1 Department of Clinical Sciences, Center for Research and Treatment on Cognitive Dysfunctions, Institute of Clinical Neurology, "Luigi Sacco" Hospital, University of Milan, Milan, Italy.
2 Neurology Unit, Department of Pathophysiology and Transplantation, University of Milan, Fondazione Ca' Granda, IRCCS Ospedale Policlinico, Milan, Italy.
Am J Alzheimers Dis Other Demen. 2017 Nov;32(7):401-407. doi: 10.1177/1533317517725812. Epub 2017 Aug 25.
To assess memory impairment insight as a predictor of dementia and Alzheimer's disease (AD) in amnestic mild cognitive impairment (MCI).
To verify whether the awareness of memory impairment assessed by Geriatric Depression Scale (GDS) was associated with the risk of progression to dementia and AD in a cohort of MCI, we used a Cox regression model adjusted for age, sex, education, subtypes of amnestic MCI, Mini-Mental State Examination, Cumulative Illness Rating Scale severity index, and apolipoprotein E genotype.
During a follow-up of 27.7 (20.8) months, 205 (63.3%) of 324 patients with amnestic MCI progressed to dementia, including 141 to AD. No association was found in the unadjusted, partially adjusted (for sociodemographic variables), and fully adjusted multivariate Cox analysis between the awareness of memory impairment and the progression to dementia and AD.
Awareness or anosognosia of memory deficits, identified by GDS, is not useful to predict progression to dementia of patients with amnestic MCI.
评估遗忘型轻度认知障碍（MCI）患者记忆障碍自知力作为痴呆和阿尔茨海默病（AD）的预测指标。
为了验证老年抑郁量表（GDS）评估的记忆障碍自知力是否与 MCI 患者向痴呆和 AD 进展的风险相关，我们使用 Cox 回归模型，对年龄、性别、教育程度、遗忘型 MCI 亚型、简易精神状态检查、累积疾病严重程度评分指数和载脂蛋白 E 基因型进行了调整。
在 27.7（20.8）个月的随访中，324 例遗忘型 MCI 患者中有 205 例（63.3%）进展为痴呆，其中 141 例进展为 AD。在未调整、部分调整（社会人口变量）和完全调整的多变量 Cox 分析中，GDS 识别的记忆障碍自知力与向痴呆和 AD 进展之间均无关联。
GDS 确定的记忆缺陷的意识或否认，对预测遗忘型 MCI 患者向痴呆的进展没有帮助。
