Clark Lindsay R, Koscik Rebecca L, Nicholas Christopher R, Okonkwo Ozioma C, Engelman Corinne D, Bratzke Lisa C, Hogan Kirk J, Mueller Kimberly D, Bendlin Barbara B, Carlsson Cynthia M, Asthana Sanjay, Sager Mark A, Hermann Bruce P, Johnson Sterling C
Wisconsin Alzheimer's Institute, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705, USA.
Alzheimer's Disease Research Center, University of Wisconsin-Madison School of Medicine and Public Health, Madison, WI 53705, USA.
Arch Clin Neuropsychol. 2016 Nov 22;31(7):675-688. doi: 10.1093/arclin/acw024.
Detecting cognitive decline in presymptomatic Alzheimer's disease (AD) and early mild cognitive impairment (MCI) is challenging, but important for treatments targeting AD-related neurodegeneration. The current study aimed to investigate the utility and performance of internally developed robust norms and standard norms in identifying cognitive impairment in late middle-age (baseline age range = 36-68; M = 54).
Robust norms were developed for neuropsychological measures based on longitudinally confirmed cognitively normal (CN) participants (n= 476). Seven hundred and seventy-nine participants enriched for AD risk were classified as psychometric MCI (pMCI) or CN based on standard and robust norms and "single-test" versus "multi-test" criteria.
Prevalence of pMCI ranged from 3% to 49% depending on the classification scheme used. Those classified as pMCI using robust norms exhibited greater subjective cognitive complaints, diagnostic stability, and mild clinical symptoms at follow-up.
Results suggest that identifying early clinically relevant cognitive decline in late middle-age is feasible using robust norms and multi-test criteria.
在症状前阿尔茨海默病(AD)和早期轻度认知障碍(MCI)中检测认知衰退具有挑战性,但对于针对AD相关神经退行性变的治疗很重要。当前研究旨在调查内部开发的稳健常模和标准常模在识别中老年晚期(基线年龄范围 = 36 - 68岁;中位数 = 54岁)认知障碍方面的效用和表现。
基于纵向确认的认知正常(CN)参与者(n = 476)制定了神经心理学测量的稳健常模。根据标准和稳健常模以及“单测试”与“多测试”标准,将779名有AD风险的参与者分类为心理测量MCI(pMCI)或CN。
根据所使用的分类方案,pMCI的患病率在3%至49%之间。使用稳健常模分类为pMCI的参与者在随访时表现出更大的主观认知抱怨、诊断稳定性和轻度临床症状。
结果表明,使用稳健常模和多测试标准在中老年晚期识别早期临床相关认知衰退是可行的。