摘要
目的:有证据表明,阿尔茨海默病(AD)患者往往在其疾病的晚期被诊断为预后不良。本研究旨在识别AD临床诊断前的体征和症状,为初级保健中的疾病早期诊断提供了一个预测模型。 设计:回顾性病历回顾;嵌套病例对照设计。 对象:包括Milton Keynes和Luton临床调试组(CCG)三次全科手术的109例患者(AD 37例,CON 72例)。没有AD的控制)。主要观察指标:回顾性分析AD诊断前是否存在体征和症状。TIM的识别在临床诊断之前首次报告的这些表现的ING和出现顺序被测量。 结果:以优势比为1.85的情景记忆出现频率最高,分别为1.38%和75.6%。听觉障碍,比数比为3.03,哈哈以前没有注意到,除非是以幻听的形式出现,否则可能有诊断价值。 结论:听觉障碍主要发生在白种人女性,可区分AD患者和非AD患者。症状,表现为14.5(平均t)在临床诊断前几年,仅在白种人和混血人群中进行了诊断。 优点:研究表明,听觉障碍可以使白种人女性早期诊断AD。发作性记忆被证实是AD患者经常注意的。a根据以前的出版物进行临床诊断。本研究为AD早期诊断的评分系统的开发提供了支持。所使用的数据不受MISI的干扰影响。信息,因为这是写在收集点,从而受益于使用GP数据是多样化,可靠和有效的。 局限性:样本规模有限,由于其在病例说明中的流行程度较低,无法对较少的观察结果进行概括。随机化没有实现,但是,最好的效果是采用连续抽样的非随机化方法。所确定的模式是负荷型的,基线可能因其他地理区域的不同而有所不同。
关键词: 回顾性病历回顾,阿尔茨海默病,病历回顾,病例对照,早期症状,症状,痴呆,早期诊断。
Current Alzheimer Research
Title:Identifying Patterns in Signs and Symptoms Preceding the Clinical Diagnosis of Alzheimer’s Disease: Retrospective Medical Record Review Study and a Nested Case-control Design
Volume: 15 Issue: 8
关键词: 回顾性病历回顾,阿尔茨海默病,病历回顾,病例对照,早期症状,症状,痴呆,早期诊断。
摘要: Objective: Evidence suggests that individuals with Alzheimer’s disease (AD) are often diagnosed in the later stages of their disease with a poor prognosis. This study is aimed to identify patterns in signs and symptoms preceding the clinical diagnosis of AD to suggest a predictive model for earlier diagnosis of the disease in the primary care.
Design: A retrospective medical record review; nested case control design.
Participants: Participants included one hundred and nine patients from three general practice (GP) surgeries in Milton Keynes and Luton Clinical Commissioning Groups (CCG) (37 cases with AD and 72 controls without AD).
Main outcome measure: A retrospective analysis using the logistic regression of the presence of signs and symptoms before the diagnosis of AD was attained. Identification of the timing and sequence of appearance of these presentations as first reported before the clinical diagnosis was measured.
Result: Episodic memory with an odds ratio of 1.85 was the most frequent presentation, documented in 1.38% of the controls and 75.6% in cases. Auditory disturbance with an odds ratio of 3.03, which has not previously been noted except in the form of auditory hallucination, could have a diagnostic value.
Conclusion: Auditory disturbance, which occurred mostly in the Caucasian females, could discriminate individuals with AD from those without the disease. The symptom, which presented up to 14.5 (mean time) years prior to clinical diagnosis, was identified in Caucasians and mixed race individuals only.
Strengths: The study demonstrates that auditory disturbance could allow an earlier diagnosis of AD in Caucasian females. Episodic memory was confirmed as being frequently noted in AD patients prior to a clinical diagnosis as per previous publications. This study supports the development of a scoring system for the earlier diagnosis of AD. The data used was free from the confounding effects of misinformation, as this was written at the point of collection, thereby benefitting from the use of GP data that is diversified, reliable and valid.
Limitations: Limited sample size that will not allow for generalization of less frequent observations due to their low prevalence in case notes. Randomisation was not achieved; however, the best available nonrandomisation which is consecutive sampling was used. Patterns identified were in LOAD, the baseline could vary with other geographical areas.
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Cite this article as:
Identifying Patterns in Signs and Symptoms Preceding the Clinical Diagnosis of Alzheimer’s Disease: Retrospective Medical Record Review Study and a Nested Case-control Design, Current Alzheimer Research 2018; 15 (8) . https://dx.doi.org/10.2174/1567205015666180404155358
DOI https://dx.doi.org/10.2174/1567205015666180404155358 |
Print ISSN 1567-2050 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-5828 |
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