AOU San Giovanni Battista - Molinette, Geriatria e Malattie Metaboliche dell'Osso, Università degli Studi di Torino , Torino , Italia.
Int Rev Psychiatry. 2013 Dec;25(6):650-8. doi: 10.3109/09540261.2013.859128.
The rate of cognitive decline in Alzheimer's disease (AD) varies considerably between individuals. Predicting rapid cognitive decline might help clinicians provide prognostic information, select subjects for trial intervention and/or reduce costs.
PubMed and PsycINFO were searched for all the English written studies published until the end of 2010 on rapid cognitive decline in AD and factors associated with it.
More than 300 individual articles were retrieved. We selected 82 relevant studies. The main findings of these papers are that younger, more educated and more impaired patients are more likely to show rapid cognitive decline. ApoE alleles seem not to modify the velocity of clinical progression of dementia, or at most could have a very small effect. No inference can be made for all the other variables analysed.
There are many studies on rapid cognitive decline. Results are heterogeneous and often contradictory. No reliable conclusions about factors that may be associated with rapid cognitive decline can yet be drawn.
阿尔茨海默病（AD）患者的认知能力下降速度存在较大个体差异。预测认知能力的快速下降可能有助于临床医生提供预后信息，选择试验干预的对象和/或降低成本。
检索 PubMed 和 PsycINFO 数据库中截至 2010 年底发表的所有关于 AD 患者认知能力快速下降及其相关因素的英文文献。
检索到 300 多篇相关文章，我们选择了 82 篇相关研究。这些文献的主要发现是，年龄较小、受教育程度较高和认知障碍程度较严重的患者更有可能出现认知能力的快速下降。载脂蛋白 E 等位基因似乎不能改变痴呆临床进展的速度，或者最多只能产生很小的影响。对于分析的所有其他变量，都无法得出确切结论。
目前有许多关于认知能力快速下降的研究。研究结果存在异质性，且常常相互矛盾。目前还不能得出关于可能与认知能力快速下降相关的因素的可靠结论。
