执行功能和处理速度作为阿尔茨海默病全球认知衰退的预测指标

Executive Functioning and Processing Speed as Predictors of Global Cognitive Decline in Alzheimer Disease.

作者信息

Haran John P, Barrett A M, Lai YuShuan, Odjidja Samuel N, Dutta Protiva, McGrath Patrick M, Samari Imane, Romeiro Lethycia, Lopes Abigail, Bucci Vanni, McCormick Beth A

出版信息

medRxiv. 2024 Nov 2:2024.10.31.24316508. doi: 10.1101/2024.10.31.24316508.

DOI:10.1101/2024.10.31.24316508

PMID:39574871

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11581065/

Abstract

INTRODUCTION

There is a lack of cognitive tools to predict disease progression in mild cognitive impairment (MCI) and Alzheimer's disease (AD).

METHODS

We assessed patients with MCI, AD, and cognitively healthy controls (cHC) using NIH toolbox assessments for attention/concentration and executive functioning and overall cognitive decline by the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog).

RESULTS

Among 183 participants over a median follow-up of 540 days, both between- and within-subjects variance in NIH toolbox and ADAS-Cog assessments increased from cHC to MCI to AD patients. Among patients with AD, pattern comparison processing speed (PCPS) and dimensional change card sort tests (DCCS) declined at 3 and 6 months prior to global cognitive decline (p=0.008 & 0.0012). A 5-point decrease in either PCPS or DCCS increased risk of global cognitive decline (HR 1.32 (1.08-1.60) and 1.62 (1.16-2.26)).

DISCUSSION

Testing for cognitive domains of attention/concentration and executive functioning may predict subsequent global cognitive, and functional decline.

摘要

引言

目前缺乏用于预测轻度认知障碍（MCI）和阿尔茨海默病（AD）疾病进展的认知工具。

方法

我们使用美国国立卫生研究院（NIH）工具箱对注意力/专注力和执行功能进行评估，并通过阿尔茨海默病评估量表 - 认知部分（ADAS - Cog）评估总体认知衰退情况，对MCI患者、AD患者和认知健康对照者（cHC）进行了评估。

结果

在183名参与者中，中位随访时间为540天，从cHC到MCI再到AD患者，NIH工具箱和ADAS - Cog评估中的组间和组内方差均增加。在AD患者中，模式比较处理速度（PCPS）和维度变化卡片分类测试（DCCS）在总体认知衰退前3个月和6个月时下降（p = 0.008和0.0012）。PCPS或DCCS下降5分会增加总体认知衰退的风险（风险比分别为1.32（1.08 - 1.60）和1.62（1.16 - 2.26））。