执行功能和处理速度作为阿尔茨海默病整体认知衰退的预测指标。
Executive functioning and processing speed as predictors of global cognitive decline in Alzheimer's 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
机构信息
Department of Emergency Medicine, University of Massachusetts Medical School, Worcester, MA, USA.
Department of Microbiology, University of Massachusetts Medical School, Worcester, MA, USA.
出版信息
J Alzheimers Dis Rep. 2025 Aug 6;9:25424823251363549. doi: 10.1177/25424823251363549. eCollection 2025 Jan-Dec.
BACKGROUND
Better cognitive tools to predict disease progression in mild cognitive impairment (MCI) and Alzheimer's disease (AD) are needed.
OBJECTIVE
In this prospective longitudinal cohort, we are testing if changes in the cognitive domains of executive functioning and processing speed can predict global cognitive decline.
METHODS
We assessed patients with MCI, AD, and cognitively healthy controls (cHC) using NIH toolbox assessments for processing speed and executive functioning and overall cognitive decline by the Alzheimer's Disease Assessment Scale-Cognitive (ADAS-Cog).
RESULTS
Among 184 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 (n = 24), 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 and 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)).
CONCLUSIONS
Testing for cognitive domains of processing speed and executive functioning may predict subsequent global cognitive.
背景
需要更好的认知工具来预测轻度认知障碍（MCI）和阿尔茨海默病（AD）的疾病进展。
目的
在这个前瞻性纵向队列研究中，我们正在测试执行功能和处理速度的认知领域变化是否能预测整体认知衰退。
方法
我们使用美国国立卫生研究院（NIH）工具箱评估处理速度和执行功能，并通过阿尔茨海默病评估量表 - 认知部分（ADAS - Cog）评估整体认知衰退，对MCI患者、AD患者和认知健康对照者（cHC）进行了评估。
结果
在184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评估中的组间和个体内差异均增加。在AD患者（n = 24）中，模式比较处理速度（PCPS）和维度变化卡片分类测试（DCCS）在整体认知衰退前3个月和6个月下降（p = 0.008和0.0012）。PCPS或DCCS下降5分会增加整体认知衰退的风险（风险比1.32（1.08 - 1.60）和1.62（1.16 - 2.26））。
结论
对处理速度和执行功能的认知领域进行测试可能预测随后的整体认知情况。
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