Stephan Blossom C M, Muniz-Terrera Graciela, Granic Antoneta, Collerton Joanna, Davies Karen, Saxby Brian K, Wesnes Keith A, Kirkwood Thomas B L, Jagger Carol
Institute of Health and Society, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, UK.
Centre for Dementia Prevention, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK.
Int J Geriatr Psychiatry. 2018 Feb;33(2):298-306. doi: 10.1002/gps.4743. Epub 2017 Jun 22.
Ageing is associated with changes in cognition in some, but not all domains. In young-old adults, defined as persons aged 65-84 years, baseline cognitive function has been shown to impact on cognitive trajectories. Whether similar patterns occur in the very-old, defined as persons aged 85 years and over, is not known.
Longitudinal changes (5 years' follow-up) in global and domain specific cognitive function including memory, attention and speed were investigated in participants from the Newcastle 85+ Study (n = 845). At baseline, participants were grouped using Mini-Mental State Examination cut-off scores and dementia status into the following: not impaired, mildly impaired or severely impaired/dementia groups.
Only a limited number of cognitive measures showed significant decline in performance over time. Where observed, change generally occurred only in the severely impaired group. In the severely impaired group, small differences in baseline age were associated with poorer performance over time on most measures. Education was not protective against cognitive decline in any group.
There are individuals who maintain a high level of cognitive function or only show mild impairments even into their ninth decade of life. This group of successful cognitive agers may provide insight for identifying predictors of cognitive integrity in later life. In individuals with severe impairment, cognitive performance shows significant decline over time, especially in measures of attention and speed. Further work to identify those individuals at highest risk of cognitive decline is necessary to implement early support and intervention strategies in this rapidly expanding age group. © 2017 The Authors. International Journal of Geriatric Psychiatry published by John Wiley & Sons Ltd.
衰老与某些但并非所有认知领域的变化相关。在年轻老年人（定义为65 - 84岁的人群）中，已表明基线认知功能会影响认知轨迹。而在年龄85岁及以上的高龄老年人中是否会出现类似模式尚不清楚。
对纽卡斯尔85岁及以上研究（n = 845）的参与者进行了包括记忆、注意力和速度在内的整体及特定领域认知功能的纵向变化（5年随访）调查。在基线时，根据简易精神状态检查表的临界分数和痴呆状态将参与者分为以下几组：未受损组、轻度受损组或重度受损/痴呆组。
随着时间推移，只有有限数量的认知测量显示出显著的性能下降。若有观察到下降情况，通常仅发生在重度受损组。在重度受损组中，基线年龄的微小差异与大多数测量指标随时间推移表现较差相关。教育对任何组的认知衰退均无保护作用。
有些人即使到了九十多岁仍保持高水平的认知功能或仅表现出轻度损伤。这组成功的认知老化者可能为识别晚年认知完整性的预测因素提供见解。在重度受损个体中，认知表现随时间显著下降，尤其是在注意力和速度测量方面。有必要进一步开展工作，以识别认知衰退风险最高的个体，从而在这个迅速扩大的年龄组中实施早期支持和干预策略。© 2017作者。《国际老年精神病学杂志》由约翰·威利父子有限公司出版
