Taragano Fernando E, Allegri Ricardo F, Lyketsos Constantine
Servicio de Neuropsicología (SIREN), y Unidad de Investigación "René Barón" del Instituto Universitario CEMIC, Buenos Aires, Argentina.
Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins University and Hospital, Baltimore, USA.
Dement Neuropsychol. 2008 Oct-Dec;2(4):256-260. doi: 10.1590/S1980-57642009DN20400004.
Mild cognitive impairment (MCI) was defined by Petersen et al. (1999) as progressive memory loss, a prodrome of Alzheimer's disease. MCI is a well-established entity that can be both a diagnosis in medical practice and a valid target of Alzheimer's prevention therapy. More recently MCI has expanded to include other cognitive domains with other potential causes: amnestic MCI, multiple domains MCI, and single domain non-amnestic MCI. Behavioral symptoms in MCI are associated with a higher risk of dementia, but their association with dementia risk in patients without MCI is unknown. The objective of our paper was to address the question of whether aging patients with behavioral symptoms with or without cognitive impairment represent a population at risk for dementia. Mild Behavioral Impairment (MBI) defines a late life syndrome with prominent psychiatric and related behavioral symptoms in the absence of major cognitive symptoms. MBI also appears to be a transitional state between normal aging and dementia. MBI may carry a higher risk for dementia than MCI. A subgroup of MBI patients is likely to exhibit symptoms of a frontotemporal dementia (FTD) prodrome. We proposed 4 subtypes of patients at risk for dementia: amnestic MCI (which is said to progress preferentially to Alzheimer's disease), multiple domain MCI (which may represent normal aging or may progress to vascular cognitive impairment or a neurodegenerative disorder), single domain non-amnestic MCI, and MBI (which may progress to frontotemporal dementia, Lewy Body dementia or Alzheimer's disease). We concluded that MBI is a counterpart of MCI as a transitional state between normal aging and dementia. These findings have implications for early detection, prevention, and treatment of patients with late-life dementia.
轻度认知障碍（MCI）由彼得森等人（1999年）定义为渐进性记忆丧失，是阿尔茨海默病的前驱症状。MCI是一个已被充分确立的实体，既可以是医学实践中的一种诊断，也是阿尔茨海默病预防治疗的一个有效靶点。最近，MCI已扩展到包括具有其他潜在病因的其他认知领域：遗忘型MCI、多领域MCI和单领域非遗忘型MCI。MCI中的行为症状与痴呆风险较高相关，但它们与无MCI患者的痴呆风险之间的关联尚不清楚。我们论文的目的是解决以下问题：有或无认知障碍的有行为症状的老年患者是否代表痴呆风险人群。轻度行为障碍（MBI）定义了一种晚年综合征，其特征是在没有主要认知症状的情况下出现突出的精神和相关行为症状。MBI似乎也是正常衰老和痴呆之间的过渡状态。MBI可能比MCI有更高的痴呆风险。MBI患者的一个亚组可能表现出额颞叶痴呆（FTD）前驱症状。我们提出了4种痴呆风险患者亚型：遗忘型MCI（据说优先发展为阿尔茨海默病）、多领域MCI（可能代表正常衰老或可能发展为血管性认知障碍或神经退行性疾病）、单领域非遗忘型MCI和MBI（可能发展为额颞叶痴呆、路易体痴呆或阿尔茨海默病）。我们得出结论，MBI作为正常衰老和痴呆之间的过渡状态，是MCI的对应物。这些发现对晚年痴呆患者的早期检测、预防和治疗具有重要意义。
