临床表现 临床表现
Melina Stark1,2, Elizabeth Kuhn2, Michael Wagner1,2
1Department for Old Age Psychiatry and Cognitive Disorders, University Hospital Bonn, Bonn, Germany.
Alzheimer's & dementia : the journal of the Alzheimer's Association
|December 25, 2025
概括
主观认知衰退 (SCD) 和轻微的神经心理缺陷 (MNPD) 预测阿尔茨海默病风险. 结合SCD和MNPD可以识别高风险个体,优化早期AD的临床试验招聘.
科学领域:
- 神经科学是一个神经科学.
- 临床神经学 临床神经学
- 生物统计学 生物统计学
背景情况:
- 招募高风险个体对于早期阿尔茨海默病 (AD) 临床试验至关重要.
- 主观认知衰退 (SCD) 和轻微的神经心理缺陷 (MNPD) 表明认知衰退风险增加.
- SCD和MNPD的综合预后值需要进一步调查.
研究的目的:
- 研究SCD和MNPD在预测认知衰退和AD病理方面的综合预后价值.
- 评估SCD和MNPD在临床试验参与者的分层风险中的有用性.
- 确定结合SCD和MNPD对临床试验所需样本大小的影响.
主要方法:
- 来自三个大队伍 (N=13,192) 的认知不受损的个体的数据.
- 定义的MNPD为z≤-0.5.5的中位数神经心理测试表现.
- 使用Cox和后勤回归来评估SCD/MNPD与MCI,痴呆症和生物标志物阳性之间的关联,并对共变量进行调整.
主要成果:
- 在SCD+/MNPD+患者中,患上MCI (HR=6.23) 和痴呆的风险最高.
- 在SCD+/MNPD+和SCD+/MNPD-组中,粉样蛋白阳性的风险增加.
- 在SCD+/MNPD+个体中,tau阳性的风险增加 (OR=2.10).
- 专注于SCD+/MNPD+个体可以将临床试验样本大小减少约三分之二.
结论:
- 在临床前的AD中,SCD和MNPD具有互补的预后价值.
- 患有SCD和MNPD (SCD+/MNPD+) 两种疾病的个体,患有AD病理和认知衰退的风险特别高.
- 建议将SCD和MNPD评估纳入,以优化临床试验在临床前AD的招聘.
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