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轻度认知障碍患者中,每种轻度行为障碍类别对痴呆转化或认知下降的离散影响。

Discrete effect of each mild behavioural impairment category on dementia conversion or cognitive decline in patients with mild cognitive impairment.

机构信息

Department of Psychiatry, National Center of Neurology and Psychiatry, Kodaira, Japan.

University of Yamanashi, Faculty of Medicine, Graduate School, Chuo, Japan.

出版信息

Psychogeriatrics. 2019 Nov;19(6):591-600. doi: 10.1111/psyg.12447. Epub 2019 Mar 19.

Abstract

BACKGROUND

Neuropsychiatric symptoms (NPS) have been recognized as risk factors for conversion to dementia in patients with mild cognitive impairment (MCI). Early detection of NPS may allow for possible interventions in such patients. The present study used mild behavioural impairment to explore the role of NPS in a wide range of patients, from those who are cognitively intact to those with dementia.

METHODS

A total of 234 patients with mild cognitive impairment were followed up for up to 3 years in a Japanese cohort study. Longitudinal data from patients who developed dementia during the study and those who did not were statistically analyzed.

RESULTS

Cox regression analysis revealed that only abnormal perception and thought was significant in terms of dementia conversion. Moreover, mixed-effects models indicated that baseline mild behavioural impairment symptoms did not affect cognitive trajectories such as changes in Mini-Mental State Examination or Alzheimer's Disease Assessment Scale-cognitive subscale scores.

CONCLUSION

We conclude that only abnormal perception and thought content were risk factors for dementia and that NPS may not lead to deterioration of cognitive function in patients with mild cognitive impairment.

摘要

背景

神经精神症状(NPS)已被认为是轻度认知障碍(MCI)患者向痴呆转化的危险因素。早期发现 NPS 可能使这些患者能够进行可能的干预。本研究使用轻度行为障碍来探索 NPS 在从认知正常到痴呆患者的广泛患者中的作用。

方法

在一项日本队列研究中,对 234 名轻度认知障碍患者进行了长达 3 年的随访。对研究期间发生痴呆和未发生痴呆的患者的纵向数据进行了统计学分析。

结果

Cox 回归分析显示,只有异常知觉和思维在痴呆转化方面具有统计学意义。此外,混合效应模型表明,基线轻度行为障碍症状不会影响认知轨迹,如 Mini-Mental State Examination 或 Alzheimer's Disease Assessment Scale-cognitive 子量表评分的变化。

结论

我们得出结论,只有异常知觉和思维内容是痴呆的危险因素,而 NPS 可能不会导致轻度认知障碍患者认知功能恶化。

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