Faster Cognitive and Functional Decline in Dysexecutive versus Amnestic Alzheimer's Subgroups: A Longitudinal Analysis of the National Alzheimer's Coordinating Center (NACC) Database

ObjectiveTo compare the rate of cognitive and functional decline in dysexecutive, typical and amnestic subgroups of Alzheimer’s disease.Methods943 participants from the National Alzheimer’s Coordinating Center (NACC) database who had a diagnosis of probable AD were followed for a mean of 2.3 years. A dysexecutive subgroup (n = 165) was defined as having executive performance >1.5 SD worse than memory performance, an amnestic subgroup (n = 157) was defined as having memory performance >1.5 SD worse than executive performance and a typical subgroup (n = 621) was defined as having a difference in executive and memory performance of ResultsCompared with the amnestic subgroup, the dysexecutive subgroup declined 2.2X faster on the Folstein MMSE (pConclusionsA dysexecutive subgroup of AD has a unique disease course in addition to cognitive phenotype.研究目的：对比阿尔茨海默病（Alzheimer’s Disease）执行功能障碍型、典型型及遗忘型亚组的认知与功能衰退速率。 研究方法：纳入国家阿尔茨海默病协调中心（National Alzheimer’s Coordinating Center, NACC）数据库中943名确诊为很可能阿尔茨海默病（probable AD）的参与者，平均随访时长为2.3年。其中，执行功能障碍亚组（n=165）的定义为执行功能得分较记忆功能得分低1.5个标准差以上；遗忘型亚组（n=157）的定义为记忆功能得分较执行功能得分低1.5个标准差以上；典型亚组（n=621）的定义为执行功能与记忆功能得分差值处于[原文存在截断]范围内。 研究结果：与遗忘型亚组相比，执行功能障碍亚组的福斯坦简易精神状态检查表（Folstein MMSE）得分下降速率快2.2倍（p值[原文未完整呈现]）。 研究结论：阿尔茨海默病的执行功能障碍亚组不仅具备独特的认知表型，还存在独特的疾病进程。