社区老人轻度认知功能损害和早期老年痴呆发生率调查及5年随访分析  

Mild Cognition Impairment and Early-stage Alzheimer's Disease of the Elderly Population in Community: A Survey and 5-year Follow-up

作　　者：谭友果[1] 甘枝勤[1] 蔡端芳 杨秀英[1] 刘波[1] 

机构地区：[1]自贡市精神卫生中心,四川自贡643020

出　　处：《四川医学》2016年第12期1326-1329,共4页Sichuan Medical Journal

基　　金：2012年自贡市重点科技计划项目(编号:2012506)

摘　　要：目的筛查老人认知功能损害和早期阿尔采莫氏病(AD)人群,并分析危险因素,了解同一人群MCI和早期AD人群时点发生率和危险因素变化情况。方法在社区随机抽取400例老人,使用自编的老年一般情况调查表、蒙特利尔认知评估量表(CMOCA)、简易精神状态检查表(MMSE)、体检和必要的辅助检查,筛查出MCI和早期AD人群,并对筛查出的MCI和早期AD人群的一般资料进行分析,了解MCI和早期AD人群的易发因素,随后在每年同一时间对同一人群重测CMOCA、MMSE等,并连续观察5年,最后对完成5年随访的MCI和AD患者进行追踪分析,以了解在无干预状况下MCI和早期AD患者的转归情况。结果入组的400例老人中,共筛查出CMOCA异常并符合MCI诊断患者151例(MCI组),符合轻度AD者78例(早期AD组),5年后仅190例完成随访,其中MCI组有79例,早期AD组有52例;MCI组5年来MCI异常率从43.77%上升到53.16%,CMOCA平均分从(24.95±2.88)下降到(21.35±2.26),早期AD组5年来异常率从22.63%上升到27.37%,平均分值从(21.64±1.87)下降到(19.64±2.13);显示5年中MCI异常率上升了10个百分点,早期AD异常率5年上升了5个百分点,两组不同年龄比较,80岁以上组异常率增加和均分值下降要大于70岁和60岁组。结论无论是MCI还是早期AD人群,当没有任何认知功能干预时,MCI和早期AD在老年人群中发病率均会逐年上升,而且年龄越大,患MCI和早期AD的风险就越高。Objective To screen population with mild cognition impairment（ MCI） and early-stage Alzheimer＇s disease（ AD）,analyze the risk factors of MCI and AD in the elderly population,and to investigate the time-point incidence of MCI and early-stage AD and the change of risk factors in the same population. Methods A total of 400 elderly people were randomly selected in the community. Self-compiled general questionnaire of the elderly,the Montreal Cognitive Assessment Scale（ CMOCA）,the Mini-Mental State Examination（ MMSE）,physical examination and necessary examinations were used to screen out population with MCI and early-stage AD. General data of the elderly screened out with MCI and early-stage AD were analyzed to investigate the susceptibility factors of MCI and AD. The same population received a 5-year follow-up and was tested using CMOCA,MMSE at the same time each year so as to understand the outcome of MCI and early-stage AD without intervention. Results Among a total of400 old people,151 cases with CMOCA abnormalities accorded with the diagnosis of MCI（ MCI group） and 78 cases were screened out with early-stage AD（ AD group）. Only 190 cases finished the 5-year follow-up,79 cases in MCI group and 52 cases in AD group. The abnormal rate of MCI in MCI group increased from 43. 77% to 53. 16% in 5 years,the average score of CMOCA decreased from（ 24. 95 ± 2. 88） to（ 21. 35 ± 2. 26）,while the changes in the AD group was 22. 63% to 27. 37%,（ 21. 64 ±1. 87） to（ 19. 64 ± 2. 13） respectively. The abnormal rate of MCI increased by 10 percentage points in 5 years,and the rate of early-stage AD increased by 5 percentages in 5 years. The increase of abnormal rate and decrease of average CMOCA in the80-year-old group were more obvious than in the 70-year-old and 60-year-old groups. Conclusions The incidence rate of MCI andearly-stage AD would increase without any intervention in the elderly. And the elder the patient was,the greater the risk of MCI and early-stage AD.

关 键 词：MCI AD发生率 5年随访 

分 类 号：R749.16[医药卫生—神经病学与精神病学]