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社区轻度认知障碍患者伴或不伴痴呆的预期寿命。

Life expectancy with and without dementia in persons with mild cognitive impairment in the community.

机构信息

Department of Epidemiology, Erasmus University Medical Center, Rotterdam, The Netherlands.

Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, The Netherlands.

出版信息

J Am Geriatr Soc. 2022 Feb;70(2):481-489. doi: 10.1111/jgs.17520. Epub 2021 Oct 18.

Abstract

BACKGROUND

Various clinical studies have provided estimates of life expectancy of patients with mild cognitive impairment (MCI) from outpatient clinics, but whether these apply to community-dwelling individuals at home or in primary care is uncertain.

METHODS

Within the population-based Rotterdam Study, we studied life expectancy with and without dementia in 648 community-dwelling persons with MCI and 6410 without MCI. Participants aged 60 years and older were assessed for MCI at baseline (2002-2014) and subsequently followed for the onset of dementia and death. We used multistate life tables to determine age-specific life expectancy with and without dementia by sex, educational attainment, and MCI subtype.

RESULTS

Total life expectancy for MCI ranged from 21.4 years (95% CI: 19.0-23.6) at age 60 to 2.6 years (1.6-3.6) at age 95. With advancing age, an increasing proportion of these years was lived with dementia (2.9 years [1.8-4.0] at age 60; 1.2 [0.2-2.2] at age 95). Women and higher educated individuals lived longer and lived more years with dementia. No differences in total life expectancy were observed by MCI subtype, although individuals with amnestic MCI lived a larger proportion of those years with dementia.

CONCLUSIONS

Prognosis of MCI, in terms of life years lived with and without dementia, is more favorable in the general population than described in prior clinical observations, due likely to a substantial proportion of individuals with MCI in the clinic not seeking medical attention in an earlier stage.

摘要

背景

多项临床研究对门诊轻度认知障碍(MCI)患者的预期寿命进行了评估,但这些研究结果是否适用于居家或在初级保健机构的社区居住者尚不确定。

方法

在基于人群的鹿特丹研究中,我们研究了 648 名社区居住的 MCI 患者和 6410 名无 MCI 患者的有痴呆和无痴呆情况下的预期寿命。年龄在 60 岁及以上的参与者在基线时(2002-2014 年)接受 MCI 评估,随后随访痴呆和死亡的发生。我们使用多状态生命表,按性别、教育程度和 MCI 亚型确定有痴呆和无痴呆情况下的特定年龄预期寿命。

结果

MCI 的总预期寿命从 60 岁时的 21.4 年(95%CI:19.0-23.6)到 95 岁时的 2.6 年(1.6-3.6)。随着年龄的增长,这些年限中有越来越多的年限是在痴呆中度过的(60 岁时为 2.9 年[1.8-4.0];95 岁时为 1.2 年[0.2-2.2])。女性和受教育程度较高的人寿命更长,且在痴呆中度过的年限更多。MCI 亚型之间的总预期寿命无差异,但遗忘型 MCI 患者在痴呆中度过的年限比例更大。

结论

从有痴呆和无痴呆的生存年限来看,MCI 的预后在一般人群中比之前的临床观察更为有利,这可能是由于临床中相当一部分 MCI 患者在早期未寻求医疗关注。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d325/9298312/e26483efe866/JGS-70-481-g003.jpg

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