主观认知衰退加上长度评估和认知障碍的风险
Moonil Kang1,2, Clara Li3, Arnav Mahajan4
1Framingham Heart Study, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts.
JAMA psychiatry
|July 3, 2024
概括
阿尔茨海默病 (AD) 连续线中的主观认知衰退 (SCD) 信号增加了轻度认知障碍 (MCI) 和痴呆症的未来风险. 这种风险独立于遗传因素,如APOE ε4和AD多基因风险评分.
科学领域:
- 神经学 神经学
- 老年学是一门学科.
- 认知科学 认知科学
背景情况:
- 主观认知衰退 (SCD) 是阿尔茨海默病 (AD) 认知连续体内的公认的早期指标.
- SCD倡议国际工作组提出了SCD-plus (SCD+) 标准,以确定患有认知衰退风险较高的个人.
- 之前对SCD+的评估是有限的,特别是在大型的社区环境中.
研究的目的:
- 用SCD+标准评估与SCD相关的风险,用于在认知正常的成年人中发展轻度认知障碍 (MCI),AD和全因痴呆症.
- 评估SCD是否是认知衰退的独立风险因素,超出已确定的遗传风险因素.
主要方法:
- 一项基于社区的前性队列研究 (弗雷明汉心脏研究) 从2005年至2019年追踪了3585名60岁以上的认知正常参与者.
- 主观认知衰退 (SCD) 被纵向评估,并被视为时间变化的变量.
- 考克斯的比例危险模型被用来分析SCD和随后的MCI,AD和所有原因痴呆症诊断之间的关联,根据年龄,性别,教育,APOE ε4状态和AD多原风险评分 (PRS) 进行调整.
主要成果:
- 在3585名参与者中,1596名 (44.5%) 报告SCD. 在12年的中位随访期间,236人 (6.6%) 患有MCI,73人 (2.0%) 患有AD,89人 (2.5%) 患有全因痴呆.
- SCD与MCI (HR, 1.57),AD (HR, 2.98) 和所有原因痴呆症 (HR, 2.14) 的风险增加显著相关.
- 在对APOE ε4和AD PRS进行调整后,这些关联仍然显著,这表明SCD可能是一个独立的风险因素.
结论:
- 在社区环境中,反映SCD+特征的SCD与未来MCI,AD和全因痴呆症的风险显著增加有关.
- 这些发现表明,SCD是痴呆风险的独立预测因素,即使考虑到APOE ε4和AD PRS等遗传风险因素.
- 在阿尔茨海默氏症连续体内,SCD可能成为神经退行性疾病的有价值的早期预警信号.
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