轻度认知障碍的神经心理损伤特征及其早期识别与干预--预防和延缓阿尔茨海默病的发生

Neuropsychological Impairment Characteristics of MCI and Its Early Detection and Intervention: Prevent and Delay The Onset of AD

轻度认知障碍(mild cognitive impairment,MCI)是介于正常老化和痴呆之间的过渡阶段,MCI患者是阿尔茨海默病(Alzheimer's disease,AD)的风险人群.本文介绍了国际上MCI诊断标准及其变化和修订,提出了理想的诊断模型.根据国内外研究,从认知和精神行为两个方面综述了MCI的神经心理损伤特征及其相应的诊断工具,简要回顾了现有针对MCI开展干预的各种方法.指出早期识别和干预研究需要从实验室小样本扩展到社区大样本老年人群,从横断研究扩展到纵向追踪,综合采用多种识别指标,并结合多种干预方法以达到最优效果.

Mild cognitive impairment （MCI） is an intermediate clinical state between normal aging and dementia, and MCI patients are the risk population for the development of Alzheimer＇s disease （AD）. This article firstly introduced the international diagnosis criteria of MCI and its variations and modifications, and based on the previous findings, we proposed an ideal diagnosis model for MCI detection in which outmeasures included both patient＇s self-report, clinician＇s judgment and objective behavioral and neuropsychological tests as well as various biomarkers through advanced imaging techniques, cerebrospinal fluid analysis, or even urine endogenous formaldehyde analysis, both cross-sectional comparisons of an individual with the norms and longitudinal changes derived from multi-time point measurements were also involved. We reviewed the recent studies on the neuropsychological impairment characteristics of MCI and the corresponding measurement tools from both cognitive and neuropsychiatric aspects such as MMSE, MoCA, NPI and SC1D, and various cognitive intervention methods for MCI were also reviewed. Future research is needed to extend the findings from experimental small samples into community-based large population, as well as from the cross-sectional studies into longitudinal studies, and to adopt multi-detection markers and multi-intervention methods to achieve the optimal effects of early detection and intervention of MCI.