社区老年人轻度认知功能损害的转归研究  

The Different Outcome of Mild Cognitive Impairment in Community-dwelling Elderly People

作　　者：韦继芳[1] 黄文湧[1] 杨敬源[1] 汪俊华[1] 杨星[1] 蔡毅媛[1] 

机构地区：[1]贵阳医学院流行病学教研室,贵州贵阳550004

出　　处：《中国慢性病预防与控制》2009年第6期611-613,共3页Chinese Journal of Prevention and Control of Chronic Diseases

基　　金：国家自然科学基金资助项目(30860245);贵州省省长资助项目(黔省专合字(2007)47);贵州省科技攻关项目(黔科合S字[2007]1042);贵阳市科技项目(筑科合字[2008]8-5)

摘　　要：目的了解贵阳市社区老年人轻度认知功能损害(MCI)的转归。方法以2004年及2005年贵阳市社区老年人MCI流行病学调查的人群为研究对象,3 a后对基线调查时经简易智能状态检查法(MMSE)筛查后诊断为MCI以及认知正常的受试者队列进行随访。比较MCI和认知正常受试者的不同状态转化率,并用寿命表法对各组的生存率进行分析。结果根据纳入和排除标准,原有343例MCI患者(遗忘型MCI 246例,非遗忘型MCI 97例)和2 200例认知正常者进入队列。随访结束时,正常组失访560例(25.3%),MCI组失访82例(23.9%),其中遗忘型MCI组65例,非遗忘型MCI组17例。正常组与MCI组间、不同亚型MCI组间失访率的差别均无统计学意义(P>0.05)。MCI组的死亡率为12.6%,痴呆转化率为5.7%;正常组死亡率为8.7%,痴呆转化率为1.7%,两组间差别有统计学意义(P<0.001)。MCI组死亡的概率约是正常组的1.4倍,发展为痴呆的概率约为正常组的3.4倍。遗忘型MCI和非遗忘型MCI组的死亡率分别为12.2%和13.8%,痴呆转化率分别为5.5%和6.3%,MCI保持率分别为19.3%和12.5%,认知正常转化率分别为63.0%和67.4%。非遗忘型MCI患者死亡、发展为痴呆及转为正常的概率均高于遗忘型MCI,遗忘型MCI保持率高于非遗忘型MCI,但差别均无统计学意义。随着观察时间的延长,各组的生存率均逐渐下降。与正常组相比,MCI及各型MCI患者的生存率均较低。结论 MCI的死亡率与痴呆转化率均高于认知正常组,且分型后不同亚型MCI的转归有所不同。Objective To study the outcome of mild cognitive impairment（MCI） in community-dwelling elderly people in Guiyang City. Methods The subjects were derived from a prevalence investigation in Guiyang in 2004-2005 and divided into MCI group and normal cognitive（NC） group, who were identified according to the results of MMSE screening, were followed up for three years. The different conversion rates of MCI and NC subjects were calculated respectively and the survival rates for each group were analyzed by using life table. Results According to the inclusion and exclusion criteria, 343 cases of subjects （246 amnestic MCI（aMCI）, 97 non-amnestic MCI（naMCI） and 2200 NC subjects were enrolled for the follow-up study. At the end of the study In 2008, 560 subjects（25.3%） of NC group were lost from the follow up, while 82 cases （23.9%） of MCI group were lost （including 65 cases of aMCI and 17 cases of naMCI）. There was no significant difference between NC and MCI group and between different subtypes of MCI. A total of 261 cases of MCI and 2 200 cases of NC were followed up. There were 12.6% died and 5.7% developed dementia in MCI group. The rates were significantly higher than those in NC （8.7% and 1.7%）. For aMCI and naMCI, the mortality was 12.2% and 13.8%; the conversion rates of dementia were 5.5% and 6.3%, respectively. On the other hand, 19.3% of aMCI and 12.5% of naMCI kept stability, and 63.0% of aMCI and 67.4% of naMCI returned to the normality. There was no significant difference between aMCI and naMCI. With the extended observation time, the survival rate of each group was gradually decreased. Compared with the normal group, the survival rate of MCI and different subtypes of MCI patients were lower. Conclusion The mortality and the conversion rate of dementia were higher in MCI than in NC group, and the outcome of different subtypes of MCI was different. Further research on MCI subtypes will he helpful to understand the natural history of MCI.

关 键 词：社区老年人 轻度认知功能损害 亚型 生存率 转归 

分 类 号：R195.4[医药卫生—卫生统计学]