Gérontopôle, Centre Hospitalier Universitaire de Toulouse, Toulouse, France.
Centre Hospitalier de Castres - Mazamet, Castres, France.
J Alzheimers Dis. 2017;60(4):1567-1578. doi: 10.3233/JAD-170229.
Subjective cognitive decline (SCD) may be a very early symptom of Alzheimer's disease (AD) and may be associated with a cognitive decline in a cognitively normal population. The McNair and Kahn Scale was used to assess memory complaints in the GuidAge study.
Our objectives were to examine if the McNair and Kahn Scale can predict cognitive decline and to screen which (if any) of the question(s) of this scale would better predict this cognitive decline.
The GuidAge study was a phase III, multicenter, randomized, double blind, placebo-controlled study. Individuals aged 70 years and older, without cognitive impairment (Clinical Dementia Rate (CDR = 0)) at baseline who had spontaneously reported SCD were included in this study. The 20-item version of the McNair and Kahn Scale was used to assess SCD and a standardized neuropsychological assessment was used to assess the cognitive status.
1,307 patients with SCD and with CDR = 0 at baseline were included. During the 5 years of follow-up, 519 patients showed cognitive decline. Incidence of aggravation score of CDR was 13.40% person years (95% CI [12.24-14.56]). Results showed a significant relationship between the McNair and Kahn Scale score and decline in cognitive performance (HR 1.012; 95% CI [1.002-1.021]; p = 0.0156). Among the 20 items, 5 were statistically significant to predict cognitive decline after adjustment.
SCD is a promising indicator of memory impairment. Our study found that using the McNair and Kahn scale can predict cognitive decline. A 5-item version of this scale could be used to screen patients in clinical practice and in clinical research.
主观认知衰退（SCD）可能是阿尔茨海默病（AD）的一个非常早期的症状，并且可能与认知正常人群的认知能力下降有关。在 GuidAge 研究中，使用了 McNair 和 Kahn 量表来评估记忆主诉。
我们的目的是检验 McNair 和 Kahn 量表是否可以预测认知下降，并筛选出该量表的哪些问题（如果有的话）可以更好地预测这种认知下降。
GuidAge 研究是一项 III 期、多中心、随机、双盲、安慰剂对照研究。该研究纳入了无认知障碍（基线时临床痴呆评定量表（CDR）=0）但有自发报告 SCD 的年龄在 70 岁及以上的个体。使用 20 项版的 McNair 和 Kahn 量表来评估 SCD，并用标准化神经心理学评估来评估认知状态。
共纳入了 1307 名 SCD 且基线时 CDR=0 的患者。在 5 年的随访期间，519 名患者出现了认知下降。CDR 恶化评分的发生率为 13.40%人年（95%CI[12.24-14.56]）。结果表明，McNair 和 Kahn 量表评分与认知表现下降之间存在显著关系（HR 1.012；95%CI[1.002-1.021]；p=0.0156）。在 20 项中，有 5 项经调整后对预测认知下降有统计学意义。
SCD 是记忆障碍的一个很有前途的指标。我们的研究发现，使用 McNair 和 Kahn 量表可以预测认知下降。该量表的 5 项版本可用于在临床实践和临床研究中筛选患者。
