Barnes Deborah E, Cenzer Irena S, Yaffe Kristine, Ritchie Christine S, Lee Sei J
Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology & Biostatistics, University of California, San Francisco, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA; Division of Geriatrics, University of California, San Francisco, San Francisco, CA, USA.
Alzheimers Dement. 2014 Nov;10(6):646-55. doi: 10.1016/j.jalz.2013.12.014. Epub 2014 Feb 1.
Our objective in this study was to develop a point-based tool to predict conversion from amnestic mild cognitive impairment (MCI) to probable Alzheimer's disease (AD).
Subjects were participants in the first part of the Alzheimer's Disease Neuroimaging Initiative. Cox proportional hazards models were used to identify factors associated with development of AD, and a point score was created from predictors in the final model.
The final point score could range from 0 to 9 (mean 4.8) and included: the Functional Assessment Questionnaire (2‒3 points); magnetic resonance imaging (MRI) middle temporal cortical thinning (1 point); MRI hippocampal subcortical volume (1 point); Alzheimer's Disease Cognitive Scale-cognitive subscale (2‒3 points); and the Clock Test (1 point). Prognostic accuracy was good (Harrell's c = 0.78; 95% CI 0.75, 0.81); 3-year conversion rates were 6% (0‒3 points), 53% (4‒6 points), and 91% (7‒9 points).
A point-based risk score combining functional dependence, cerebral MRI measures, and neuropsychological test scores provided good accuracy for prediction of conversion from amnestic MCI to AD.
本研究的目的是开发一种基于评分的工具，以预测遗忘型轻度认知障碍（MCI）向可能的阿尔茨海默病（AD）的转化。
研究对象为阿尔茨海默病神经影像学计划第一阶段的参与者。采用Cox比例风险模型识别与AD发生相关的因素，并根据最终模型中的预测因素创建一个评分。
最终评分范围为0至9分（平均4.8分），包括：功能评估问卷（2 - 3分）；磁共振成像（MRI）颞中皮质变薄（1分）；MRI海马体皮质下体积（1分）；阿尔茨海默病认知量表-认知子量表（2 - 3分）；以及时钟测试（1分）。预后准确性良好（Harrell's c = 0.78；95% CI 0.75, 0.81）；3年转化率分别为6%（0 - 3分）、53%（4 - 6分）和91%（7 - 9分）。
一种结合功能依赖、脑部MRI测量和神经心理学测试分数的基于评分的风险评分，对预测遗忘型MCI向AD的转化具有良好的准确性。
