Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, 06351, Korea.
Neuroscience Center, Samsung Medical Center, 06351, Seoul, Korea.
Sci Rep. 2018 Jul 11;8(1):10468. doi: 10.1038/s41598-018-28881-1.
To evaluate prediction models of cognitive trajectories in patients with nonamnestic mild cognitive impairment (naMCI) using group-based trajectory analysis, we evaluated 121 patients with naMCI who underwent at least their first three yearly assessments. Group-based trajectory models were used to classify cognitive trajectories based on Clinical Dementia Rating Sum of Boxes scores over four years in patients with naMCI. A total of 22 patients (18.2%) were classified into the "fast-decliners" group, while 99 patients (81.8%) were classified into the "slow-decliners" group. The mean age was higher in the fast-decliners than in the slow-decliners (p = 0.037). Compared to the slow-decliners, the fast-decliners were more frequently impaired in the domains of language (p = 0.038) and frontal/executive functions (p = 0.042), and had more frequent multiple-domain cognitive impairment (p = 0.006) on baseline neuropsychological tests. The rate of conversion to dementia was significantly higher in the fast-decliners than in the slow-decliners (86.4% vs. 10.1%, p < 0.001). Our findings showed that there are indeed distinct patterns of cognitive trajectories in patients with naMCI. Close observation of naMCI patients' baseline demographic and clinical profiles in clinical settings may help identify individuals at greatest risk for dementia.
为了使用基于群组的轨迹分析来评估非遗忘型轻度认知障碍（naMCI）患者认知轨迹的预测模型，我们评估了 121 名接受了至少前三次年度评估的 naMCI 患者。基于群组的轨迹模型用于根据 naMCI 患者四年内的临床痴呆评定量表总和评分对认知轨迹进行分类。共有 22 名患者（18.2%）被归类为“快速下降者”组，而 99 名患者（81.8%）被归类为“缓慢下降者”组。快速下降者的平均年龄高于缓慢下降者（p=0.037）。与缓慢下降者相比，快速下降者在语言（p=0.038）和额叶/执行功能（p=0.042）领域的障碍更为频繁，在基线神经心理学测试中更频繁出现多领域认知障碍（p=0.006）。快速下降者向痴呆的转化率明显高于缓慢下降者（86.4% vs. 10.1%，p<0.001）。我们的研究结果表明，naMCI 患者确实存在不同的认知轨迹模式。在临床环境中密切观察 naMCI 患者的基线人口统计学和临床特征，可能有助于识别痴呆风险最大的个体。
