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评估加拿大研究方案中轻度认知障碍参与者的真实世界代表性:记忆诊所患者与研究样本特征的比较

Evaluating the Real-World Representativeness of Participants with Mild Cognitive Impairment in Canadian Research Protocols: a Comparison of the Characteristics of a Memory Clinic Patients and Research Samples.

作者信息

Huang Vivian, Hogan David B, Ismail Zahinoor, Maxwell Colleen J, Smith Eric E, Callahan Brandy L

机构信息

Department of Psychology, Ryerson University, Toronto, ON.

Cumming School of Medicine, University of Calgary, Calgary, AB.

出版信息

Can Geriatr J. 2020 Dec 1;23(4):297-328. doi: 10.5770/cgj.23.416. eCollection 2020 Dec.

Abstract

BACKGROUND

Studies of mild cognitive impairment (MCI) employ rigorous eligibility criteria, resulting in sampling that may not be representative of the broader clinical population.

OBJECTIVE

To compare the characteristics of MCI patients in a Calgary memory clinic to those of MCI participants in published Canadian studies.

METHODS

Clinic participants included 555 MCI patients from the PROspective Registry of Persons with Memory SyMPToms (PROMPT) registry in Calgary. Research participants included 4,981 individuals with MCI pooled from a systematic literature review of 112 original, English-language peer-reviewed Canadian studies. Both samples were compared on baseline sociodemographic variables, medical and psychiatric comorbidities, and cognitive performance for MCI due to Alzheimer's disease and Parkinson's disease.

RESULTS

Overall, clinic patients tended to be younger, more often male, and more educated than research participants. Psychiatric disorders, traumatic brain injury, and sensory impairment were commonplace in PROMPT (up to 83% affected) but > 80% studies in the systematic review excluded these conditions. PROMPT patients also performed worse on global cognition measures than did research participants.

CONCLUSION

Stringent eligibility criteria in Canadian research studies excluded a considerable subset of MCI patients with comorbid medical or psychiatric conditions. This exclusion may contribute to differences in cognitive performance and outcomes compared to real-world clinical samples.

摘要

背景

轻度认知障碍(MCI)的研究采用了严格的纳入标准,导致样本可能无法代表更广泛的临床人群。

目的

比较卡尔加里记忆诊所的MCI患者与加拿大已发表研究中的MCI参与者的特征。

方法

诊所参与者包括来自卡尔加里记忆症状前瞻性登记册(PROMPT)的555名MCI患者。研究参与者包括从112项英文同行评审的加拿大原始研究的系统文献综述中汇总的4981名MCI患者。比较了两个样本在基线社会人口统计学变量、医学和精神疾病共病情况以及阿尔茨海默病和帕金森病所致MCI的认知表现方面的差异。

结果

总体而言,诊所患者往往比研究参与者更年轻、男性比例更高、受教育程度更高。精神疾病、创伤性脑损伤和感觉障碍在PROMPT中很常见(高达83%的患者受影响),但系统综述中超过80%的研究排除了这些情况。PROMPT患者在整体认知测量方面的表现也比研究参与者差。

结论

加拿大研究中的严格纳入标准排除了相当一部分患有合并内科或精神疾病的MCI患者。与实际临床样本相比,这种排除可能导致认知表现和结果的差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9c62/7704078/453c75612752/cgj-23-297f1.jpg

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