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主观认知衰退与阿尔茨海默病及非阿尔茨海默病痴呆症的发病速度。

Subjective cognitive decline and rates of incident Alzheimer's disease and non-Alzheimer's disease dementia.

机构信息

Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.

Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands; Department of Epidemiology and Biostatistics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, the Netherlands.

出版信息

Alzheimers Dement. 2019 Mar;15(3):465-476. doi: 10.1016/j.jalz.2018.10.003. Epub 2018 Dec 13.

DOI:10.1016/j.jalz.2018.10.003
PMID:30555032
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC6465066/
Abstract

INTRODUCTION

In this multicenter study on subjective cognitive decline (SCD) in community-based and memory clinic settings, we assessed the (1) incidence of Alzheimer's disease (AD) and non-AD dementia and (2) determinants of progression to dementia.

METHODS

Eleven cohorts provided 2978 participants with SCD and 1391 controls. We estimated dementia incidence and identified risk factors using Cox proportional hazards models.

RESULTS

In SCD, incidence of dementia was 17.7 (95% Poisson confidence interval 15.2-20.3)/1000 person-years (AD: 11.5 [9.6-13.7], non-AD: 6.1 [4.7-7.7]), compared with 14.2 (11.3-17.6) in controls (AD: 10.1 [7.7-13.0], non-AD: 4.1 [2.6-6.0]). The risk of dementia was strongly increased in SCD in a memory clinic setting but less so in a community-based setting. In addition, higher age (hazard ratio 1.1 [95% confidence interval 1.1-1.1]), lower Mini-Mental State Examination (0.7 [0.66-0.8]), and apolipoprotein E ε4 (1.8 [1.3-2.5]) increased the risk of dementia.

DISCUSSION

SCD can precede both AD and non-AD dementia. Despite their younger age, individuals with SCD in a memory clinic setting have a higher risk of dementia than those in community-based cohorts.

摘要

简介

本研究为多中心社区和记忆诊所的主观认知下降（SCD）研究，旨在评估（1）阿尔茨海默病（AD）和非 AD 痴呆的发病率，以及（2）向痴呆进展的决定因素。

方法

11 个队列纳入 2978 名 SCD 患者和 1391 名对照者。我们使用 Cox 比例风险模型估计痴呆发病率和识别危险因素。

结果

SCD 患者痴呆的发病率为 17.7（95%泊松可信区间 15.2-20.3）/1000 人年（AD：11.5 [9.6-13.7]，非 AD：6.1 [4.7-7.7]），而对照组为 14.2（11.3-17.6）（AD：10.1 [7.7-13.0]，非 AD：4.1 [2.6-6.0]）。在记忆诊所环境中，SCD 患者的痴呆风险显著增加，而在社区环境中则相对较低。此外，年龄较高（风险比 1.1 [95%置信区间 1.1-1.1]）、简易精神状态检查得分较低（0.7 [0.66-0.8]）和载脂蛋白 E ε4（1.8 [1.3-2.5]）增加了痴呆风险。

讨论

SCD 可先于 AD 和非 AD 痴呆出现。尽管年龄较小，但记忆诊所环境中的 SCD 患者比社区队列中的患者痴呆风险更高。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57b4/6465066/2ad434537e01/nihms-1021068-f0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57b4/6465066/648b02bcadc9/nihms-1021068-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57b4/6465066/f1e294a3630e/nihms-1021068-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57b4/6465066/a3aa858e223d/nihms-1021068-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57b4/6465066/2ad434537e01/nihms-1021068-f0004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57b4/6465066/648b02bcadc9/nihms-1021068-f0001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57b4/6465066/f1e294a3630e/nihms-1021068-f0002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57b4/6465066/a3aa858e223d/nihms-1021068-f0003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/57b4/6465066/2ad434537e01/nihms-1021068-f0004.jpg

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