Conversion to Alzheimer's disease dementia from normal cognition directly or with the intermediate mild cognitive impairment stage.

IF 13 1区医学 Q1 CLINICAL NEUROLOGY Alzheimer's & Dementia Pub Date : 2024-11-19 DOI:10.1002/alz.14393

Xinlin Lu, Yahui Zhang, Yichen Tang, Charles Bernick, Guogen Shan

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Abstract

Introduction: Progression to Alzheimer's disease (AD) dementia from normal cognition (NC) can follow different trajectories, with most progressing through a recognizable mild cognitive impairment stage (NC-MCI-AD), while some individuals transition quickly from NC to AD dementia (NC-AD).

Methods: We compared demographic characteristics, health factors, and cognitive and functional assessments across three time points: the first NC visit, the last NC visit, and the first AD dementia visit.

Results: The NC-MCI-AD group showed greater impairment in cognitive and functional scores at AD dementia diagnosis, despite maintaining better cognitive function during the NC stage. Analysis of yearly changes revealed negligible differences during NC. However, the yearly change during the AD dementia stage suggested potentially more rapid functional decline in the NC-AD group.

Discussion: These findings highlight the heterogeneity in AD disease progression and emphasize the importance of considering diverse progression patterns in AD research and clinical practice.

Highlights: We investigated the disease progression difference between patients who converted to Alzheimer's disease (AD) dementia from normal cognition (NC) directly or through the mild cognitive impairment (MCI) stage. We found that the NC-MCI-AD group showed greater impairment in cognitive and functional scores at AD dementia diagnosis. We discovered that the NC-AD group had rapid functional decline once patients were confirmed with AD onset.

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从正常认知直接转为阿尔茨海默氏症痴呆，或进入轻度认知障碍中期阶段。

导言：从正常认知（NC）发展到阿尔茨海默病（AD）痴呆症可能会经历不同的轨迹，大多数人都会经历一个可识别的轻度认知障碍阶段（NC-MCI-AD），而有些人则会从NC迅速过渡到AD痴呆症（NC-AD）：我们比较了三个时间点的人口统计学特征、健康因素、认知和功能评估：首次NC就诊、最后一次NC就诊和首次AD痴呆就诊：结果：尽管NC-MCI-AD组在NC阶段保持了较好的认知功能，但在诊断出AD痴呆症时，NC-MCI-AD组的认知和功能评分受损程度更大。对年度变化的分析表明，NC期间的差异可以忽略不计。然而，AD痴呆阶段的年度变化表明，NC-AD组的功能衰退可能更快：讨论：这些发现凸显了AD疾病进展的异质性，强调了在AD研究和临床实践中考虑不同进展模式的重要性：我们研究了从认知正常（NC）直接或通过轻度认知障碍（MCI）阶段转为阿尔茨海默病（AD）痴呆患者的疾病进展差异。我们发现，NC-MCI-AD 组患者在确诊为 AD 痴呆症时，其认知和功能评分受损程度更大。我们发现，NC-AD 组患者一旦被确诊为 AD 发病，功能就会迅速下降。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Alzheimer's & Dementia 医学-临床神经学

CiteScore

14.50

自引率

5.00%

发文量

299

审稿时长

3 months

期刊介绍： Alzheimer's & Dementia is a peer-reviewed journal that aims to bridge knowledge gaps in dementia research by covering the entire spectrum, from basic science to clinical trials to social and behavioral investigations. It provides a platform for rapid communication of new findings and ideas, optimal translation of research into practical applications, increasing knowledge across diverse disciplines for early detection, diagnosis, and intervention, and identifying promising new research directions. In July 2008, Alzheimer's & Dementia was accepted for indexing by MEDLINE, recognizing its scientific merit and contribution to Alzheimer's research.