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轻度认知障碍老年人转化为可能的阿尔茨海默病的神经心理学预测因素

Neuropsychological predictors of conversion to probable Alzheimer disease in elderly with mild cognitive impairment.

作者信息

García-Herranz Sara, Díaz-Mardomingo M Carmen, Peraita Herminia

机构信息

Department of Psychology Basic I, National University of Distance Education (UNED), Madrid, Spain.

出版信息

J Neuropsychol. 2016 Sep;10(2):239-55. doi: 10.1111/jnp.12067. Epub 2015 Mar 23.

DOI:10.1111/jnp.12067
PMID:25809316
Abstract

In the field of neuropsychology, it is essential to determine which neuropsychological tests predict Alzheimer's disease (AD) in people with mild cognitive impairment (MCI) and which cut-off points should be used to identify people at greater risk for converting to dementia. The aim of the present study was to analyse the predictive value of the cognitive tests included in a neuropsychological battery for conversion to AD among MCI participants and to analyse the influence of some sociodemographic variables - sex, age, schooling - and others, such as follow-up time and emotional state. A total of 105 participants were assessed with a neuropsychological battery at baseline and during a 3-year follow-up period. For the present study, the data were analysed at baseline. During the follow-up period, 24 participants (22.85%) converted to dementia (2.79 ± 1.14 years) and 81 (77.14%) remained as MCI. The logistic regression analysis determined that the long delay cued recall and the performance time of the Rey figure test were the best predictive tests of conversion to dementia after an MCI diagnosis. Concerning the sociodemographic factors, sex had the highest predictive power. The results reveal the relevance of the neuropsychological data obtained in the first assessment. Specifically, the data obtained in the episodic verbal memory tests and tests that assess visuospatial and executive components may help to identify people with MCI who may develop AD in an interval not longer than 4 years, with the masculine gender being an added risk factor.

摘要

在神经心理学领域,确定哪些神经心理学测试能够预测轻度认知障碍(MCI)患者是否会患上阿尔茨海默病(AD),以及应使用哪些临界点来识别转化为痴呆风险更高的人群至关重要。本研究的目的是分析一套神经心理测验中包含的认知测试对MCI参与者转化为AD的预测价值,并分析一些社会人口统计学变量——性别、年龄、受教育程度——以及其他因素,如随访时间和情绪状态的影响。共有105名参与者在基线时和3年随访期内接受了一套神经心理测验评估。在本研究中,对基线时的数据进行了分析。在随访期间,24名参与者(22.85%)转化为痴呆(2.79±1.14年),81名(77.14%)仍为MCI。逻辑回归分析确定,长延迟线索回忆和雷氏图形测验的执行时间是MCI诊断后转化为痴呆的最佳预测测试。关于社会人口统计学因素,性别具有最高的预测力。结果揭示了首次评估中获得的神经心理学数据的相关性。具体而言,情景性言语记忆测试以及评估视觉空间和执行成分的测试中获得的数据,可能有助于识别在不超过4年的时间间隔内可能发展为AD的MCI患者,男性是一个额外的风险因素。

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