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首页> 外文期刊>Archives of general psychiatry. >Prediction of dementia by subjective memory impairment: effects of severity and temporal association with cognitive impairment.
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Prediction of dementia by subjective memory impairment: effects of severity and temporal association with cognitive impairment.

机译：预测老年痴呆症的主观记忆缺陷:严重程度和时间的影响与认知障碍。

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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 in AD (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.
机译：背景:主观记忆障碍(重度)作为一个pre-mild收到越来越多的关注认知障碍(MCI)条件老年痴呆的临床表现病(AD)。转换到任何痴呆,痴呆的广告,或由重度血管性痴呆、分级的水平SMI-related担心和时间重度精神病协会和随后的MCI。与后续的纵向队列研究考试在1(1/2)和3年之后基线。注册表样本。受试者没有认知障碍或75年老在德国研究衰老,认知和痴呆在初级护理病人。措施:转换到任何痴呆、痴呆广告,或者在后续1或血管性痴呆随访2预测重度有或没有担心在基线和随访2的预测在基线和MCI重度的不同课程随访1。与基线与担心转换到任何痴呆的风险最大(风险比[HR], 3.53;(CI), 2.07 - -6.03)或痴呆的广告(6.54;在随访1或随访2 2.82 - -15.20)。敏感性,特异性69.0%广告74.3%的转换为痴呆。分析、重度在基线和MCI在随访1与最大风险转换吗任何痴呆(优势比[或],8.92;3.69 - -21.60)或痴呆的广告(19.33;在随访2。遗忘MCI在随访1增加了风险转换到任何痴呆(OR, 29.24;CI, 8.75 - -97.78)或痴呆的广告(60.28;12.23 - -297.10),敏感性为66.7%,特异性为98.3%转换为痴呆在广告。广告通过与后续重度遗忘MCI的支持连续的模型强度临床广告通过MCI从重度痴呆的表现。

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