老年人认知功能对不同亚型MCI预测作用  

Changes of cognitive function and their predictive value to different subtypes of mild cognitive impairment among the elderly

作　　者：蒋芝月[1] 黄文湧[1] 杨敬源[1] 杨星[1] 汪俊华[1] 邓厚才[1] 

机构地区：[1]贵阳医学院公共卫生学院流行病学教研室,贵州贵阳550004

出　　处：《中国公共卫生》2013年第8期1150-1153,共4页Chinese Journal of Public Health

基　　金：国家自然科学基金(30860245);贵州省省长资金项目[黔省专合字(2007)47];贵州省科技攻关项目(黔科合S字[2007]1042)

摘　　要：目的了解老年人认知功能领域在轻度认知功能损害(mild cognitive impairment,MCI)发生过程中的变化特点,探索不同认知功能领域对不同亚型MCI的预测价值。方法于2008年7—10月对2004—2005年在贵州省贵阳市城区采用分层整群抽样方法抽取的26个社区居委会的2 197名≥60岁认知正常老年人进行随访调查,按照随访结局分为正常对照组及不同亚型MCI组,分析认知功能领域在MCI发生过程中的变化特点及不同认知领域对不同亚型MCI发生的预测作用。结果本次调查完成随访者1 409人,随访率为64.13%;其中认知正常者1 279人,遗忘型轻度认知功能损害(aMCI)72例,非遗忘型轻度认知功能损害(naMCI)34例,痴呆24例;aMCI组老年人基线语言词汇运用力得分为(3.65±0.56)分,低于正常对照组老年人的(3.78±0.46)分(t=-2.196,P=0.022);naMCI组老年人基线记忆力、计算力、视空间能力和总体认知功能得分分别为(7.97±1.66)、(3.15±1.46)、(0.41±0.49)和(25.32±2.67)分,均低于正常对照组老年人的(9.08±1.89)、(4.01±1.39)、(0.71±0.45)和(27.21±2.65)分(P<0.05);aMCI组老年人记忆力、计算力、视空间能力和总体认知功能得分分别下降(3.33±2.17)、(2.26±1.56)、(0.27±0.63)和(3.97±2.98)分,naMCI组老年人定向力、语言词汇运用力、语言词汇理解力和总体认知功能得分分别下降(1.59±1.81)、(0.41±0.70)、(0.62±1.18)和(3.82±2.61)分,与正常对照组老年人比较,差异均有统计学意义(P<0.05);在控制年龄、文化程度、职业后,记忆力和语言词汇运用力对aMCI组老年人的发生有预测意义(P=0.000);计算力和视空间能力对naMCI的发生有意义(P<0.05)。结论不同亚型MCI老年人认知功能领域变化不同,对早期区别不同亚型MCI有预测作用。Objective To study the changes and determinants of cognitive function and to explore its predictive value to different subtypes of mild cognitive impairment（MCI）among the elderly in Guiyang city. Methods Using multistage sampling,2 197 people aged 60 years and older were selected from urban communities in Guiyang for a baseline survey in 2004-2005 and followed up in 2008.The subjects were divided into normal cognitive（NC）and different subtypes of MCI groups according to the outcomes of follow-up examination.The cognitive function was assessed by using the Mini-Mental State Examination（MMSE）,and logistic regression model was used to analyze the predictive value of cognitive function for different subtypes of MCI. Results A total of 1 409 participants completed follow-up examination,with a follow-up rate of 64.13%.Among the elderly,there were 1 279 with normal cognitive function,72 cases of amnestic mild cognitive impairment（aMCI）,34 cases of nonamnestic mild cognitive impairment（naMCI）,and 24 cases of dementia.The aMCI cases had a lower score（3.65±0.56）in using vocabulary compared with the normal control group（3.78±0.46）in baseline study.The naMCI cases had lower scores in memory,computing power,visual-spatial ability,and overall cognitive function compared with the normal control group.The scores of memory,computing power,visual-spatial ability,and overall cognitive function in aMCI group decreased to 3.33±2.17,2.26±1.56,0.27±0.63,and 3.97±2.98,respectively.The scores of orientation,ability of using vocabulary,the understanding of language,and overall cognitive funciton in naMCI group declined to 1.59±1.81,0.41±0.70,0.62±1.18,and 3.82±2.61,respectively.After controlling for age,education level and occupation,the memory and ability of using vocabulary showed a value for prediction to aMCI,and so did the computing power and visual-spatial ability to naMCI. Conclusion There are different changes in cognitive functions among the elderly with different subtypes of MCI and the chan

关 键 词：老年人 轻度认知功能损害 遗忘型 非遗忘型 随访研究 

分 类 号：R749.1[医药卫生—神经病学与精神病学]