Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA; Veteran Affairs San Diego Healthcare System, San Diego, CA, USA.
San Diego State University/University of California, San Diego (SDSU/UCSD) Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
Alzheimers Dement. 2019 Oct;15(10):1322-1332. doi: 10.1016/j.jalz.2019.06.4948. Epub 2019 Sep 5.
The low mild cognitive impairment (MCI) to cognitively normal (CN) reversion rate in the Alzheimer's Disease Neuroimaging Initiative (2-3%) suggests the need to examine reversion by other means. We applied comprehensive neuropsychological criteria (NP criteria) to determine the resulting MCI to CN reversion rate.
Participants with CN (n = 641) or MCI (n = 569) were classified at baseline and year 1 using NP criteria. Demographic, neuropsychological, and Alzheimer's disease biomarker variables as well as progression to dementia were examined across stable CN, reversion, and stable MCI groups.
NP criteria produced a one-year reversion rate of 15.8%. Reverters had demographics, Alzheimer's disease biomarkers, and risk-of-progression most similar to the stable CN group and showed the most improvement on neuropsychological measures from baseline to year 1.
NP criteria produced a reversion rate that is consistent with, albeit modestly improved from, reversion rates in meta-analyses. Reverters' biomarker profiles and progression rates suggest that NP criteria accurately tracked with underlying pathophysiologic status.
阿尔茨海默病神经影像学倡议（Alzheimer's Disease Neuroimaging Initiative，ADNI）中轻度认知障碍（mild cognitive impairment，MCI）向认知正常（cognitively normal，CN）的低逆转率（2-3%）表明需要通过其他方法来检查逆转情况。我们应用综合神经心理学标准（neuropsychological criteria，NP 标准）来确定由此产生的 MCI 向 CN 的逆转率。
使用 NP 标准对基线时为 CN（n=641）或 MCI（n=569）的参与者进行分类，并在第 1 年进行分类。对稳定 CN、逆转和稳定 MCI 组的人口统计学、神经心理学、阿尔茨海默病生物标志物变量以及向痴呆的进展进行了检查。
NP 标准产生的一年逆转率为 15.8%。逆转者的人口统计学、阿尔茨海默病生物标志物和进展风险与稳定 CN 组最相似，并且在从基线到第 1 年的神经心理学测量中表现出最大的改善。
NP 标准产生的逆转率与荟萃分析中的逆转率一致，尽管略有改善。逆转者的生物标志物特征和进展率表明，NP 标准准确地反映了潜在的病理生理状态。
