军队老年人轻度认知损害向Alzheimer病转化的5年随访研究

目的研究军队老年人轻度认知损害(MCI)向Alzheimer病(AD)的转化率,为进一步研究AD提供依据。方法以2001年石家庄市26个部队干休所进行MCI患病率调查的2674名60岁及以上的离退休干部为研究对象,对调查时诊断为MCI的216例患者(平均年龄74.2岁)和2302名认知正常的受试者(平均年龄73.9岁)进行为期5年的队列研究,探讨MCI患者向AD的转化率及MCI患者与认知正常的受试者相比较转化为AD的相对危险性(RR)和95%可信区间(95%CI)。结果随访5年后MCI患者的死亡率为7.9%,认知正常受试者为3.4%,差异有统计学意义(P=0.001);老年MCI患者在随访第3年时有16.8%进展为AD,第5年时则有33.7%进展为AD;MCI患者向AD的平均年转化率为6.7/百人年(95%CI=5.4～8.0),认知正常的老年人AD的平均年发病率为0.8/百人年(95%CI=0.6～1.0);男性和女性MCI患者AD的平均年发病率差异无统计学意义(P=0.62);随着文化程度的提高,MCI患者AD的平均年发病率有降低的趋势(P=0.03);MCI患者转化为AD的相对危险性为认知正常者的8.1倍(95%CI=6.1～10.6,P<0.0001)。结论军队老年MCI患者转化为AD的危险性远大于认知正常的老年人,应加强对老年MCI患者这一AD高危人群的监测。

The Conversion Rates from Mild Cognitive Impairment to Alzheimer Disease in Elderly Veterans:A Population-based Five-year Follow-up Study

Objective To evaluate the conversion rates from mild cognitive impairment(MCI) to Alzheimer disease(AD) in elderly veterans during an average of 5 years follow-up.Methods This study was a prospective cohort study based on diagnosis.The study subjects were derived from a prevalence investigation of MCI in Shijiazhuang,China,in the year 2001.A total of 216 MCI subjects(mean age,74.2 years) and other 2 302 normal cognitive(NC) subjects(mean age,73.9 years) were followed up for an average of 5 years.The diagnos...