在正常认知和轻度认知障碍患者中,控制与认知的关联
Ifrah Zawar1, Jaideep Kapur1, Meghan K Mattos1
1From the Department of Neurology (I.Z., J.K., C.M.A., C.M., M.Q.), and School of Nursing (M.K.M.), University of Virginia, Charlottesville.
Neurology
|August 22, 2024
概括
活跃发作显著加速正常认知和轻度认知障碍 (MCI) 的个体的认知衰退. 远程发作没有显示这种关联,强调了管理活跃的重要性,以保持大脑健康.
科学领域:
- 神经学 神经学
- 老年学是指老年学的学科.
- 认知科学 认知科学
背景情况:
- 发作是痴呆症的一个已知的并发症,通常与更快的认知恶化有关.
- 主动与远程对认知功能的明显影响仍未得到充分探索,特别是在具有正常认知或轻度认知障碍 (MCI) 的个体中.
- 了解这些差异对于开发有针对性的干预措施来缓解认知衰退至关重要.
研究的目的:
- 调查活跃发作和远程发作对认知衰退的不同影响.
- 将这些影响与正常认知和轻度认知障碍 (MCI) 患者进行比较.
- 评估发作状态与患上MCI或痴呆症的风险之间的关联.
主要方法:
- 一项纵向的多中心队列研究,利用来自39个阿尔茨海默病中心 (美国,2005-2021) 的国家阿尔茨海默病协调中心数据.
- 包括具有正常认知和MCI至少两次访问的参与者.
- 用临床痴呆症评分 (CDR) 测量认知衰退. 发作状态被分类为活跃 (在12个月内),远程 (之前,在12个月内没有) 或没有发作. 根据人口和健康因素调整的考克斯回归模型被用于评估MCI和/或痴呆的风险.
主要成果:
- 在认知健康的成年人中,活跃性发作增加了认知障碍的风险2.13倍 (aHR),并将时间减少到~1年,而远程或没有发作则是~3年.
- 在患有MCI的个体中,活跃发作将痴呆的风险提高了1.58倍 (aHR),并将衰退时间缩短到1年左右,而远程或没有发作则减少了2年左右.
- 在这两组中,远程发作与认知能力下降的风险增加无关.
结论:
- 活跃,但不是远程,在认知正常和MCI人群中显著与加速认知衰退有关.
- 这些发现独立于其他已知的痴呆风险因素,表明发作是认知障碍的直接贡献者.
- 早期识别和管理活跃发作可能是减轻患者老年人认知衰退的关键策略.
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