Ebly E M, Hogan D B, Parhad I M
Department of Pathology, University of Calgary, Alberta.
Arch Neurol. 1995 Jun;52(6):612-9. doi: 10.1001/archneur.1995.00540300086018.
To describe a population that was categorized as "cognitively impaired not demented" (CIND) and to examine the utility of some of the proposed criteria for describing this degree of cognitive impairment.
Population-based prevalence study of dementia in those subjects who were 65 years and older.
Community and institutional settings in Canada.
Individuals who underwent a clinical evaluation (N = 2914).
Initial screening with the Modified Mini-Mental State Examination (3MS) to identify potential cognitive impairment; the 3MS was followed by a detailed clinical examination to confirm the presence of dementia and to determine the probable cause. Clinical examinations were performed on all those subjects who were residing in institutions, those in the community with a 3MS score less than 78, and a sample of those in the community with a 3MS score of 78 or more. Neuropsychological testing was performed as part of the clinical examination when the 3MS score was 50 or more. At the conclusion of the assessment, subjects were categorized as being cognitively normal, CIND, and demented.
Frequency of a diagnosis of CIND; demographical, cognitive, and functional characteristics of cognitively normal and CIND subjects and those with early and late dementia; and proportion of subjects who were CIND and met the proposed criteria.
Subjects who were categorized as CIND were common and fell between cognitively normal subjects and those with dementia in terms of age, 3MS score, general intellectual function, and performance of daily activities. Because of the restrictive inclusion and exclusion criteria, the proposed criteria for cognitive impairment described only 30% of our subjects who were CIND.
Subjects who were categorized as CIND appeared to be distinct from and intermediate between subjects with dementia and cognitively normal subjects. Most individuals did not meet the criteria that were evaluated for describing this group. While the various criteria that were evaluated may accurately define a select subset of cognitively impaired individuals, the natural history and prognosis of such groups, currently unknown, may not be generalizable to the larger population of subjects who are CIND. Further work is needed to clearly define this group, and longitudinal studies are required to determine an outcome.
描述被归类为“认知功能受损但未患痴呆症”（CIND）的人群，并检验一些用于描述这种认知功能受损程度的既定标准的效用。
针对65岁及以上受试者进行的基于人群的痴呆症患病率研究。
加拿大的社区和机构场所。
接受临床评估的个体（N = 2914）。
先用改良简易精神状态检查表（3MS）进行初步筛查，以识别潜在的认知功能受损情况；随后对3MS筛查结果进行详细的临床检查，以确认是否患有痴呆症并确定可能的病因。对所有居住在机构中的受试者、社区中3MS得分低于78分的受试者以及社区中3MS得分在78分及以上的受试者样本进行临床检查。当3MS得分在50分及以上时，进行神经心理学测试作为临床检查的一部分。在评估结束时，将受试者分为认知功能正常、CIND和痴呆症患者。
CIND诊断的频率；认知功能正常和CIND受试者以及早期和晚期痴呆症患者的人口统计学、认知和功能特征；以及属于CIND且符合既定标准的受试者比例。
被归类为CIND的受试者很常见，在年龄、3MS得分、一般智力功能和日常活动表现方面介于认知功能正常的受试者和患有痴呆症的受试者之间。由于纳入和排除标准的限制，所评估的认知功能受损标准仅涵盖了30%被归类为CIND的受试者。
被归类为CIND的受试者似乎与患有痴呆症的受试者和认知功能正常的受试者不同，且处于两者之间。大多数个体不符合用于描述该群体的评估标准。虽然所评估的各种标准可能准确地定义了一部分认知功能受损个体，但目前尚不清楚这类群体的自然病史和预后情况，可能无法推广到更大的CIND受试者群体。需要进一步的研究来明确界定该群体，并开展纵向研究以确定其转归情况。
