Prediction of Dementia by Subjective Memory Impairment Effects of Severity and Temporal Association With Cognitive Impairment

被引：536

作者：

Jessen, Frank ^{[1
]}

Wiese, Birgitt ^{[2
]}

Bachmann, Cadja

Eifflaender-Gorfer, Sandra ^{[6
]}

Haller, Franziska ^{[1
]}

Koelsch, Heike ^{[1
]}

Luck, Tobias ^{[5
]}

Moesch, Edelgard ^{[7
]}

van den Bussche, Hendrik ^{[3
]}

Wagner, Michael ^{[1
]}

Wollny, Anja ^{[8
]}

Zimmermann, Thomas ^{[3
]}

Pentzek, Michael ^{[8
]}

Riedel-Heller, Steffi G. ^{[5
]}

Romberg, Heinz-Peter

Weyerer, Siegfried ^{[6
]}

Kaduszkiewicz, Hanna ^{[3
]}

Maier, Wolfgang ^{[1
,4
]}

Bickel, Horst ^{[7
]}

机构：

[1] Univ Bonn, Dept Psychiat, D-53105 Bonn, Germany

[2] Hannover Med Sch, Inst Biometr, D-3000 Hannover, Germany

[3] Univ Med Ctr Hamburg Eppendorf, Dept Primary Med Care, Hamburg, Germany

[4] German Ctr Neurodegenerat Dis, Bonn, Germany

[5] Univ Leipzig, Dept Psychiat, Leipzig, Germany

[6] Cent Inst Mental Hlth, D-6800 Mannheim, Germany

[7] Tech Univ Munich, Dept Psychiat, Munich, Germany

[8] Univ Med Ctr Dusseldorf, Dept Gen Practice, Dusseldorf, Germany

来源：

ARCHIVES OF GENERAL PSYCHIATRY | 2010年 / 67卷 / 04期

关键词：

ALZHEIMERS-DISEASE; OLDER-ADULTS; COMPLAINTS; MCI; DETERIORATION; POPULATION; PREVALENCE; CONVERSION; DIAGNOSIS; PATTERNS;

D O I：

10.1001/archgenpsychiatry.2010.30

中图分类号：

R749 [精神病学];

学科分类号：

100205 ;

摘要：

Context: Subjective memory impairment (SMI) is receiving increasing attention as a pre-mild cognitive impairment (MCI) condition in the course of the clinical manifestation of Alzheimer disease (AD). Objectives: To determine the risk for conversion to any dementia, dementia in AD, or vascular dementia by SMI, graded by the level of SMI-related worry and by the temporal association of SMI and subsequent MCI. Design: Longitudinal cohort study with follow-up examinations at 1 (1)/(2) and 3 years after baseline. Setting: Primary care medical record registry sample. Participants: A total of 2415 subjects without cognitive impairment 75 years or older in the German Study on Aging, Cognition and Dementia in Primary Care Patients. Main Outcome Measures: Conversion to any dementia, dementia in AD, or vascular dementia at follow-up 1 or follow-up 2 predicted by SMI with or without worry at baseline and at follow-up 2 predicted by different courses of SMI at baseline and MCI at follow-up 1. Results: In the first analysis, SMI with worry at baseline was associated with greatest risk for conversion to any dementia (hazard ratio [HR], 3.53; 95% confidence interval [CI], 2.07-6.03) or dementia in AD (6.54; 2.82-15.20) at follow-up 1 or follow-up 2. The sensitivity was 69.0% and the specificity was 74.3% conversion to dementia in AD. In the second analysis, SMI at baseline and MCI at follow-up 1 were associated with greatest risk for conversion to any dementia (odds ratio [ OR], 8.92; 95% CI, 3.69-21.60) or dementia in AD (19.33; 5.29-70.81) at follow-up 2. Furthermore, SMI at baseline and amnestic MCI at follow-up 1 increased the risk for conversion to any dementia (OR, 29.24; 95% CI, 8.75-97.78) or dementia inAD (60.28; 12.23-297.10), with a sensitivity of 66.7% and a specificity of 98.3% for conversion to dementia in AD. Conclusion: The prediction of dementia in AD by SMI with subsequent amnestic MCI supports the model of a consecutive 3-stage clinical manifestation of AD from SMI via MCI to dementia.

引用

页码：414 / 422

页数：9

共 42 条

[1] Prodromal Alzheimer's Disease: Successive Emergence of the Clinical Symptoms [J].