Abstract

Background:

Research suggests that actuarial neuropsychological criteria improve the accuracy of mild cognitive impairment (MCI) diagnoses relative to conventional diagnostic methods.

Objective:

We sought to examine the utility of actuarial criteria relative to consensus diagnostic methods used in the National Alzheimer’s Coordinating Center (NACC) Uniform Data Set (UDS), and more broadly across the continuum of normal aging, MCI, and dementia.

Methods:

We compared rates of cognitively normal (CN), MCI, and dementia diagnoses at baseline using actuarial versus consensus diagnostic methods in 1524 individuals from the NACC UDS.

Results:

Approximately one-third (33.59%) of individuals diagnosed as CN and more than one-fifth (22.03%) diagnosed with dementia based on consensus methods, met actuarial criteria for MCI. Many participants diagnosed with MCI via consensus methods also appeared to represent possible diagnostic errors. Notably, the CN_a/CN_c group (i.e., participants diagnosed as CN based on both actuarial [_a] and consensus [_c] criteria) had a lower proportion of apolipoprotein E ɛ4 carriers than the MCI_a/MCI_c group, which in turn had a lower proportion of ɛ4 carriers than the dementia (Dem)_a/Dem_c group. Proportions of ɛ4 carriers were comparable between the CN_a/CN_c and CN_a/MCI_c, MCI_a/MCI_c and MCI_a/CN_c, MCI_a/MCI_c and MCI_a/Dem_c, and Dem_a/Dem_c and Dem_a/MCI_c groups. These results were largely consistent with diagnostic agreement/discrepancy group comparisons on neuropsychological performance.

Conclusion:

The present results extend previous findings and suggest that actuarial neuropsychological criteria may enhance diagnostic accuracy relative to consensus methods, and across the wider continuum of normal aging, MCI, and dementia. Findings have implications for both clinical practice and research.

中文翻译：

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精算神经心理学标准在正常衰老、轻度认知障碍和痴呆症的连续过程中的效用的证据

摘要

背景：

研究表明，与传统诊断方法相比，精算神经心理学标准提高了轻度认知障碍 (MCI) 诊断的准确性。

客观的：

我们试图检查精算标准相对于国家阿尔茨海默病协调中心 (NACC) 统一数据集 (UDS) 中使用的共识诊断方法的效用，更广泛地跨越正常衰老、MCI 和痴呆的连续性。

方法：

我们使用精算与共识诊断方法在 NACC UDS 的 1524 名个体中比较了基线时认知正常 (CN)、MCI 和痴呆症的诊断率。

结果：

根据共识方法，大约三分之一 (33.59%) 被诊断为 CN 的个体和超过五分之一 (22.03%) 被诊断为痴呆的个体符合 MCI 的精算标准。许多通过共识方法诊断为 MCI 的参与者似乎也代表了可能的诊断错误。值得注意的是，CN _a /CN _c组（即根据精算 [ _a ] 和共识 [ _c ] 标准诊断为 CN 的参与者）载脂蛋白 E ɛ 4 携带者的比例低于 MCI _a /MCI _c组，后者反过来，ɛ 4 携带者的比例低于痴呆 (Dem) _a /Dem _c团体。的比例ɛ 4个载波是可比较的CN之间_一个/ CN _ç和CN_一个/ MCI _ç，MCI_一个/ MCI _ç和MCI_一个/ CN _ç，MCI_一个/ MCI _ç和MCI_一个/ DEM _ç，和DEM_一个/ DEM _c和 Dem _a /MCI _c组。这些结果与神经心理学表现的诊断一致性/差异组比较基本一致。

结论：

目前的结果扩展了先前的研究结果，并表明精算神经心理学标准可能会提高相对于共识方法的诊断准确性，以及更广泛的正常衰老、MCI 和痴呆的连续性。研究结果对临床实践和研究都有影响。