Verghese Joe, Lipton Richard, Ayers Emmeline
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA; Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA.
Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA.
Alzheimers Dement. 2017 Sep;13(9):985-992. doi: 10.1016/j.jalz.2017.01.023. Epub 2017 Mar 3.
Spatial navigation deficits are reported in dementia, but their temporal relationship to cognitive decline is not established.
This is a prospective cohort study in 442 nondemented adults (mean age 79.9 years). Spatial navigation measured with the Floor Maze Test and reported as immediate maze time (IMT) and delayed maze time (DMT). Predementia syndromes, mild cognitive impairment syndrome (MCI) and motoric cognitive risk syndrome (MCR), were primary outcomes.
Over a mean follow-up of 16.5 ± 13.7 months, 41 participants developed MCI and 30 participants developed MCR. In Cox models adjusted for age, sex, education, cognitive status, comorbid illnesses, and maze errors, a 10-second increment on IMT predicted incident MCI (adjusted hazard ratio [aHR]: 1.25; 95% confidence interval [CI]: 1.06-1.48) and MCR (aHR: 1.53; 95% CI: 1.23-1.90). DMT predicted MCR but not MCI.
Spatial navigation performance predicted predementia syndromes in aging and implicates navigational impairments as an early feature in dementias.
痴呆症患者存在空间导航缺陷，但其与认知衰退的时间关系尚未明确。
这是一项针对442名非痴呆成年人（平均年龄79.9岁）的前瞻性队列研究。通过地板迷宫测试测量空间导航能力，并报告即时迷宫时间（IMT）和延迟迷宫时间（DMT）。痴呆前综合征、轻度认知障碍综合征（MCI）和运动认知风险综合征（MCR）为主要研究结果。
在平均16.5±13.7个月的随访期内，41名参与者发展为MCI，30名参与者发展为MCR。在对年龄、性别、教育程度、认知状态、合并疾病和迷宫错误进行校正的Cox模型中，IMT每增加10秒，预测发生MCI（校正风险比[aHR]：1.25；95%置信区间[CI]：1.06 - 1.48）和MCR（aHR：1.53；95%CI：1.23 - 1.90）的风险增加。DMT可预测MCR，但不能预测MCI。
空间导航表现可预测老年人的痴呆前综合征，并表明导航障碍是痴呆症的早期特征。
