Behavioral Neurology and Dementias Research Group, Neurosciences Research Program, IMIM-Hospital del Mar Research Institute, Barcelona, Spain.
J Alzheimers Dis. 2013;33(1):191-203. doi: 10.3233/JAD-2012-121123.
The retrogenesis model states that the progression of brain aging and Alzheimer's disease (AD) deterioration proceeds inversely to human ontogenic acquisition patterns. Our aim was to assess if the progressive decline of cognitive abilities and functional capacity in AD follows an inverse sequence of acquisition compared to normal developmental patterns. One hundred eighty one children ranging in age from 4 to 12 years and 148 adults (cognitively normal, subjects with mild cognitive impairment, and mild-moderately severe AD) were assessed with the same cognitive and functional tools. The statistical analyses showed a progressive and inverse distribution on cognitive, functional, and mental age scores when comparing results of children classified by chronological age and patients by dementia staging. The pattern of cognitive acquisition in children showed a progressive development of overall cognitive function along all age ranges, in addition to a simultaneous acquisition of instrumental and basic daily living activities in the functional domain. AD patients showed a progressive decline in cognitive and functional domains, which concurs with the sequence of impairment reported in this dementia. Our findings provide support to the inverse and progressive pattern of functional and cognitive decline observed in AD patients compared to the developmental acquisition of these capacities in children, as stated by the retrogenesis model. Nonetheless, certain differences should be considered when comparing the sequence of acquisition during ontogenic development with that of progressive loss during the course of AD. Retrogenesis may account for the progressive loss of neocortical-related functions in AD.
退行发生模型表明，大脑衰老和阿尔茨海默病（AD）恶化的进展与人类个体发生获得模式相反。我们的目的是评估 AD 患者认知能力和功能能力的逐渐下降是否遵循与正常发育模式相反的获得顺序。我们评估了 181 名年龄在 4 至 12 岁之间的儿童和 148 名成年人（认知正常、轻度认知障碍和轻度至中度严重 AD），使用相同的认知和功能工具。统计分析显示，当比较按年龄分类的儿童和按痴呆分期分类的患者的结果时，认知、功能和心理年龄评分呈渐进和反向分布。儿童认知获得模式显示，在所有年龄段，整体认知功能都在逐步发展，同时在功能领域中同时获得工具性和基本日常生活活动。AD 患者在认知和功能领域表现出逐渐下降，这与该痴呆症报告的损害顺序一致。我们的发现支持退行发生模型中提出的 AD 患者的功能和认知下降呈反方向和渐进模式，与儿童这些能力的发育获得相反。然而，在将个体发生发育过程中的获得顺序与 AD 过程中的进行性丧失进行比较时，应考虑某些差异。退行发生可能解释了 AD 中与新皮质相关的功能的进行性丧失。
