Centre for Research on Ageing, Health and Wellbeing.
College of Engineering and Computer Science, The Australian National University, Canberra, Australia.
J Gerontol B Psychol Sci Soc Sci. 2020 Aug 13;75(7):1393-1402. doi: 10.1093/geronb/gbz011.
This study aimed to investigate the predictive value of cognitive/functional measures in combination with hippocampal volume (HCV) on the probability of conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD).
The Rey Auditory Verbal Learning Test for immediate memory, Mini-Mental State Examination, a functional assessment for independent daily activities and Alzheimer's Disease Assessment Scale were used as cognitive/functional measures and HCV as neuroimaging measure. Logistic regression and Cox proportional hazard analyses were used to explore the measures' predictive values for AD conversion and time to conversion.
The probability of conversion from MCI to AD was associated with cognitive function, but this was moderated by HCV: higher at lower HCV and lower at higher HCV. General cognitive/functional measures were less predictive than immediate memory in predicting time to conversion to AD at small HCVs.
Effectiveness of cognitive measures and subtle functional abnormality in predicting conversion from MCI to AD is dependent on HCV, thus combined evaluation should be considered. A combination of HCV and immediate memory appear to perform best in predicting time to conversion.
本研究旨在探讨认知/功能测量与海马体积(HCV)相结合对从轻度认知障碍(MCI)向阿尔茨海默病(AD)转化概率的预测价值。
采用即时记忆的 Rey 听觉言语学习测试、简易精神状态检查、独立日常生活功能评估和阿尔茨海默病评估量表作为认知/功能测量,HCV 作为神经影像学测量。采用逻辑回归和 Cox 比例风险分析来探讨这些测量指标对 AD 转化和转化时间的预测价值。
从 MCI 向 AD 转化的概率与认知功能相关,但受 HCV 调节:HCV 较低时较高,HCV 较高时较低。在 HCV 较小的情况下,一般认知/功能测量在预测向 AD 转化的时间方面不如即时记忆预测准确。
认知测量和细微功能异常在预测从 MCI 向 AD 转化方面的有效性取决于 HCV,因此应考虑联合评估。HCV 和即时记忆的结合似乎在预测转化时间方面表现最佳。