Title:Early Detection of Dementia using Risk Classification in MCI: Outcomes
of Shanghai Mild Cognitive Impairment Cohort Study
Volume: 20
Issue: 6
关键词:
轻度认知障碍、痴呆、危险因素、PAACC、风险分类、阿尔茨海默病。
摘要:
Introduction: The purpose of this study is to identify the risk factors and risk classification
associated with the conversion from mild cognitive impairment (MCI) to Alzheimer’s disease
(AD) dementia to facilitate early intervention and the design of clinical trials for AD.
Methods: The study comprised a prospective cohort study of 400 subjects with MCI who had annual
follow-ups for 3 years.
Results: During an average follow-up period of 3.5 years, 109 subjects were diagnosed with all
cause of dementia, of whom 104 subjects converted to Alzheimer’s dementia and 5 subjects converted
to other types of dementia. The cumulative conversion rate was 5.5% (95% CI: 3.4, 8.6),
16.3% (95% CI: 12.9, 21.1), and 31.0% (95% CI: 25.4, 36.5) in each of the first 3 follow-up years,
respectively. The factors associated with a greater risk of conversion from MCI to AD included
smoking status, ApoE4 carrier status, right hippocampal volume (rt. HV), left temporal lobe volume,
and scores on the Revised Chinese version of the Alzheimer’s Disease Assessment Scale-Cognitive
Subscale 13 (ADAS-Cog-C). The risk classification of the ADAS-Cog-C or Preclinical
Alzheimer Cognitive Composite (PACC) score combined with the rt. HV showed a conversion difference
among the groups at every annual follow-up.
Conclusion: A simple risk classification using the rt. HV and neuropsychological test scores, including
those from the ADAS-Cog-C and PACC, could be a practicable and efficient approach to
indentify individuals at risk of all-cause dementia.
