Chronic Diseases Research Center, NOVA Medical School, NOVA University of Lisbon, Lisbon, Portugal.
Faculty of Medicine, University of Lisbon, Lisbon, Portugal.
J Alzheimers Dis. 2018;62(4):1703-1711. doi: 10.3233/JAD-171034.
Although the diagnosis of mild cognitive impairment (MCI) corresponds to a condition likely to progress to dementia, essentially Alzheimer's disease, longitudinal studies have shown that some patients may not convert to dementia and maintain the diagnosis of MCI even after many years.
To determine whether patients that maintain the diagnosis of MCI in the long term (10 years) are really stable or just declining slowly, and to identify clinical and neuropsychological characteristics associated with long-term stability.
The Cognitive Complaints Cohort (CCC) was searched for MCI cases who maintained that diagnosis for at least 10 years. For each long-term-stable MCI patient, two MCI patients that converted to dementia during follow-up, matched for age and education, were selected from the same database. The baseline and last neuropsychological evaluations for long-term-stable MCI and converter MCI were compared. Baseline neuropsychological predictors of long-term stability were searched for.
Long-term-stable MCI (n = 22) and converter MCI (n = 44) patients did not differ in terms of gender distribution, education, age at first assessment and time between symptom onset and first evaluation. Time of follow-up was on average 11 years for long-term-stable MCI and 3 years for converter MCI. The baseline and follow-up neuropsychological tests were not significantly different in long-term-stable MCI patients, whereas a general decline was observed in converter MCI patients. Higher scores on one memory test, the Word Delayed Total Recall, and on the non-verbal abstraction test, Raven's Progressive Matrices, at the baseline predicted long-term (10 years) clinical stability.
Some patients with MCI remain clinically and neuropsychologically stable for a decade. Better performances at baseline in memory and non-verbal abstraction tests predict long-term stability.
尽管轻度认知障碍（MCI）的诊断符合可能进展为痴呆症的情况，主要是阿尔茨海默病，但纵向研究表明，一些患者可能不会转化为痴呆症，并且即使经过多年也仍保持 MCI 的诊断。
确定长期（10 年）内保持 MCI 诊断的患者是否真的稳定，还是仅仅缓慢下降，并确定与长期稳定相关的临床和神经心理学特征。
在认知主诉队列（CCC）中搜索至少维持 10 年 MCI 诊断的患者。对于每个长期稳定的 MCI 患者，从同一数据库中选择了两名在随访期间转换为痴呆的 MCI 患者作为对照，这些患者在年龄和教育程度上相匹配。比较长期稳定的 MCI 和转化为痴呆的 MCI 患者的基线和最后一次神经心理学评估。寻找长期稳定的基线神经心理学预测因素。
长期稳定的 MCI（n = 22）和转化为痴呆的 MCI（n = 44）患者在性别分布、教育程度、首次评估时的年龄和症状出现与首次评估之间的时间上没有差异。长期稳定的 MCI 的随访时间平均为 11 年，而转化为痴呆的 MCI 的随访时间为 3 年。在长期稳定的 MCI 患者中，基线和随访的神经心理学测试没有显著差异，而在转化为痴呆的 MCI 患者中则观察到总体下降。基线时在一项记忆测试（单词延迟总回忆）和一项非言语抽象测试（Raven 的渐进矩阵）上的得分较高，预测了 10 年的临床稳定性。
一些 MCI 患者在临床上和神经心理学上可以保持稳定十年。在记忆和非言语抽象测试中表现更好的基线预测了长期稳定性。
