》第四版标准，在多学科共识病例会议上确定。主要的统计分析使用 Cox 比例风险模型（以年龄为时间尺度），调整性别、教育和抑郁症状。
48 名参与者在中位数为 3.3 年的随访期间发生了新发 AD。认知状态的自我和知情者报告以及情景记忆和心理运动速度测试的基线分数预测了 AD 的发病，但在同时检查所有变量的模型中，只有情景记忆测试和知情者报告与 AD 风险相关。似然比检验证实了知情者报告除了神经心理学测试分数之外还有附加的预测效果（P =.03）。
在没有痴呆的老年人中，知情者评分除了客观的记忆障碍外，还能提高 AD 转换的预测能力。结合这些认知测量方法可能为识别未来 AD 高危个体提供一种有用的、基于经验的方法。
