单项评估的主观记忆主诉在显性遗传阿尔茨海默病中的诊断价值：DIAN研究结果
Diagnostic Value of Subjective Memory Complaints Assessed with a Single Item in Dominantly Inherited Alzheimer's Disease: Results of the DIAN Study.
作者信息
Laske Christoph, Sohrabi Hamid R, Jasielec Mateusz S, Müller Stephan, Koehler Niklas K, Gräber Susanne, Förster Stefan, Drzezga Alexander, Mueller-Sarnowski Felix, Danek Adrian, Jucker Mathias, Bateman Randall J, Buckles Virginia, Saykin Andrew J, Martins Ralph N, Morris John C
机构信息
German Center for Neurodegenerative Diseases (DZNE), 72076 Tübingen, Germany ; Section for Dementia Research, Department of Cellular Neurology, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, 72076 Tübingen, Germany ; Department of Psychiatry and Psychotherapy, University of Tübingen, 72076 Tübingen, Germany.
Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Perth, WA 6027, Australia ; School of Psychiatry and Clinical Neurosciences, University of Western Australia, Nedlands, WA 6009, Australia.
出版信息
Biomed Res Int. 2015;2015:828120. doi: 10.1155/2015/828120. Epub 2015 Apr 2.
OBJECTIVE
We examined the diagnostic value of subjective memory complaints (SMCs) assessed with a single item in a large cross-sectional cohort consisting of families with autosomal dominant Alzheimer's disease (ADAD) participating in the Dominantly Inherited Alzheimer Network (DIAN).
METHODS
The baseline sample of 183 mutation carriers (MCs) and 117 noncarriers (NCs) was divided according to Clinical Dementia Rating (CDR) scale into preclinical (CDR 0; MCs: n = 107; NCs: n = 109), early symptomatic (CDR 0.5; MCs: n = 48; NCs: n = 8), and dementia stage (CDR ≥ 1; MCs: n = 28; NCs: n = 0). These groups were subdivided by the presence or absence of SMCs.
RESULTS
At CDR 0, SMCs were present in 12.1% of MCs and 9.2% of NCs (P = 0.6). At CDR 0.5, SMCs were present in 66.7% of MCs and 62.5% of NCs (P = 1.0). At CDR ≥ 1, SMCs were present in 96.4% of MCs. SMCs in MCs were significantly associated with CDR, logical memory scores, Geriatric Depression Scale, education, and estimated years to onset.
CONCLUSIONS
The present study shows that SMCs assessed by a single-item scale have no diagnostic value to identify preclinical ADAD in asymptomatic individuals. These results demonstrate the need of further improvement of SMC measures that should be examined in large clinical trials.
目的
我们在一个由参与显性遗传阿尔茨海默病网络（DIAN）的常染色体显性遗传阿尔茨海默病（ADAD）家庭组成的大型横断面队列中，研究了用单个项目评估的主观记忆主诉（SMC）的诊断价值。
方法
根据临床痴呆评定量表（CDR），将183名突变携带者（MC）和117名非携带者（NC）的基线样本分为临床前期（CDR 0；MC：n = 107；NC：n = 109）、早期症状期（CDR 0.5；MC：n = 48；NC：n = 8）和痴呆期（CDR≥1；MC：n = 28；NC：n = 0）。这些组再根据是否存在SMC进行细分。
结果
在CDR 0时，12.1%的MC和9.2%的NC存在SMC（P = 0.6）。在CDR 0.5时，66.7%的MC和62.5%的NC存在SMC（P = 1.0）。在CDR≥1时，96.4%的MC存在SMC。MC中的SMC与CDR、逻辑记忆得分、老年抑郁量表、教育程度和预计发病年限显著相关。
结论
本研究表明，用单项量表评估的SMC对识别无症状个体的临床前期ADAD没有诊断价值。这些结果表明需要进一步改进SMC测量方法，这应在大型临床试验中进行检验。
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