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首页> 外文期刊>Alzheimer s Research & Therapy >Alzheimer’s Disease Assessment Scale–Cognitive subscale variants in mild cognitive impairment and mild Alzheimer’s disease: change over time and the effect of enrichment strategies
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Alzheimer’s Disease Assessment Scale–Cognitive subscale variants in mild cognitive impairment and mild Alzheimer’s disease: change over time and the effect of enrichment strategies

机译：阿尔茨海默氏症疾病评估量表–轻度认知障碍和轻度阿尔茨海默氏症的认知亚量表变体：随着时间的推移发生变化和丰富化策略的效果

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Development of new treatments for Alzheimer’s disease (AD) has broadened into early interventions in individuals with modest cognitive impairment and a slow decline. The 11-item version of the Alzheimer’s Disease Assessment Scale–Cognitive subscale (ADAS-Cog) was originally developed to measure cognition in patients with mild to moderate AD. Attempts to improve its properties for early AD by removing items prone to ceiling and/or by adding cognitive measures known to be impaired early have yielded a number of ADAS-Cog variants. Using Alzheimer’s Disease Neuroimaging Initiative data, we compared the performance of the 3-, 5-, 11- and 13-item ADAS-Cog variants in subjects with early AD. Given the interest in enrichment strategies, we also examined this aspect with a focus on cerebrospinal fluid (CSF) markers. Subjects with mild cognitive impairment (MCI) and mild AD with available ADAS-Cog 13 and CSF data were analysed. The decline over time was defined by change from baseline. Direct cross-comparison of the ADAS-Cog variants was performed using the signal-to-noise ratio (SNR), with higher values reflecting increased sensitivity to detect change over time. The decline over time on any of the ADAS-Cog variants was minimal in subjects with MCI. Approximately half of subjects with MCI fulfilled enrichment criteria for positive AD pathology. The impact of enrichment was detectable but subtle in MCI. The annual decline in mild AD was more pronounced but still modest. More than 90?% of subjects with mild AD had positive AD pathology. SNRs were low in MCI but greater in mild AD. The numerically largest SNRs were seen for the ADAS-Cog 5 in MCI and for both the 5- and 13-item ADAS-Cog variants in mild AD, although associated confidence intervals were large. The possible value of ADAS-Cog expansion or reduction is less than compelling, particularly in MCI. In mild AD, adding items known to be impaired at early stages seems to provide more benefit than removing items on which subjects score close to ceiling.
机译：针对阿尔茨海默氏病（AD）的新疗法的开发已扩展到对中度认知障碍和缓慢下降的个体进行早期干预。阿尔茨海默氏症疾病评估量表-认知子量表（ADAS-Cog）的11个项目最初是为了测量轻度至中度AD患者的认知度而开发的。尝试通过去除容易产生上限的物品和/或通过添加已知为早期受损的认知措施来改善其早期AD的特性，已经产生了许多ADAS-Cog变体。利用阿尔茨海默氏病神经成像计划的数据，我们比较了3、5、11和13项ADAS-Cog变体在患有AD的早期受试者中的表现。鉴于对浓缩策略的兴趣，我们还重点研究了脑脊髓液（CSF）标记物的这一方面。分析患有轻度认知障碍（MCI）和轻度AD并具有可用ADAS-Cog 13和CSF数据的受试者。随时间下降的定义是与基线相比的变化。使用信噪比（SNR）对ADAS-Cog变体进行直接交叉比较，其中较高的值反映了随着时间变化检测灵敏度的提高。在患有MCI的受试者中，任何ADAS-Cog变体随时间的下降最小。约有一半的MCI受试者符合阳性AD病理的丰富标准。富集的影响是可检测的，但在MCI中微妙。轻度AD的年度下降较为明显，但仍不大。超过90％的患有轻度AD的受试者的AD病理呈阳性。在MCI中，SNR低，而在轻度AD中，SNR高。尽管在MCI中ADAS-Cog 5以及轻度AD中的5和13项ADAS-Cog变体均出现了数值最大的SNR，但相关的置信区间很大。 ADAS-Cog扩大或减少的可能价值小于令人信服的价值，特别是在MCI中。在轻度AD中，添加已知在早期受损的项目似乎比删除受试者得分接近最高的项目提供更多好处。

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