Chung Jae Kyung, Jang Jae-Won
Department of Neurology, Kangwon National University Hospital, Chuncheon, Korea.
Department of Neurology, Kangwon National University College of Medicine, Chuncheon, Korea.
Ann Geriatr Med Res. 2021 Mar;25(1):39-44. doi: 10.4235/agmr.21.0010. Epub 2021 Mar 15.
A comprehensive visual rating scale (CVRS) using brain magnetic resonance imaging (MRI) was previously developed to evaluate structural changes in the brains of older patients. This study investigated the usefulness of the CVRS in predicting dementia with Alzheimer disease (AD) in patients with prodromal AD.
We included 189 patients with prodromal AD with available data from the Alzheimer's Disease Neuroimaging Initiative study. We evaluated all patients using CVRS and assessed their progression to AD dementia over 3 years of longitudinal follow-up. Survival analysis was performed using the Cox proportional hazards model to analyze the hazard ratios of the CVRS for progression to AD dementia.
Among 189 patients with prodromal AD, 61 (32.3%) progressed to dementia. The mean baseline CVRS scores differed significantly between the stable and progressive groups (9.9±5.1 vs. 12.4±4.9; p=0.002). An initial high CVRS score was an independent risk factor for the progression to AD dementia (hazard ratio=1.110; 95% confidence interval, 1.043-1.182).
The baseline CVRS score predicted the progression to dementia in patients with prodromal AD, indicating its independent association with longitudinal cognitive decline.
先前已开发出一种使用脑磁共振成像（MRI）的综合视觉评分量表（CVRS），用于评估老年患者大脑的结构变化。本研究调查了CVRS在预测前驱期阿尔茨海默病（AD）患者发生AD痴呆方面的有效性。
我们纳入了189例来自阿尔茨海默病神经影像学倡议研究且有可用数据的前驱期AD患者。我们使用CVRS对所有患者进行评估，并在3年的纵向随访中评估他们向AD痴呆的进展情况。使用Cox比例风险模型进行生存分析，以分析CVRS对进展为AD痴呆的风险比。
在189例前驱期AD患者中，61例（32.3%）进展为痴呆。稳定组和进展组的平均基线CVRS评分存在显著差异（9.9±5.1对12.4±4.9；p=0.002）。初始CVRS高分是进展为AD痴呆的独立危险因素（风险比=1.110；95%置信区间，1.043 - 1.182）。
基线CVRS评分可预测前驱期AD患者向痴呆的进展，表明其与纵向认知衰退存在独立关联。
