JAMA Neurol:老年人群Aβ病变、海马萎缩状态与多个领域认知衰退的关系

2017-11-08 zhangfan MedSci原创

研究认为,在80岁以上的高龄无痴呆症状老年人群中,超过75%的老人存在Aβ病变或和海马萎缩。不同的Aβ病变与海马萎缩状态老年人群在记忆、语言以及执行能力方面存在较大差异

阿尔茨海默病脑部病理状况异常率随着年龄的增长而增高。高龄老人中临床前生物标志物分布及其临床意义的研究十分有限,许多无痴呆症状的老人其生物标志物检测却成阳性。近日研究人员对无痴呆症状高龄人群的生物标志物状态与多个领域的长期认知衰退模式之间的关系进行了考察。

本次纵向观察研究随访12.2年,总计197名参与者参与,参与者无痴呆症状,能够进行核磁神经影像学研究。所有参与者中175人参与了结果分析,其中140人(80%)认知正常,35人(20%)存在中度认知障碍。依据参与者的生物标志物进行分层,包括Aβ阴性(Aβ-)/神经退行性阴性(ND-)、Aβ阳性(Aβ+)/ND-、Aβ-/神经退行性阳性(ND+)以及Aβ-/ND+。多领域评估包括记忆、执行功能、语言、视觉空间推理、注意力和精神运动速度。利用线性混合模型对认知衰退斜率进行了评价,调整参与者年龄、性别以及教育年限。

175名参与者中,71人为女性,平均年龄86.0岁,年龄跨度82-95岁,其中42名(24.0%)参与者为Aβ-/ND-, 32人 (18.3%)为Aβ+/ND-, 35人(20.0%)为Aβ-/ND+, 66 (37.7%)人为Aβ+/ND+。Aβ+/ND+组在所有领域的认知评估中均表现出最严重的认知衰退。相对于Aβ-/ND-组,Aβ+/ND-组在语言和视觉记忆力、执行控制操作以及语言方面存在快速衰退;Aβ-/ND+组视觉记忆领域存在快速衰退。

研究认为,在80岁以上的高龄无痴呆症状老年人群中,超过75%的老人存在Aβ病变或和海马萎缩,但不同的Aβ病变与海马萎缩状态老年人群在记忆、语言以及执行能力方面存在较大差异。

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    2017-11-25 yinhl1978
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    2018-07-05 chendoc252
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    2017-11-10 膀胱癌