Rubin E H, Storandt M, Miller J P, Kinscherf D A, Grant E A, Morris J C, Berg L
Department of Psychiatry, Alzheimer's Disease Research Center, Washington University, St Louis, Mo 63110, USA.
Arch Neurol. 1998 Mar;55(3):395-401. doi: 10.1001/archneur.55.3.395.
To examine the earliest cognitive changes associated with the onset of dementia as well as changes associated with normal aging.
Longitudinal evaluation of participants with annual clinical and psychometric examinations for up to 15 1/2 years.
Elderly volunteers (n = 82) enrolled with a Clinical Dementia Rating of 0 (cognitively intact) in longitudinal studies.
None.
Clinical Dementia Rating and results of a 1 1/2-hour psychometric battery.
As estimated with survival analysis, 40% of participants had a Clinical Dementia Rating greater than 0 (cognitive decline) within 12 years of enrollment; 59% of these were judged to have dementia of the Alzheimer type or incipient dementia. Participants with poorer performance on psychometric testing at enrollment were at higher risk for cognitive decline subsequently. The rate of change in psychometric performance before clinically detectable cognitive change occurred was not significantly different between those who eventually developed dementia and those who remained stable, except for performance on the Logical Memory subtest of the Wechsler Memory Scale. When subtle cognitive decline was clinically detected, however, an abrupt deterioration in performance on independently administered psychometric tests was observed.
Cognitively healthy elderly people maintain stable cognitive performance when measured longitudinally by both careful clinical evaluation and repeated psychometric testing. This stability is maintained unless and until they develop a dementing illness, at which time a sharp decline in performance is observed.
研究与痴呆症发病相关的最早认知变化以及与正常衰老相关的变化。
对参与者进行长达15年半的纵向评估，每年进行临床和心理测量检查。
82名老年志愿者参与纵向研究，临床痴呆评定量表评分为0（认知功能正常）。
无。
临床痴呆评定量表以及1个半小时心理测量测试的结果。
通过生存分析估计，40%的参与者在入组12年内临床痴呆评定量表评分大于0（认知功能下降）；其中59%被判定为阿尔茨海默病型痴呆或早期痴呆。入组时心理测量测试表现较差的参与者随后发生认知功能下降的风险更高。在临床上可检测到认知变化之前，最终发展为痴呆症的参与者和保持稳定的参与者在心理测量表现上的变化率没有显著差异，但韦氏记忆量表逻辑记忆子测试的表现除外。然而，当临床上检测到轻微认知功能下降时，独立进行的心理测量测试的表现会突然恶化。
通过仔细的临床评估和重复的心理测量测试进行纵向测量时，认知健康的老年人保持稳定的认知表现。这种稳定性会一直保持，除非他们患上痴呆症，此时会观察到表现急剧下降。
