Department of Geriatric Medicine, Hachioji Medical Center, Tokyo Medical University, Tokyo, Japan.
Geriatr Gerontol Int. 2013 Jul;13(3):555-62. doi: 10.1111/j.1447-0594.2012.00934.x. Epub 2012 Sep 10.
Although several researchers have examined the effect of age on disease progression in patients with Alzheimer's disease (AD), the results are controversial. We investigated the effect of age on the rate of progression of cognitive impairment and on regional cerebral blood flow (rCBF) deficits using longitudinal single photon emission computed tomography (SPECT) studies.
We divided 75 patients with AD who were followed up for 24-90 months into the younger AD group (n=32, age at initial examination ≤ 75 years) and the older AD group (n=43, age at initial examination >75 years). We assessed changes in Mini-Mental State Examination (MMSE) scores and rCBF between initial and final examinations.
The change in the annual MMSE score was greater in the younger AD group than in the older AD group. The mean annual MMSE score changes correlated significantly with age at the initial examination. The initial and follow-up SPECT studies showed more severe and extensive rCBF deficits in the younger AD group than in the older AD group.
Our longitudinal SPECT study showed that the rate of progression of cognitive impairment and the rCBF deficits were higher in younger patients with AD than in older patients with AD. Therefore, age is an important factor to consider, not only in the diagnosis, but also in the treatment and prognosis of patients with AD.
尽管有几位研究人员研究了年龄对阿尔茨海默病（AD）患者疾病进展的影响，但结果存在争议。我们通过纵向单光子发射计算机断层扫描（SPECT）研究，调查了年龄对认知障碍进展速度和区域性脑血流（rCBF）缺损的影响。
我们将 75 例 AD 患者（随访时间 24-90 个月）分为年龄较小的 AD 组（n=32，初次检查时年龄≤75 岁）和年龄较大的 AD 组（n=43，初次检查时年龄>75 岁）。我们评估了初次和最后检查时简易精神状态检查（MMSE）评分和 rCBF 的变化。
年轻 AD 组的 MMSE 评分年变化大于年龄较大的 AD 组。每年 MMSE 评分的变化与初次检查时的年龄呈显著相关。初始和随访 SPECT 研究显示，年轻 AD 组的 rCBF 缺损比年龄较大的 AD 组更严重、更广泛。
我们的纵向 SPECT 研究表明，年轻 AD 患者认知障碍进展速度和 rCBF 缺损比年龄较大的 AD 患者更高。因此，年龄不仅是 AD 患者诊断的重要因素，也是治疗和预后的重要因素。
