轻度认知障碍患者转为痴呆症的预测因素:低体温的作用

Journal of Clinical Medicine Research Pub Date : 2023-04-01 Epub Date: 2023-04-28 DOI:10.14740/jocmr4883
Kannayiram Alagiakrishnan, Prabhpaul Dhami, Ambikaipakan Senthilselvan
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摘要

背景:轻度认知障碍(MCI)患者可发展为痴呆症。研究表明,神经心理测试、生物或放射标记物单独或联合使用有助于确定从 MCI 转为痴呆症的风险。这些技术既复杂又昂贵,而且这些研究并未考虑临床风险因素。本研究探讨了人口统计学、生活方式和包括低体温在内的临床因素,这些因素可能在老年患者从 MCI 转为痴呆症的过程中发挥作用:在这项回顾性研究中,我们对在阿尔伯塔大学医院就诊的 61-103 岁患者进行了病历审查。研究人员通过电子数据库从患者病历中收集了有关 MCI 发病、人口、社会和生活方式因素、痴呆症家族史和临床因素以及基线当前用药的信息。此外,还确定了 5.5 年内从 MCI 转为痴呆症的情况。研究人员进行了逻辑回归分析,以确定与 MCI 转为痴呆症相关的基线因素:基线 MCI 患病率为 25.6%(335/1,330)。在5.5年的随访期间,43%的受试者(143/335)从MCI转为痴呆。与MCI转为痴呆症明显相关的因素包括痴呆症家族史(几率比(OR):2.78,95% 置信区间(CI):1.56 - 4.95,P = 0.001)、蒙特利尔认知评估(MoCA)得分(OR:0.91,95% CI:0.85 - 0.97,P = 0.01)和低体温(低于36 °C)(OR:10.01,95% CI:3.59 - 27.88,P < 0.001):结论:除痴呆症家族史和MoCA外,低体温也与MCI转为痴呆症有关。这项研究有助于临床医生识别哪些MCI患者最有可能转化为痴呆症。
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Predictors of Conversion to Dementia in Patients With Mild Cognitive Impairment: The Role of Low Body Temperature.

Background: Subjects with mild cognitive impairment (MCI) can progress to dementia. Studies have shown that neuropsychological tests, biological or radiological markers individually or in combination have helped to determine the risk of conversion from MCI to dementia. These techniques are complex and expensive, and clinical risk factors were not considered in these studies. This study examined demographic, lifestyle and clinical factors including low body temperature that may play a role in the conversion of MCI to dementia in elderly patients.

Methods: In this retrospective study, a chart review was conducted on patients aged 61 to 103 years who were seen at the University of Alberta Hospital. Information on onset of MCI and demographic, social, and lifestyle factors, family history of dementia and clinical factors, and current medications at baseline was collected from patient charts on an electronic database. The conversion from MCI to dementia within 5.5 years was also determined. Logistic regression analysis was conducted to identify the baseline factors associated with conversion from MCI to dementia.

Results: The prevalence of MCI at baseline was 25.6% (335/1,330). During the 5.5 years follow-up period, 43% (143/335) of the subjects converted to dementia from MCI. The factors that were significantly associated with conversion from MCI to dementia were family history of dementia (odds ratio (OR): 2.78, 95% confidence interval (CI): 1.56 - 4.95, P = 0.001), Montreal cognitive assessment (MoCA) score (OR: 0.91, 95% CI: 0.85 - 0.97, P = 0.01), and low body temperature (below 36 °C) (OR: 10.01, 95% CI: 3.59 - 27.88, P < 0.001).

Conclusion: In addition to family history of dementia and MoCA, low body temperature was shown to be associated with the conversion from MCI to dementia. This study would help clinicians to identify patients with MCI who are at highest risk of conversion to dementia.

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