Clem Matthew A, Holliday Ryan P, Pandya Seema, Hynan Linda S, Lacritz Laura H, Woon Fu L
Departments of *Psychiatry §Clinical Sciences, and ∥Neurology and Neurotherapeutics, University of Texas Southwestern Medical Center at Dallas, Dallas, Texas †Veterans Affairs North Texas Health Care System, Dallas, Texas ¶Seton Brain & Spine Institute, Department of Neurology, Dell Medical School, University of Texas at Austin, Austin, Texas ‡Department of Clinical and Health Psychology, University of Florida, Gainesville, Florida.
Cogn Behav Neurol. 2017 Mar;30(1):8-15. doi: 10.1097/WNN.0000000000000119.
In half to two thirds of patients who are diagnosed with mild cognitive impairment (MCI), the diagnosis neither converts to dementia nor reverts to normal cognition; however, little is known about predictors of MCI stability. Our study aimed to identify those predictors.
We obtained 3-year longitudinal data from the National Alzheimer's Coordinating Center Uniform Data Set for patients with a baseline diagnosis of MCI. To predict MCI stability, we used the patients' baseline data to conduct three logistic regression models: demographics, global function, and neuropsychological performance.
Our final sample had 1059 patients. At the end of 3 years, 596 still had MCI and 463 had converted to dementia. The most reliable predictors of stable MCI were higher baseline scores on delayed recall, processing speed, and global function; younger age; and absence of apolipoprotein E4 alleles.
Not all patients with MCI progress to dementia. Of the protective factors that we identified from demographic, functional, and cognitive data, the absence of apolipoprotein E4 alleles best predicted MCI stability. Our predictors may help clinicians better evaluate and treat patients, and may help researchers recruit more homogeneous samples for clinical trials.
在被诊断为轻度认知障碍（MCI）的患者中，有一半至三分之二的患者其诊断结果既未转变为痴呆，也未恢复到正常认知状态；然而，关于MCI稳定性的预测因素却知之甚少。我们的研究旨在确定这些预测因素。
我们从国家阿尔茨海默病协调中心统一数据集获取了基线诊断为MCI的患者的3年纵向数据。为了预测MCI的稳定性，我们使用患者的基线数据进行了三个逻辑回归模型分析：人口统计学、整体功能和神经心理学表现。
我们的最终样本有1059名患者。3年后，596名患者仍为MCI，463名患者已转变为痴呆。稳定MCI最可靠的预测因素是延迟回忆、处理速度和整体功能方面较高的基线分数；较年轻的年龄；以及不存在载脂蛋白E4等位基因。
并非所有MCI患者都会发展为痴呆。从人口统计学、功能和认知数据中确定的保护因素中，不存在载脂蛋白E4等位基因最能预测MCI的稳定性。我们确定的预测因素可能有助于临床医生更好地评估和治疗患者，也可能有助于研究人员为临床试验招募更具同质性的样本。
