墨西哥轻度认知障碍老年人转化为痴呆症的临床和人口统计学预测因素

Clinical and Demographic Predictors of Conversion to Dementia in Mexican Elderly with Mild Cognitive Impairment.

作者信息

Aguilar-Navarro Sara G, Mimenza-Alvarado Alberto J, Ávila-Funes José Alberto, Juárez-Cedillo Teresa, Bernal-López Carolina, Hernández-Favela Celia G

机构信息

Geriatrics Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.

Epidemiology and Health Services Research Unit, Area of Aging, Centro Médico Nacional Siglo XXI, Instituto Mexicano del Seguro Social and Faculty of Superior Studies (FES) Zaragoza, Universidad Nacional Autónoma de México, Mexico City, Mexico.

出版信息

Rev Invest Clin. 2017 Jan-Feb;69(1):33-39. doi: 10.24875/ric.17002064.

DOI:10.24875/ric.17002064

PMID:28239180

Abstract

BACKGROUND

Mild cognitive impairment (MCI) is considered a clinical stage between normal cognitive aging and dementia. The clinical course of MCI is heterogeneous, with a significant number of cases progressing to dementia or reverting back to normal.

OBJECTIVE

To determine the predictors of conversion from mild cognitive impairment to dementia among Mexican older adults.

MATERIALS AND METHODS

A sample of 175 persons underwent clinical and neuropsychological evaluation to establish mild cognitive impairment diagnosis. These patients were followed-up for a mean 3.5 years.

RESULTS

Mean age was 81.7 (± 6.9) years, 57% were women, and mean education level was 9.5 (± 6.1) years. Sixty-one percent of mild cognitive impairment participants progressed to dementia. Multivariate Cox regression analysis showed that progression to dementia was associated with age (HR: 4.95; 95% CI: 1.96-12.46; p = 0.001), low education level (HR: 5.81; 95% CI: 1.90-7.78; p < 0.002), history of stroke (HR: 3.92; 95% CI: 1.37-11.16; p < 0.012) and cognitive decline (HR: 1.31; 95% CI: 1.18-1.45; p = 0.000).

CONCLUSIONS

Age, poor education, cognitive decline, and a history of stroke were predictors of conversion to dementia. The identification and control of modifiable risk factors could influence conversion to dementia.

摘要

背景

轻度认知障碍（MCI）被认为是正常认知老化与痴呆之间的一个临床阶段。MCI的临床病程具有异质性，相当数量的病例会进展为痴呆或恢复正常。

目的

确定墨西哥老年人群中从轻度认知障碍转变为痴呆的预测因素。

材料与方法

对175人进行了临床和神经心理学评估，以确立轻度认知障碍的诊断。对这些患者进行了平均3.5年的随访。

结果

平均年龄为81.7（±6.9）岁，57%为女性，平均教育水平为9.5（±6.1）年。61%的轻度认知障碍参与者进展为痴呆。多变量Cox回归分析显示，进展为痴呆与年龄（风险比：4.95；95%置信区间：1.96 - 12.46；p = 0.001）、低教育水平（风险比：5.81；95%置信区间：1.90 - 7.78；p < 0.002）、中风病史（风险比：3.92；95%置信区间：1.37 - 11.16；p < 0.012）和认知衰退（风险比：1.31；95%置信区间：1.18 - 1.45；p = 0.000）有关。