Gillett Sarah R, Thacker Evan L, Letter Abraham J, McClure Leslie A, Wadley Virginia G, Unverzagt Frederick W, Kissela Brett M, Kennedy Richard E, Glasser Stephen P, Levine Deborah A, Cushman Mary
a Department of Medicine , University of Vermont College of Medicine , Colchester , VT , USA.
Clin Neuropsychol. 2015;29(4):466-86. doi: 10.1080/13854046.2015.1042524. Epub 2015 May 15.
To identify approximately 500 cases of incident cognitive impairment (ICI) in a large, national sample adapting an existing cognitive test-based case definition and to examine relationships of vascular risk factors with ICI.
Participants were from the REGARDS study, a national sample of 30,239 African-American and White Americans. Participants included in this analysis had normal cognitive screening and no history of stroke at baseline, and at least one follow-up cognitive assessment with a three-test battery (TTB). Regression-based norms were applied to TTB scores to identify cases of ICI. Logistic regression was used to model associations with baseline vascular risk factors.
We identified 495 participants with ICI of 17,630 eligible participants. In multivariable modeling, income (OR 1.83 CI 1.27,2.62), stroke belt residence (OR 1.45 CI 1.18,1.78), history of transient ischemic attack (OR 1.90 CI 1.29,2.81), coronary artery disease(OR 1.32 CI 1.02,1.70), diabetes (OR 1.48 CI 1.17,1.87), obesity (OR 1.40 CI 1.05,1.86), and incident stroke (OR 2.73 CI 1.52,4.90) were associated with ICI.
We adapted a previously validated cognitive test-based case definition to identify cases of ICI. Many previously identified risk factors were associated with ICI, supporting the criterion-related validity of our definition.
在一个大型全国样本中，采用现有的基于认知测试的病例定义来识别约500例新发认知障碍（ICI）病例，并研究血管危险因素与ICI之间的关系。
参与者来自REGARDS研究，这是一个由30239名非裔美国人和白人组成的全国样本。纳入本次分析的参与者在基线时认知筛查正常且无卒中史，并且至少进行过一次包含三项测试的认知评估（TTB）。将基于回归的常模应用于TTB分数以识别ICI病例。采用逻辑回归对与基线血管危险因素的关联进行建模。
在17630名符合条件的参与者中，我们识别出495例ICI患者。在多变量建模中，收入（比值比[OR]1.83，置信区间[CI]1.27,2.62）、居住在卒中带（OR 1.45，CI 1.18,1.78）、短暂性脑缺血发作史（OR 1.90，CI 1.29,2.81）、冠状动脉疾病（OR 1.32，CI 1.02,1.70）、糖尿病（OR 1.48，CI 1.17,1.87）、肥胖（OR 1.40，CI 1.05,1.86）和新发卒中（OR 2.73，CI 1.52,4.90）与ICI相关。
我们采用了先前验证的基于认知测试的病例定义来识别ICI病例。许多先前确定的危险因素与ICI相关，支持了我们定义的标准相关效度。
