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韩国老年人轻度认知障碍的转化模式及预测因素

Conversion pattern and predictive factor of mild cognitive impairment in elderly Koreans.

作者信息

Shim Sung-Mi, Song Jihyun, Kim Jong-Hoon, Jeon Jae-Pil

机构信息

Division of Brain Diseases, Center for Biomedical Sciences, Korea National Institute of Health, 187 Osongsaengmyung-2-ro, Osong-eup, Cheongju-si, Chungcheongbuk-do, Republic of Korea; Department of Biotechnology, College of Life Sciences and Biotechnology, Korea University, 5-1 Anam-Dong, Seongbuk-Gu, Seoul, Republic of Korea.

Division of Brain Diseases, Center for Biomedical Sciences, Korea National Institute of Health, 187 Osongsaengmyung-2-ro, Osong-eup, Cheongju-si, Chungcheongbuk-do, Republic of Korea.

出版信息

Arch Gerontol Geriatr. 2016 May-Jun;64:146-50. doi: 10.1016/j.archger.2016.02.007. Epub 2016 Feb 11.

Abstract

OBJECTIVE

We aimed to understand conversion characteristics of mild cognitive impairment (MCI) in elderly Koreans.

METHODS

We analyzed clinical data of 760 individuals who participated in a two-year follow-up study. Neuropsychological assessments and clinical examination were conducted in the follow-ups. Logistic regression model was used to estimate predictive risk factors of MCI conversion.

RESULT

The participants at baseline (n=760) represented 462 cognitively normal individuals (60.8%), 286 individuals with MCI (37.6%), and 12 individuals with dementia (1.6%). Among the cognitively normal individuals (n=462), 108 (23.4%) progressed to MCI during the two-year follow-up period, including 92 with amnestic mild cognitive impairment (aMCI; 19.9%) and 16 with non-amnestic mild cognitive impairment (non-aMCI; 3.5%). Interestingly, 3.7% of participants with aMCI converted to non-aMCI, while 45.5% of participants with non-aMCI converted to aMCI. Moreover, a higher proportion of non-aMCI (27.3%) reverted to a cognitively normal state, compared to aMCI participants (18.6%), indicating that non-amnestic cognitive impairment is more unstable than amnestic cognitive impairment, and probably converges toward aMCI. Additionally, we found that weight loss was associated with incident MCI and future MCI. Weight loss was negatively correlated with Clinical Dementia Rating (p=0.005), and significantly associated with a higher risk of MCI conversion from a cognitively normal state (OR=1.10, 95% CI: 1.00-1.21, p=0.042).

CONCLUSION

This study supports that non-amnestic MCI is prone to converge toward amnestic MCI, and the elderly people with weight loss are at risk for developing cognitive decline.

摘要

目的

我们旨在了解韩国老年人轻度认知障碍(MCI)的转化特征。

方法

我们分析了760名参与为期两年随访研究的个体的临床数据。随访期间进行了神经心理学评估和临床检查。采用逻辑回归模型估计MCI转化的预测风险因素。

结果

基线时的参与者(n = 760)包括462名认知正常个体(60.8%)、286名MCI个体(37.6%)和12名痴呆个体(1.6%)。在认知正常个体(n = 462)中,108名(23.4%)在两年随访期内进展为MCI,其中92名患有遗忘型轻度认知障碍(aMCI;19.9%),16名患有非遗忘型轻度认知障碍(非aMCI;3.5%)。有趣的是,3.7%的aMCI参与者转化为非aMCI,而45.5%的非aMCI参与者转化为aMCI。此外,与aMCI参与者(18.6%)相比,更高比例的非aMCI(27.3%)恢复到认知正常状态,这表明非遗忘型认知障碍比遗忘型认知障碍更不稳定,并且可能趋向于aMCI。此外,我们发现体重减轻与新发MCI和未来MCI相关。体重减轻与临床痴呆评定量表呈负相关(p = 0.005),并且与从认知正常状态转化为MCI的较高风险显著相关(OR = 1.10,95%CI:1.00 - 1.21,p = 0.042)。

结论

本研究支持非遗忘型MCI易于趋向于遗忘型MCI,且体重减轻的老年人有发生认知衰退的风险。

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