老年人轻度认知功能障碍不同诊断标准的比较

目的 使用广义轻度认知功能损害（MCI）诊断标准了解老年人MCI患病,与Petersen标准进行比较,观察3年后两种标准MCI痴呆发病情况.方法 以465名≥60岁老年人为研究对象,进行神经心理检查,观察MCI患病率,并与Petersen标准进行比较.3年后,对诊断为MCI的患者随访,比较两种标准MCI痴呆发病情况.结果 广义MCI患者76例（16.34％）,与Petersen标准诊断患病情况（50例,10.75％）比较,患病率较高,差异有统计学意义（x2=6.206,P＜0.05）.3年后,76例MCI患者中痴呆发病30例（年发病率为13.16％）,进展为AD者23例,其他类型痴呆7例;按Petersen标准诊断A-MCI组痴呆发病22例（年发病率为14.67％）,全部进展为AD.两种方法诊断的MCI痴呆发病率差异无统计学意义（x2=0.255,P＞0.05）.在广义MCI组内,A-MCI与非A-MCI痴呆发病差异无统计学意义（x2=1.253,P＞0.05）.同时,正常组痴呆发病19例（年发病率为4.54％）,MCI组痴呆发病率高,差异有统计学意义（x2=80.689,P＜0.05）.结论 采用广义MCI诊断标准较Petersen标准诊断MCI患病率高,其包含了更多类型的痴呆临床前体,有利于早期发现MCI及防治.

Comparation of two diagnostic criteria on mild cognitive impairment in an elderly cohort

Objective To investigate the prevalence of mild cognitive impairment （MCI） in an elderly cohort in comparison to the frequency of MCI by Petersen＇s diagnostic criteria.Three year later,the prevalence of dementia in MCI diagnosed by different criteria was compared.Methods Totals of 465 participants aged over 60 years underwent neuropsychological assessment.The prevalence of MCI was assessed in comparison to the frequency of Petersen＇s diagnostic criteria.The MCI were followed up for 3 years.The prevalence of dementia from MCI diagnosed by different criteria was compared.Results MCI was present in 76 subjects （16.34％）,which compared to Petersen＇s diagnostic criteria （10.75％） was higher （x2 =6.206,P ＜ 0.05）.Three year later,30 of the cases with MCI developed dementia,in which 23 developed AD,7 developed other types of dementia.22 of the cases with A-MCI developed AD.The prevalence of dementia didn＇t differ in MCI diagnosed by different criteria （x2 =0.255,P ＞ 0.05）.In MCI group,there was no significant difference in the prevalence of dementia between A-MCI and others （x2 =1.253,P ＞ 0.05）.And 19 of the cases in normal elders developed dementia.The prevalence of dementia in MCI was higher than normal elders （x2 =80.689,P ＜ 0.05）.Conclusions The prevalence of mild cognitive impairment by general diagnostic criteria of MCI adopted in this investigation is higher than that according to Petersen＇s.This diagnostic criteria could include more types of highrisk subjects for later developing dementia and be beneficial to monitoring preclinical state of dementia.