Jutten Roos J, Harrison John E, Brunner A J, Vreeswijk R, van Deelen R A J, de Jong Frank Jan, Opmeer Esther M, Ritchie Craig W, Aleman André, Scheltens Philip, Sikkes Sietske A M
Alzheimer Center Amsterdam Department of Neurology Amsterdam Neuroscience, Amsterdam Amsterdam UMC the Netherlands.
Metis Cognition Ltd Wiltshire UK.
Alzheimers Dement (N Y). 2020 Apr 17;6(1):e12020. doi: 10.1002/trc2.12020. eCollection 2020.
In an attempt to capture clinically meaningful cognitive decline in early dementia, we developed the Cognitive-Functional Composite (CFC). We investigated the CFC's sensitivity to decline in comparison to traditional clinical endpoints.
This longitudinal construct validation study included 148 participants with subjective cognitive decline, mild cognitive impairment, or mild dementia. The CFC and traditional tests were administered at baseline, 3, 6, and 12 months. Sensitivity to change was investigated using linear mixed models and effect sizes.
CFC scores declined over time (= -.16, .001), with steepest decline observed in mild Alzheimer's dementia (= -.25, .001). The CFC showed medium-to-large effect sizes at succeeding follow-up points ( = .08-.42), exhibiting greater change than the Clinical Dementia Rating scale ( = .02-.12). Moreover, change on the CFC was significantly associated with informant reports of cognitive decline (= .38, < .001).
By showing sensitivity to decline, the CFC could enhance the monitoring of disease progression in dementia research and clinical practice.
为了捕捉早期痴呆临床上有意义的认知衰退，我们开发了认知功能综合指标（CFC）。我们研究了CFC与传统临床终点相比对衰退的敏感性。
这项纵向结构验证研究纳入了148名有主观认知衰退、轻度认知障碍或轻度痴呆的参与者。在基线、3个月、6个月和12个月时进行CFC和传统测试。使用线性混合模型和效应量研究对变化的敏感性。
CFC得分随时间下降（= -0.16，P < 0.001），在轻度阿尔茨海默病痴呆中下降最为明显（= -0.25，P < 0.001）。CFC在后续随访点显示出中到大的效应量（= 0.08 - 0.42），比临床痴呆评定量表（= 0.02 - 0.12）表现出更大的变化。此外，CFC的变化与认知衰退的 informant 报告显著相关（= 0.38，P < 0.001）。
通过显示对衰退的敏感性，CFC可以加强痴呆研究和临床实践中疾病进展的监测。
