Translational Research Center for Medical Innovation, Foundation for Biomedical Research and Innovation, Kobe, Japan.
Institute of Neurology, Huashan Hospital Fudan University, Shanghai, China.
Curr Alzheimer Res. 2019;16(2):156-165. doi: 10.2174/1567205016666181128151144.
BACKGROUND & OBJECTIVE: The purpose of this study is to identify the risk factors associated with the conversion from Mild Cognitive Impairment (MCI) to Alzheimer's Disease (AD) dementia for the early detection of AD.
The study comprised a prospective cohort study that included 400 MCI subjects with annual follow-ups for 3 years.
During the first 12 months' follow-up, 42 subjects converted to Alzheimer's dementia (21 probable AD and 21 possible AD), two subjects converted to other types of dementia and 56 subjects lost follow. The factors associated with a greater risk of conversion from MCI to AD included gender, whole brain volume, and right hippocampal volume (rt. HV), as well as scores on the Revised Chinese version of the Alzheimer's Disease Assessment Scale-Cognitive subscale 13 (ADAS-Cog-C), Clock Drawing Test (CDT), Symbol Digit Modalities Test (SDMT), and Rey-Osterrieth Complex Figure Test (ROCFT). The risk classification of the combined ADAS-Cog-C and Alzheimer Cognitive Composite (ACC) score with the rt. HV and left Entorhinal Cortex Volume (lt. ECV) showed a conversion difference among the groups.
Early detection of AD and potential selection for clinical trial design should utilize the rt. HV, as well as neuropsychological test scores, including those of the ADAS-Cog-C and ACC.
本研究旨在确定轻度认知障碍（MCI）向阿尔茨海默病（AD）痴呆转化的相关风险因素，以便早期发现 AD。
本研究为前瞻性队列研究，纳入了 400 例 MCI 患者，每年随访 3 年。
在最初的 12 个月随访中，42 例患者转化为阿尔茨海默病痴呆（21 例可能 AD，21 例可能 AD），2 例患者转化为其他类型痴呆，56 例患者失访。与 MCI 向 AD 转化风险增加相关的因素包括性别、全脑体积和右侧海马体积（rt. HV），以及修订后的中文版阿尔茨海默病评估量表认知分量表 13（ADAS-Cog-C）、画钟测验（CDT）、符号数字模态测验（SDMT）和 Rey-Osterrieth 复杂图形测验（ROCFT）的评分。ADAS-Cog-C 和阿尔茨海默认知综合评分（ACC）与 rt. HV 和左侧内嗅皮层体积（lt. ECV）的联合风险分类显示，各组之间存在转化差异。
AD 的早期发现和临床试验设计的潜在选择应利用 rt. HV 以及神经心理学测试评分，包括 ADAS-Cog-C 和 ACC。
