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听觉词语学习测试的短期延迟回忆在预测轻度认知障碍临床结局方面与长期延迟回忆具有同等价值:一项纵向随访研究。

Short-term delayed recall of auditory verbal learning test provides equivalent value to long-term delayed recall in predicting MCI clinical outcomes: A longitudinal follow-up study.

作者信息

Xu Yan, Chen Keliang, Zhao Qianhua, Li Fang, Guo Qihao

机构信息

Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.

Department of Gerontology, Fuxing Hospital, Capital Medical University, Beijing, China.

出版信息

Appl Neuropsychol Adult. 2020 Jan-Feb;27(1):73-81. doi: 10.1080/23279095.2018.1481067. Epub 2018 Nov 23.

Abstract

This study was conducted to compare predictive power of Auditory verbal learning test (AVLT) recall measures for Alzheimer's disease (AD) conversion and normal cognition (NC) reversion from mild cognitive impairment (MCI). A total of 262 amnestic MCI patients were followed up longitudinally, who were then classified into different groups based on clinical outcomes. Demographic information and AVLT recall scores at baseline were compared among these groups. Receiver operating characteristic (ROC) curves were constructed to evaluate differentiating value of AVLT recall measures for MCI outcomes. Binary stepwise logistic regression analysis was performed to identify predictive AVLT measures. After average 30.8 ± 11.6 months follow-up, 89 patients converted to AD and 88 participants reverted to NC. At baseline, AD converters scored significantly lower in AVLT than nonconverters, while NC reverters performed much better than nonreverters ( < .01). AVLT-SR and AVLT-LR had larger areas under curve than AVLT-IR and AVLT-REC in distinguishing patients who progressed to AD or not ( < .05). Both AVLT-SR and AVLT-LR were significant predictors of MCI-to-AD conversion and MCI-to-NC reversion. Among AVLT recall measures, AVLT-SR and AVLT-LR provided the best and equivalent values in predicting MCI outcomes. Patients with lower AVLT-SR and AVLT-LR scores are more likely to develop AD. Consequently, AVLR-SR is a valuable and time-saving memory measure that deserves further application in memory clinical practice.

摘要

本研究旨在比较听觉词语学习测试(AVLT)回忆测量对阿尔茨海默病(AD)转化以及从轻度认知障碍(MCI)恢复到正常认知(NC)的预测能力。对总共262例遗忘型MCI患者进行纵向随访,然后根据临床结局将他们分为不同组。比较这些组的人口统计学信息和基线时的AVLT回忆分数。构建受试者工作特征(ROC)曲线以评估AVLT回忆测量对MCI结局的鉴别价值。进行二元逐步逻辑回归分析以确定具有预测性的AVLT测量指标。经过平均30.8±11.6个月的随访,89例患者转化为AD,88例参与者恢复为NC。在基线时,AD转化者的AVLT得分显著低于未转化者,而NC恢复者的表现比未恢复者好得多(P<0.01)。在区分进展为AD的患者与否方面,AVLT-SR和AVLT-LR的曲线下面积大于AVLT-IR和AVLT-REC(P<0.05)。AVLT-SR和AVLT-LR均是MCI向AD转化和MCI向NC恢复的显著预测指标。在AVLT回忆测量指标中,AVLT-SR和AVLT-LR在预测MCI结局方面提供了最佳且相当的价值。AVLT-SR和AVLT-LR得分较低的患者更有可能发展为AD。因此,AVLR-SR是一种有价值且节省时间的记忆测量方法,值得在记忆临床实践中进一步应用。

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