Camarda Cecilia, Pipia Carmela, Azzarello Delia, Battaglini Iacopo, Romeo Giovanni, Chiodi Marcello, Camarda Rosolino
Department of Experimental Biomedicine and Clinical Neurosciences, University of Palermo, Palermo, Italy.
Fondazione "Salvatore Maugeri", Sciacca, Italy.
Curr Alzheimer Res. 2018;15(7):679-690. doi: 10.2174/1567205015666180119110712.
Mild Cognitive Impairment (MCI) is a transitional state between normal cognition and dementia.
The aim of this study is to investigate the role of vascular risk factors, vascular diseases, cerebrovascular disease and brain atrophy in a large hospital-based cohort of MCI types including 471 amnestic MCI (a-MCI), 693 amnestic MCI multiple domain (a-MCImd), 322 single non-memory MCI (snm-MCI), and 202 non amnestic MCI multiple domain (na-MCImd). For comparison, 1,005 neurologically and cognitively healthy subjects were also evaluated.
Several vascular risk factors and vascular diseases were assessed. All participants underwent neurological, neuropsychological and behavioural assessments as well as carotid ultrasonography and standard brain MRI. Multinomial logistic regression models on the MCI cohort with the NCH group and a-MCI type as reference categories were used to assess the effects of the variables evaluated on the estimated probability of one of the four MCI types.
This study demonstrates that cerebrovascular disease contributes substantially to the risk of non-memory MCI types and a-MCImd type, and that brain atrophy is present in all MCI types and is greater in multiple domain types particularly in the na-MCI type.
Improving detection and control of cerebrovascular disease in aging individuals should be mandatory. Since the incidence of MCI and dementia will be expected to rise because of the progressive life expectancy, a better management of cerebrovascular disease could indeed prevent or delay the onset of MCI, or could delay progression of MCI to dementia.
轻度认知障碍(MCI)是正常认知与痴呆之间的过渡状态。
本研究旨在调查血管危险因素、血管疾病、脑血管疾病和脑萎缩在一个大型医院队列中对多种MCI类型的作用,该队列包括471例遗忘型MCI(a-MCI)、693例多领域遗忘型MCI(a-MCImd)、322例单一非记忆型MCI(snm-MCI)和202例非遗忘型多领域MCI(na-MCImd)。为作比较,还对1005名神经和认知功能正常的受试者进行了评估。
评估了多种血管危险因素和血管疾病。所有参与者均接受了神经、神经心理学和行为评估,以及颈动脉超声检查和标准脑磁共振成像。以NCH组和a-MCI类型作为参照类别,对MCI队列使用多项逻辑回归模型,以评估所评估变量对四种MCI类型之一的估计概率的影响。
本研究表明,脑血管疾病在很大程度上增加了非记忆型MCI类型和a-MCImd类型的风险,并且脑萎缩存在于所有MCI类型中,在多领域类型中更为明显,尤其是在na-MCI类型中。
必须加强对老年个体脑血管疾病的检测和控制。由于预期寿命的不断延长,MCI和痴呆的发病率预计将会上升,因此更好地管理脑血管疾病确实可以预防或延缓MCI的发作,或者可以延缓MCI向痴呆的进展。