Wu Yah-Yuan, Hsu Wen-Chuin, Huang Yu-Hua, Ho Wei-Min, Chen Yi-Chun
Department of Neurology, Chang Gung Memorial Hospital Linkou Medical Center and College of Medicine, Chang Gung University, Taoyuan 333, Taiwan.
Dementia Center, Chang Gung Memorial Hospital, Taoyuan 333, Taiwan.
J Clin Med. 2019 Nov 7;8(11):1900. doi: 10.3390/jcm8111900.
Memory complaint is one of the earliest symptoms of dementia. The causes and prognosis of memory complaint in the middle-aged population remain largely unknown. We reviewed the register-based data of 2129 patients with memory complaints. Among them, 404 participants were between 40 and 65 years old. The participants were separated into three groups: subjective cognitive decline (SCD), neurodegenerative diseases (ND), and non-neurodegenerative diseases (NND). One-year decline was defined as a decrease of ≥1 on the mini-mental state examination (MMSE). At baseline, 131 participants (32%) were diagnosed with SCD, 141 (35%) with ND, and 132 (33%) with NND. The 1-year cognitive decline rate was higher among patients with ND (36.8%) than in the SCD (7.3%, = 1.3 × 10) and NND groups (7.6%, = 1.1 × 10). One-year decline did not differ between the SCD and NND groups. Lower baseline MMSE score predicted increased risk of 1-year cognitive decline (odds ratio (OR) = 1.126, 95% confidence interval (CI) = 1.076-1.178, = 2.52 × 10). Memory complaint in middle age carried a risk of 1-year cognitive decline, and baseline MMSE is an independent predictor of decline. An initial diagnosis of SCD held the same risk effect for decline as NND. These findings highlighted the necessity for neuropsychological tests in those with memory complaints presenting to the clinic.
记忆障碍是痴呆症最早出现的症状之一。中年人群记忆障碍的病因和预后在很大程度上仍不清楚。我们回顾了2129例有记忆障碍患者的登记数据。其中，404名参与者年龄在40至65岁之间。参与者被分为三组：主观认知下降（SCD）、神经退行性疾病（ND）和非神经退行性疾病（NND）。一年的衰退定义为简易精神状态检查表（MMSE）得分下降≥1分。基线时，131名参与者（32%）被诊断为SCD，141名（35%）为ND，132名（33%）为NND。ND组患者的1年认知衰退率（36.8%）高于SCD组（7.3%， = 1.3 × 10）和NND组（7.6%， = 1.1 × 10）。SCD组和NND组之间的一年衰退情况没有差异。较低的基线MMSE得分预示着1年认知衰退风险增加（优势比（OR） = 1.126，95%置信区间（CI） = 1.076 - 1.178， = 2.52 × 10）。中年时期的记忆障碍具有1年认知衰退的风险，基线MMSE是衰退的独立预测因素。SCD的初始诊断与NND对衰退具有相同的风险效应。这些发现凸显了对到诊所就诊的有记忆障碍者进行神经心理测试的必要性。
