Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, School of Medicine, La Jolla, CA, USA.
San Diego State University/University of California, San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
Alzheimers Dement. 2019 Apr;15(4):561-569. doi: 10.1016/j.jalz.2018.10.008. Epub 2019 Jan 11.
We examined reasons for low mild cognitive impairment (MCI)-to-cognitively normal (CN) reversion rates in the Alzheimer's Disease Neuroimaging Initiative (ADNI).
CN and MCI participants were identified as remaining stable, progressing, or reverting at 1-year of follow-up (Year 1). Application of ADNI's MCI criteria at Year 1 in addition to Alzheimer's disease biomarkers by group were examined.
The MCI-to-CN reversion rate was 3.0%. When specific components were examined, 22.5% of stable MCI participants had normal memory performance at Year 1 and their Alzheimer's disease biomarkers were consistent with the stable CN group. At Year 1, when all MCI criteria were not met, the more subjective Clinical Dementia Rating rather than objective memory measure appeared to drive continuation of the MCI diagnosis.
Results demonstrate an artificially low 1-year MCI-to-CN reversion rate in ADNI-diagnosed participants. If the Logical Memory cutoffs had been consistently applied, the reversion rate would have been at least 21.8%.
我们研究了阿尔茨海默病神经影像学倡议（ADNI）中轻度认知障碍（MCI）到认知正常（CN）逆转率低的原因。
在 1 年随访（第 1 年）时，将 CN 和 MCI 参与者确定为稳定、进展或逆转。检查第 1 年时 ADNI 的 MCI 标准的应用，以及按组的阿尔茨海默病生物标志物。
MCI 到 CN 的逆转率为 3.0%。当检查特定的组成部分时，22.5%的稳定 MCI 参与者在第 1 年的记忆表现正常，他们的阿尔茨海默病生物标志物与稳定的 CN 组一致。在第 1 年，当不符合所有 MCI 标准时，更主观的临床痴呆评定量表而不是客观的记忆测量似乎推动了 MCI 诊断的继续。
结果表明，ADNI 诊断的参与者中 1 年 MCI 到 CN 的逆转率人为偏低。如果逻辑记忆的截止值一直被应用，那么逆转率至少会是 21.8%。
