Research Team for Social Participation and Community Health, Tokyo Metropolitan Institute of Gerontology, Tokyo, Japan.
Institute of Gerontology, The University of Tokyo, Tokyo, Japan.
Geriatr Gerontol Int. 2017 Nov;17(11):1928-1935. doi: 10.1111/ggi.12996. Epub 2017 Mar 14.
The present prospective study used repeated measures analysis to identify potential Mini-Mental State Examination (MMSE) score trajectories and determine whether MMSE trajectory was associated with incident disabling dementia among community-dwelling older Japanese adults.
A total of 1724 non-demented adults (mean age 71.4 years [SD 5.7]; 56.7% women) aged 65-90 years participated in annual geriatric health assessments during the period from June 2002 through July 2014. The total number of observations was 6755, and the average number of follow-up assessments was 3.9. A review of municipal databases in the Japanese public long-term care insurance system showed that 205 (11.9%) participants developed disabling dementia through December 2014.
We identified three distinct MMSE score trajectory patterns (high, middle and low) in adults aged 65-90 years. After adjusting for important confounders, participants with middle (42.8%) and low (5.1%) MMSE trajectories had hazard ratios of 2.46 (95% confidence interval 1.64-3.68) and 10.73 (95% confidence interval 4.91-23.45), respectively, for incident disabling dementia, as compared with those in the high (52.1%) trajectory group.
Approximately half of the participants were classified as having a high MMSE trajectory, whereas 43% and 5% had middle and low MMSE trajectories, respectively, in this population. Individuals with middle and low MMSE trajectories had a higher risk for incident disabling dementia, which suggests that a high-risk approach to dementia prevention should target people with mild and more rapid cognitive decline. Geriatr Gerontol Int 2017; 17: 1928-1935.
本前瞻性研究采用重复测量分析来确定潜在的简易精神状态检查（MMSE）评分轨迹，并确定 MMSE 轨迹是否与社区居住的老年日本成年人发生致残性痴呆有关。
共有 1724 名无痴呆的成年人（平均年龄 71.4 岁[SD 5.7]；56.7%为女性）年龄在 65-90 岁，参加了 2002 年 6 月至 2014 年 7 月期间的年度老年健康评估。总观察数为 6755，平均随访评估次数为 3.9 次。通过查阅日本公共长期护理保险系统的市数据库，我们发现有 205 名（11.9%）参与者在 2014 年 12 月前发生了致残性痴呆。
我们在 65-90 岁的成年人中确定了三种不同的 MMSE 评分轨迹模式（高、中、低）。在调整了重要混杂因素后，中（42.8%）和低（5.1%）MMSE 轨迹的参与者发生致残性痴呆的风险比分别为 2.46（95%置信区间 1.64-3.68）和 10.73（95%置信区间 4.91-23.45），与高（52.1%）轨迹组相比。
在该人群中，约一半的参与者被归类为高 MMSE 轨迹，而 43%和 5%分别为中、低 MMSE 轨迹。中、低 MMSE 轨迹的个体发生致残性痴呆的风险较高，这表明针对轻度和认知衰退较快的人群采取预防痴呆的高危方法是合理的。老年医学与老年病学国际 2017；17:1928-1935.
