Hänninen T, Hallikainen M, Koivisto K, Helkala E L, Reinikainen K J, Soininen H, Mykkänen L, Laakso M, Pyörälä K, Riekkinen P J
Department of Neurology, University of Kuopio, Finland.
J Am Geriatr Soc. 1995 Sep;43(9):1007-15. doi: 10.1111/j.1532-5415.1995.tb05565.x.
To examine the clinical course of age-associated memory impairment (AAMI) and to evaluate the value of neuropsychological tests in predicting cognitive decline in AAMI subjects in a follow-up period of more than 3 years.
Prospective cohort study.
The outpatient Memory Research Unit of the Department of Neurology at the University of Kuopio in Eastern Finland.
A sample of 229 subjects (mean age 71.7 years) identified in two screening studies as having AAMI.
A battery of neuropsychological tests and a structured inquiry for health status and subjective memory complaints were performed at baseline and follow-up to diagnose AAMI according to the criteria proposed by a National Institute of Mental Health work group.
Of the 229 subjects, 176 (76.9%) participated in the follow-up for, on average, 3.6 years after the baseline. Of the participants, 104 (59.1%) still met the AAMI criteria. Other subjects were classified into five subgroups: (1) subjects showing decline in cognition meeting dementia diagnosis (16, 9.1% (13 of them AD)); (2) subjects with mild cognitive decline meeting neither dementia nor AAMI criteria (13, 7.4%); (3) subjects with memory performance now superior to AAMI criteria (17, 9.7%); (4) subjects having a disease classified as exclusion in the criteria (15, 8.5%); (5) subjects not now reporting subjective memory loss in everyday life (9, 5.1%). Two subjects (1.1%) were not classified because of incomplete data. Neuropsychological tests predicted which subjects would develop dementia during the follow-up period. The best discriminators between these subjects and those who remained AAMI were memory and verbal fluency tests.
The study suggests that, in general, AAMI is nonprogressive, but the AAMI population also includes subjects with early dementia and subjects without genuine memory loss. However, these subjects can be differentiated with a more detailed neuropsychological evaluation.
研究年龄相关性记忆障碍（AAMI）的临床病程，并评估神经心理学测试在预测AAMI受试者3年多随访期内认知功能衰退方面的价值。
前瞻性队列研究。
芬兰东部库奥皮奥大学神经科门诊记忆研究室。
在两项筛查研究中确定的229名受试者样本（平均年龄71.7岁），被诊断为患有AAMI。
在基线和随访时进行一系列神经心理学测试以及关于健康状况和主观记忆主诉的结构化询问，以根据美国国立精神卫生研究所工作组提出的标准诊断AAMI。
229名受试者中，176名（76.9%）参与了随访，平均在基线后3.6年。在参与者中，104名（59.1%）仍符合AAMI标准。其他受试者被分为五个亚组：（1）认知功能下降符合痴呆诊断标准的受试者（16名，9.1%（其中13名患有阿尔茨海默病））；（2）轻度认知功能下降但不符合痴呆或AAMI标准的受试者（13名，7.4%）；（3）记忆表现现在优于AAMI标准的受试者（17名，9.7%）；（4）患有标准中列为排除疾病的受试者（15名，8.5%）；（5）目前在日常生活中未报告主观记忆丧失的受试者（9名，5.1%）。两名受试者（1.1%）因数据不完整未分类。神经心理学测试预测了哪些受试者在随访期间会发展为痴呆。这些受试者与仍为AAMI的受试者之间的最佳区分指标是记忆和语言流畅性测试。
该研究表明，一般而言，AAMI是不进展的，但AAMI人群中也包括早期痴呆患者和无真正记忆丧失的受试者。然而，通过更详细的神经心理学评估可以区分这些受试者。
