认知脆弱，预防老年人依赖的新目标。
Cognitive frailty, a novel target for the prevention of elderly dependency.
机构信息
Shanghai Institute of Geriatrics and Gerontology, Shanghai 200040, China; Research Center of Aging and Medicine, Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China.
Shanghai Institute of Geriatrics and Gerontology, Shanghai 200040, China; Research Center of Aging and Medicine, Shanghai Key Laboratory of Clinical Geriatrics, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China; Department of Geriatrics, Huadong Hospital, Shanghai Medical College, Fudan University, Shanghai 200040, China.
出版信息
Ageing Res Rev. 2015 Mar;20:1-10. doi: 10.1016/j.arr.2014.12.004. Epub 2014 Dec 30.
Frailty is a complex and heterogeneous clinical syndrome. Cognitive frailty has been considered as a subtype of frailty. In this study, we refine the definition of cognitive frailty based on existing reports about frailty and the latest progress in cognition research. We obtain evidence from the literature regarding the role of pre-physical frailty in pathological aging. We propose that cognitive impairment of cognitive frailty results from physical or pre-physical frailty and comprises two subtypes: the reversible and the potentially reversible. Reversible cognitive impairment is indicated by subjective cognitive decline (SCD) and/or positive fluid and imaging biomarkers of amyloid-β accumulation and neurodegeneration. Potentially reversible cognitive impairment is MCI (CDR=0.5). Based on the severity of cognitive impairment, it is possible to determine the primary and secondary preventative measures for cognitive frailty. We further determine whether SCD is a component of pre-clinical AD or the early stage of other neurodegenerative diseases, which is required for guiding personal clinical intervention.
衰弱是一种复杂且异质的临床综合征。认知衰弱已被认为是衰弱的一种亚型。在本研究中，我们根据现有的关于衰弱的报告和认知研究的最新进展，对认知衰弱的定义进行了细化。我们从文献中获得了关于前躯体衰弱在病理性衰老中的作用的证据。我们提出，认知衰弱的认知障碍是由躯体或前躯体衰弱引起的，包括两种亚型：可逆性和潜在可逆性。可逆性认知障碍表现为主观认知下降（SCD）和/或正性的液体和淀粉样蛋白-β 积聚及神经退行性变的影像学生物标志物。潜在可逆性认知障碍为轻度认知障碍（CDR=0.5）。根据认知障碍的严重程度，可以确定认知衰弱的一级和二级预防措施。我们还进一步确定 SCD 是否是临床前 AD 的组成部分，或者是其他神经退行性疾病的早期阶段，这对于指导个人临床干预是必要的。
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