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记忆门诊样本中主观认知衰退和临床前阿尔茨海默病标准的纵向评估

Longitudinal evaluation of criteria for subjective cognitive decline and preclinical Alzheimer's disease in a memory clinic sample.

作者信息

Eckerström Marie, Göthlin Mattias, Rolstad Sindre, Hessen Erik, Eckerström Carl, Nordlund Arto, Johansson Boo, Svensson Johan, Jonsson Michael, Sacuiu Simona, Wallin Anders

机构信息

Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.

Department of Neurology, Akershus University Hospital, Oslo, Norway.

出版信息

Alzheimers Dement (Amst). 2017 May 16;8:96-107. doi: 10.1016/j.dadm.2017.04.006. eCollection 2017.

DOI:10.1016/j.dadm.2017.04.006
PMID:28560310
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5443895/
Abstract

INTRODUCTION

Subjective cognitive decline (SCD) and biomarker-based "at-risk" concepts such as "preclinical" Alzheimer's disease (AD) have been developed to predict AD dementia before objective cognitive impairment is detectable. We longitudinally evaluated cognitive outcome when using these classifications.

METHODS

Memory clinic patients ( = 235) were classified as SCD ( = 122): subtle cognitive decline ( = 36) and mild cognitive impairment ( = 77) and subsequently subclassified into SCDplus and National Institute on Aging-Alzheimer's Association (NIA-AA) stages 0 to 3. Mean (standard deviation) follow-up time was 48 (35) months. Proportion declining cognitively and prognostic accuracy for cognitive decline was calculated for all classifications.

RESULTS

Among SCDplus patients, 43% to 48% declined cognitively. Among NIA-AA stage 1 to 3 patients, 50% to 100% declined cognitively. The highest positive likelihood ratios (+LRs) for subsequent cognitive decline (+LR 6.3), dementia (+LR 3.4), and AD dementia (+LR 6.5) were found for NIA-AA stage 2.

DISCUSSION

In a memory clinic setting, NIA-AA stage 2 seems to be the most successful classification in predicting objective cognitive decline, dementia, and AD dementia.

摘要

引言

主观认知下降（SCD）以及基于生物标志物的“风险”概念，如“临床前”阿尔茨海默病（AD），已被用于在可检测到客观认知障碍之前预测AD痴呆。我们纵向评估了使用这些分类时的认知结果。

方法

记忆门诊患者（n = 235）被分类为SCD（n = 122）、轻微认知下降（n = 36）和轻度认知障碍（n = 77），随后再细分为SCDplus和美国国立衰老研究所 - 阿尔茨海默病协会（NIA - AA）0至3期。平均（标准差）随访时间为48（35）个月。计算所有分类的认知下降比例和认知下降的预后准确性。

结果

在SCDplus患者中，43%至48%出现认知下降。在NIA - AA 1至3期患者中，50%至100%出现认知下降。NIA - AA 2期对于随后的认知下降（阳性似然比[+LR] 6.3）、痴呆（+LR 3.4）和AD痴呆（+LR 6.5）具有最高的阳性似然比。

讨论

在记忆门诊环境中，NIA - AA 2期似乎是预测客观认知下降、痴呆和AD痴呆最成功的分类。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fab1/5443895/6c6ed6b4db25/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fab1/5443895/e98cc7bd3d12/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fab1/5443895/6c6ed6b4db25/gr2.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fab1/5443895/e98cc7bd3d12/gr1.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fab1/5443895/6c6ed6b4db25/gr2.jpg

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