@article {Borlande1142作者={艾玛宝蓝和克里斯·埃德加和埃里克Stomrud和尼古拉斯·卡伦和奥斯卡·汉森和塞巴斯蒂安Palmqvist}, title ={认知结果在临床前和临床相关的变化有前驱症状的认知阶段},体积={99}={11},页面= {e1142——e1153} = {2022}, doi = {10.1212 / WNL。出版商0000000000200817}= {Wolters Kluwer健康,公司代表美国神经病学学会},文摘={背景和目标识别具有临床意义的认知测试成绩的变化是至关重要的,当使用认知作为临床首页试验的结果。这是特别相关,因为临床试验越来越功能认知测试的新型复合材料。我们的主要目标是建立最小临床重要差异(MCIDs)常用的认知测试,使用anchor-based和发布出去是依靠方法,我们的二级目标是调查一个复合认知测量最佳预测临床痴呆评定的最小变化{\ textemdash}笔盒(CDR-SB)。从瑞典BioFINDER队列研究方法,我们连续包括认知没有(铜)患者和没有主观或轻度认知障碍(MCI)。我们计算MCIDs与改变> = 0.5或1.0 > = CDR-SB细微精神状态检查的(MMSE), ADAS-Cog延迟回忆十个字列表,斯特鲁,字母S流利,动物流利,象征数字形式测试(SDMT)和Trailmaking测试(TMT) a和B,和三角MCIDs为临床使用铜、MCI、amyloid-positive铜参与者。为研究认知措施的最佳预测改变CDR-SB > = 0.5或> = 1.0点,我们接受者操作特征进行了分析。结果我们的研究包括451名认知正常个体,90年与主观认知能力下降和361在无症状的认知能力下降(池平均随访时间32.4个月,SD 26.8, 12 {\ textendash} 96个月),和292个患有轻度认知障碍(池平均随访时间19.2个月,SD 19.0, 12 {\ textendash} 72个月)。我们确定了潜在的三角MCIDs(认知能力受损;MCI)在一系列的认知测试结果:患者的-1.5,-1.7;ADAS延迟回忆1.4,1.1;斯特鲁5.5,9.3; Animal Fluency: -2.8, -2.9; Letter S Fluency -2.9, -1.8; SDMT: -3.5, -3.8; TMT A 11.7, 13.0; and TMT B 24.4, 20.1. For amyloid-positive CU, we found the best predicting composite cognitive measure included gender and changes in ADAS delayed recall, MMSE, SDMT, and TMT B. This produced an AUC of 0.87 (95\% CI 0.79{\textendash}0.94, sensitivity 75\%, specificity 88\%).Discussion Our MCIDs may be applied in clinical practice or clinical trials for identifying whether a clinically relevant change has occurred. The composite measure can be useful as a clinically relevant cognitive test outcome in preclinical AD trials.AD=Alzheimer Disease; ADAS=Alzheimer{\textquoteright}s Disease Assessment Scale; ADL=activities of daily living; AIC=Akaike Information Criterion; AUC=area under the ROC curve; CDR-SB=clinical dementia rating{\textemdash}sum of boxes; CU=cognitively unimpaired; ES=estimates of effect size; FDA=Food and Drug Administration; MCI=mild cognitive impairment; MCID=minimal clinically important difference; MMSE=Mini-Mental State Examination; PACC=preclinical Alzheimer cognitive composite; RCI=reliable change index; SDMT=Symbol Digit Modalities Test; SRM=standardized response mean; TMT=Trailmaking Test}, issn = {0028-3878}, URL = {//www.ez-admanager.com/content/99/11/e1142}, eprint = {//www.ez-admanager.com/content/99/11/e1142.full.pdf}, journal = {Neurology} }
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