Pai Ya-Tang, Matsuda Hiroshi, Pai Ming-Chyi
National Cheng Kung University Hospital, Tainan 704, Taiwan.
Department of Neurology, Chang Gung Memorial Hospital, Linkou Medical Center, Taoyuan 333, Taiwan.
Diagnostics (Basel). 2024 Aug 15;14(16):1780. doi: 10.3390/diagnostics14161780.
(1) Background: Mild cognitive impairment (MCI) due to Alzheimer's disease (AD) progresses to dementia at a higher annual rate, while other MCIs may remain stable or even improve over time. Discriminating progressive from non-progressive cases of MCI is crucial and challenging. (2) Methods: A retrospective study of individuals with MCI was conducted at a university hospital located in southern Taiwan. The researchers collected demographic data, comorbidities, the scores of cognitive tests, three easy Z-score imaging system (eZIS) indicators (severity, extent, and ratio), Fazekas scale scores, mesial temporal atrophy (MTA) scores, clinical outcomes including deterioration of Cognitive Abilities Screening Instrument, Mini-mental State Examination, Clinical Dementia Rating Sum of Box scores, and the conversion from MCI to dementia. Those who converted to dementia in three years and non-converters were compared by the three eZIS indicators to test the predictive utility, and the clinical outcomes were evaluated by regression and ROC curve analysis. (3) Results: The three eZIS indicators were significantly higher in the group of progressive MCI than in stable MCI. eZIS severity is positively correlated with a deterioration in the scores of the Cognitive Abilities Screening Instrument and Clinical Dementia Rating Sum of Box. eZIS severity is also positively correlated with conversion from MCI to dementia. The AUC for severity is 0.719, and the optimal cutoff value of severity for predicting conversion is 1.22. (4) Conclusions: During three years of follow-up, MCI individuals with greater eZIS severity were significantly associated with worse cognitive assessment scores and a higher conversion rate to dementia.
(1)背景:阿尔茨海默病(AD)所致的轻度认知障碍(MCI)每年进展为痴呆的发生率更高,而其他类型的MCI可能随时间保持稳定甚至改善。区分MCI的进展性和非进展性病例至关重要且具有挑战性。(2)方法:在台湾南部的一家大学医院对MCI患者进行了一项回顾性研究。研究人员收集了人口统计学数据、合并症、认知测试分数、三个简易Z评分成像系统(eZIS)指标(严重程度、范围和比率)、法泽卡斯量表分数、内侧颞叶萎缩(MTA)分数、临床结局,包括认知能力筛查工具恶化情况、简易精神状态检查表、临床痴呆评定量表框分总和以及从MCI转化为痴呆的情况。通过三个eZIS指标对三年内转化为痴呆的患者和未转化者进行比较,以测试预测效用,并通过回归分析和ROC曲线分析评估临床结局。(3)结果:进展性MCI组的三个eZIS指标显著高于稳定型MCI组。eZIS严重程度与认知能力筛查工具分数和临床痴呆评定量表框分总和的恶化呈正相关。eZIS严重程度也与MCI转化为痴呆呈正相关。严重程度的AUC为0.719,预测转化的严重程度最佳截断值为1.22。(4)结论:在三年的随访期间,eZIS严重程度较高的MCI患者与较差的认知评估分数和较高的痴呆转化率显著相关。