部队老年人轻度认知损害的发生及向Alzheimer病的转化情况

The prevalence of mild cognitive impairment and the conversion rate from MCI to Alzheimer disease among elderly veterans

目的调查部队老年人轻度认知损害(MCI)的发病率及向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个部队休干所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,对患病率调查时诊断为MCI的216例患者和2302名认知正常受试者进行为期3年的队列研究,比较MCI患者和认知正常受试者AD的平均年发病率。结果认知正常的老年人MCI的发病率为4.8%(人年),AD的平均年发病率为0.8%(人年);MCI患者AD的平均年发病率为5.6%(人年);男性和女性MCI患者AD的平均年发病率差别无统计学意义(P>0.05);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<0.05);而随着年龄的增长,MCI患者AD的平均年发病率有增高的趋势(P<0.01)。MCI转化为AD的相对危险性为认知正常者的7.4倍。结论军队老年MCI患者转化为AD的危险性远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。

Objective To evaluate the prevalelence of MCI and the conversion rates from MCI to Alzheimer disease （AD） among elderly veterans . Methods The subjects were derived from a prevalence investigation of MCI in Shijiazhuang, in 2001. A total of 216 MCI and 2 302 normal cognitive （NC） subjects were followed up for an average of 3 years. The dementia and AD were diagnosed by neurologists using the DSM-IV and NINCDS-ADRDA criteria. The conversion rates were calculated by using the person-year method. Results The incidence of MCI among elderly NC subjects was 4.8 per 100 person-year and the incidence of AD was 0. 8 per 100 person-year. The conversion rates from MCI to AD were 5.6 per 100 person-year, but no significant difference was found between men and women （P〉0. 05）. There was a trend of increase in the conversion rate to AD with the age increasement in MCI subjects （P〈 0. 01）. The conversion rate of MCI to AD were decreased with the elevated degree of education （P〈 0. 05）. The relative risk for MCI subjects converting to AD was 7.4 times that for NC subjects. Conclusions The conversion rate from MCI subjects to AD among elderly veterans is much higher than that from the normal cognitive subjects. There are sufficient data to recommend that the evaluation and clinical monitoring of persons with mild cognitive impairment should be reinforced due to their increased risk for AD development.