从轻度认知障碍到正常认知的转变：使用多状态马尔可夫模型确定逆转的预测因子。
Transition from mild cognitive impairment to normal cognition: Determining the predictors of reversion with multi-state Markov models.
机构信息
Department of Experimental Psychology, Complutense University of Madrid (UCM), Madrid, Spain.
Alzheimer Disease Research Unit, CIEN Foundation, Carlos III Institute of Health, Queen Sofía Foundation Alzheimer Center, Madrid, Spain.
出版信息
Alzheimers Dement. 2022 Jun;18(6):1177-1185. doi: 10.1002/alz.12448. Epub 2021 Sep 5.
INTRODUCTION
The theoretical framework of the Alzheimer's disease continuum considers transition between stages in a unidirectional manner. Here we examine the rate of reversion from mild cognitive impairment (MCI) to normal cognition (NC) and explore a set of potential variables associated with this phenomenon.
METHODS
A total of 985 Spanish community-dwelling individuals aged 70 years and over at baseline were monitored for 5 years. During this time, 173 MCI and 36 dementia cases were identified. Multi-state Markov models were performed to characterize transitions between states through the dementia continuum.
RESULTS
The rate of reversion from MCI to NC was 11%. There were significant non-modifiable (age, socioeconomic status, or apolipoprotein E) and modifiable factors (cognitive training or absence of affective symptoms) associated with reversion.
DISCUSSION
Overall, our results highlight that the likelihood of progression from MCI to dementia is very similar to that of reversion from MCI to NC.
简介
阿尔茨海默病连续体的理论框架认为各阶段之间的转变是单向的。在这里，我们研究了从轻度认知障碍（MCI）恢复到正常认知（NC）的速度，并探讨了一组与这种现象相关的潜在变量。
方法
共有 985 名年龄在 70 岁及以上的西班牙社区居民在基线时接受了 5 年的监测。在此期间，发现了 173 例 MCI 和 36 例痴呆病例。采用多状态马尔可夫模型通过痴呆连续体来描述状态之间的转变。
结果
从 MCI 恢复到 NC 的比例为 11%。与恢复相关的因素包括不可改变的因素（年龄、社会经济地位或载脂蛋白 E）和可改变的因素（认知训练或无情感症状）。
讨论
总的来说，我们的结果强调了从 MCI 进展到痴呆的可能性与从 MCI 恢复到 NC 的可能性非常相似。
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