摘要
背景:工具性日常生活的(IADL)在患者身上呈现从遗忘型轻度认知损害(MCI)开始转变到阿尔茨海默病(AD)痴呆的损伤。然而,在临床正常老年人中大多数IADL量表没有表现出IADL改变。本研究的目的是确定哪个与IADL有关的日常认知量表项目对早期功能变化的检测最敏感。方法:我们从阿尔茨海默病神经成像启动计划评估了290 例CN和495例 MCI受试者。我们进行logistic回归分析预测CN的概率。MCI诊断只采用了与IADL有关的17个基于参加者和17个基于记录者的日常认知量表项目。然后我们进行Cox回归分析预测CN到MCI的发展。所有的分析对人口学特征进行了调整。结果:我们发现,对于“记住一些 购物项目”(基于参与者和观察者的P< 0.0001),“记住约会”(基于参与者和观察者的P< 0.0001),“制定一个时间表提前安排事件”(基于参与者P = 0.007),“核对支票簿”(基于参与者P = 0.02),和“组织邮件和文字”(基于观察者P = 0.002)有更糟糕的表现,可很好地鉴别MCI 到CN。我们发现,对“组织邮件和文字”更糟糕的表现(基于参与者的风险比(HR)= 2.27,P = 0.07)能边缘性的预测从CN到MCI进程中更大的风险。结论:我们的研究结果表明,针对早期功能变化的几个简单问题,无论是个人或观察者强调的,能有效区分CN老年人和MIC患者。此外,与上述问题之一有关的组织提出CN个人可能会发展成为MCI患者。
关键词: 关键词:日常生活活动,阿尔茨海默氏病,临床评估,日常活动,临床正常老年人,轻度认知损伤的活性。
Current Alzheimer Research
Title:Everyday Cognition Scale Items that Best Discriminate Between and Predict Progression From Clinically Normal to Mild Cognitive Impairment
Volume: 11 Issue: 9
Author(s): Gad A. Marshall, Amy S. Zoller, Kathleen E. Kelly, Rebecca E. Amariglio, Joseph J. Locascio, Keith A. Johnson, Reisa A. Sperling, Dorene M. Rentz and for the Alzheimer's Disease Neuroimaging Initiative
Affiliation:
关键词: 关键词:日常生活活动,阿尔茨海默氏病,临床评估,日常活动,临床正常老年人,轻度认知损伤的活性。
摘要: Background: Impairment in instrumental activities of daily living (IADL) starts as individuals with amnestic mild cognitive impairment (MCI) transition to Alzheimer’s disease (AD) dementia. However, most IADL scales have not shown IADL alterations in clinically normal (CN) elderly. The objective of this study was to determine which of the IADL-related Everyday Cognition (ECog) scale items are most sensitive for detection of early functional changes. Methods: We assessed 290 CN and 495 MCI participants from the Alzheimer’s Disease Neuroimaging Initiative. We performed logistic regression analyses predicting the probability of CN vs. MCI diagnosis using only the 17 participant-based and 17 informant-based ECog items related to IADL. We then performed Cox regression analyses to predict progression from CN to MCI. All analyses were adjusted for demographic characteristics. Results: We found that worse performance on “remembering a few shopping items” (participant and informant-based p<0.0001), “remembering appointments” (participant and informant-based p<0.0001), “developing a schedule in advance of anticipated events” (participant-based p=0.007), “balancing checkbook” (participant-based p=0.02), and “keeping mail and papers organized” (informant-based p=0.002) best discriminated MCI from CN. We found that worse performance on “keeping mail and papers organized” (participant-based Hazard Ratio (HR)=2.27, p=0.07) marginally predicted greater hazard of progressing from CN to MCI. Conclusions: Our results indicate that a few simple questions targeting early functional changes, addressed either to the individual or informant, can effectively distinguish between CN elderly and individuals with MCI. Additionally, one of the above questions related to organization suggested which CN individuals are likely to progress to MCI.
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Marshall A. Gad, Zoller S. Amy, Kelly E. Kathleen, Amariglio E. Rebecca, Locascio J. Joseph, Johnson A. Keith, Sperling A. Reisa, Rentz M. Dorene and for the Alzheimer's Disease Neuroimaging Initiative , Everyday Cognition Scale Items that Best Discriminate Between and Predict Progression From Clinically Normal to Mild Cognitive Impairment, Current Alzheimer Research 2014; 11 (9) . https://dx.doi.org/10.2174/1567205011666141001120903
DOI https://dx.doi.org/10.2174/1567205011666141001120903 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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