Lothian Birth Cohorts, School of Philosophy, Psychology & Language Sciences, University of Edinburgh, Edinburgh, UK.
Edinburgh Dementia Prevention, University of Edinburgh, Edinburgh, UK.
J Alzheimers Dis. 2021;80(1):225-232. doi: 10.3233/JAD-201282.
Mild cognitive impairment (MCI) describes a borderland between healthy cognition and dementia. Progression to and reversion from MCI is relatively common but more research is required to understand the factors affecting this fluidity and improve clinical care interventions.
We explore these transitions in MCI status and their predictive factors over a six-year period in a highly-phenotyped longitudinal study, the Lothian Birth Cohort 1936.
MCI status was derived in the LBC1936 at ages 76 (n = 567) and 82 years (n = 341) using NIA-AA diagnostic guidelines. Progressions and reversions between healthy cognition and MCI over the follow-up period were assessed. Multinomial logistic regression assessed the effect of various predictors on the likelihood of progressing, reverting, or maintaining cognitive status.
Of the 292 participants who completed both time points, 41 (14%) participants had MCI at T1 and 56 (19%) at T2. Over the follow-up period, 74%remained cognitively healthy, 12%transitioned to MCI, 7%reverted to healthy cognition, and 7%maintained their baseline MCI status. Findings indicated that membership of these transition groups was affected by age, cardiovascular disease, and number of depressive symptoms.
Findings that higher baseline depressive symptoms increase the likelihood of reverting from MCI to healthy cognition indicate that there may be an important role for the treatment of depression for those with MCI. However, further research is required to identify prevention strategies for those at high risk of MCI and inform effective interventions that increase the likelihood of reversion to, and maintenance of healthy cognition.
轻度认知障碍 (MCI) 描述了健康认知与痴呆之间的交界地带。从 MCI 进展到恢复以及从 MCI 恢复到正常认知是相对常见的，但需要更多的研究来了解影响这种流动性的因素，并改善临床护理干预措施。
我们在一项高度表型的纵向研究——洛锡安出生队列 1936 中，探索了 MCI 状态的这些转变及其在六年期间的预测因素。
在 LBC1936 中，使用 NIA-AA 诊断标准，在 76 岁（n=567）和 82 岁（n=341）时确定 MCI 状态。在随访期间评估认知健康与 MCI 之间的进展和恢复情况。多项逻辑回归评估了各种预测因素对进展、恢复或维持认知状态的可能性的影响。
在完成两次时间点的 292 名参与者中，41 名（14%）参与者在 T1 时有 MCI，56 名（19%）参与者在 T2 时有 MCI。在随访期间，74%的参与者保持认知健康，12%的参与者转变为 MCI，7%的参与者恢复到健康认知，7%的参与者维持其基线 MCI 状态。研究结果表明，这些转变组的成员资格受到年龄、心血管疾病和抑郁症状数量的影响。
研究结果表明，较高的基线抑郁症状增加了从 MCI 恢复到认知健康的可能性，这表明对于 MCI 患者，治疗抑郁可能具有重要作用。然而，需要进一步的研究来确定对 MCI 高危人群的预防策略，并为增加恢复到健康认知和维持健康认知的可能性提供有效的干预措施。
