Sachs-Ericsson Natalie, Blazer Dan G
a Department of Psychology , Florida State University , Tallahassee , FL , USA.
Aging Ment Health. 2015 Jan;19(1):2-12. doi: 10.1080/13607863.2014.920303. Epub 2014 Jun 10.
The Diagnostic Statistical Manual-5 (DSM-5) has included a category named the neurocognitive disorder which was formally known in DSM-IV as 'dementia, delirium, amnestic, and other cognitive disorders'. The DSM-5 distinguishes between 'mild' and 'major' neurocognitive disorders. Major neurocognitive disorder replaces the DSM-IV's term 'dementia or other debilitating conditions'. A pivotal addition is 'mild neurocognitive disorder (mNCD)' defined by a noticeable decrement in cognitive functioning that goes beyond normal changes seen in aging. It is a disorder that may progress to dementia - importantly, it may not. Presently, our understanding of mNCD is derived from research on mild cognitive impairment (MCI). Whereas there is currently no clear treatment for mNCD, many experimental therapies now and into the future will focus upon secondary prevention, namely decreasing the risk of progression to major NCD. In this article, we will focus on mNCD by reviewing the relevant literature on MCI. We will review the research on the incidence and prevalence of MCI, conversion rates from MCI to dementia, risk factors for conversion of MCI to dementia, comorbidity of MCI with other neuropsychiatric disorders (NPS), and the development of treatment strategies for neuropsychiatric disorders in MCI. The presence of NPS is common among individuals with MCI and is an important risk for progression to dementia. However, there has been little research on effective treatments for NPS in MCI. Clinicians and investigators must determine if the treatment of the NPS in mNCD will improve quality of life and help reduce the progression of the cognitive impairment.
《精神疾病诊断与统计手册》第5版（DSM - 5）纳入了一个名为神经认知障碍的类别，该类别在DSM - IV中正式称为“痴呆、谵妄、遗忘及其他认知障碍”。DSM - 5区分了“轻度”和“重度”神经认知障碍。重度神经认知障碍取代了DSM - IV中的术语“痴呆或其他衰弱性疾病”。一个关键的新增内容是“轻度神经认知障碍（mNCD）”，它被定义为认知功能出现明显下降，且超出了衰老过程中常见的正常变化。这是一种可能发展为痴呆的疾病——重要的是，它也可能不会。目前，我们对mNCD的理解源于对轻度认知障碍（MCI）的研究。虽然目前尚无针对mNCD的明确治疗方法，但现在及未来的许多实验性疗法将聚焦于二级预防，即降低发展为重度神经认知障碍的风险。在本文中，我们将通过回顾关于MCI的相关文献来聚焦mNCD。我们将回顾MCI的发病率和患病率、从MCI转变为痴呆的转化率、MCI转变为痴呆的风险因素、MCI与其他神经精神障碍（NPS）的共病情况，以及MCI中神经精神障碍治疗策略的发展。NPS在MCI患者中很常见，并且是发展为痴呆的重要风险因素。然而，针对MCI中NPS的有效治疗方法的研究很少。临床医生和研究人员必须确定治疗mNCD中的NPS是否会改善生活质量并有助于减缓认知障碍的进展。
