Dissecting the clinical and pathological prognosis of MCI patients who reverted to normal cognition: a longitudinal study.

IF 7 1区医学 Q1 MEDICINE, GENERAL & INTERNAL

BMC Medicine Pub Date : 2025-05-06 DOI:10.1186/s12916-025-04092-0

Hai-Hong Yu, Lan Tan, Meng-Jiao Jiao, Yi-Ju Lv, Xin-Hao Zhang, Chen-Chen Tan, Wei Xu

{"title":"Dissecting the clinical and pathological prognosis of MCI patients who reverted to normal cognition: a longitudinal study.","authors":"Hai-Hong Yu, Lan Tan, Meng-Jiao Jiao, Yi-Ju Lv, Xin-Hao Zhang, Chen-Chen Tan, Wei Xu","doi":"10.1186/s12916-025-04092-0","DOIUrl":null,"url":null,"abstract":"Background: Controversy existed in the prognosis of reversion from mild cognitive impairment (MCI) to normal cognition (NC). We aim to depict the prognostic characteristics of cognition, neuroimaging, and pathology biomarkers, as well as the risk of Alzheimer's disease (AD) dementia for MCI reverters.Methods: A total of 796 non-demented participants (mean age = 73.3 years, female = 54.4%, MCI = 55.7%), who were divided into MCI reverters (n = 109), stable MCI (n = 334), and stable NC (n = 353) based on 2-year diagnosis changes, were subsequently followed up for 6 years. Cox proportional hazard regression models were applied to assess the AD dementia hazard. Linear mixed-effect models were used to evaluate the differences in changing rates of cognitive scores, brain volumes, brain metabolism, and AD biomarkers among three groups.Results: The 2-year MCI reversion rate was 18.17%. MCI reversion was associated with an 89.6% lower risk of AD dementia (HR = 0.104, 95% confidence interval = [0.033, 0.335], p < 0.001) than stable MCI. No significant difference in incident AD risk was found between MCI reverters and stable NC (p = 0.533). Compared to stable MCI, reverters exhibited slower decreases in cognitive performance (false discovery rate corrected p value [FDR-Q] < 0.050), brain volumes (FDR-Q < 0.050), brain metabolism (FDR-Q < 0.001), and levels of cerebrospinal fluid β-amyloid1-42 (FDR-Q = 0.008). The above-mentioned differences were not found between MCI reverters and stable NC (FDR-Q > 0.050).Conclusions: Reversion from MCI to NC predicts a favorable prognosis of pathological, neurodegenerative, and cognitive trajectory.","PeriodicalId":9188,"journal":{"name":"BMC Medicine","volume":"23 1","pages":"260"},"PeriodicalIF":7.0000,"publicationDate":"2025-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12054060/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"BMC Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s12916-025-04092-0","RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Controversy existed in the prognosis of reversion from mild cognitive impairment (MCI) to normal cognition (NC). We aim to depict the prognostic characteristics of cognition, neuroimaging, and pathology biomarkers, as well as the risk of Alzheimer's disease (AD) dementia for MCI reverters.

Methods: A total of 796 non-demented participants (mean age = 73.3 years, female = 54.4%, MCI = 55.7%), who were divided into MCI reverters (n = 109), stable MCI (n = 334), and stable NC (n = 353) based on 2-year diagnosis changes, were subsequently followed up for 6 years. Cox proportional hazard regression models were applied to assess the AD dementia hazard. Linear mixed-effect models were used to evaluate the differences in changing rates of cognitive scores, brain volumes, brain metabolism, and AD biomarkers among three groups.

Results: The 2-year MCI reversion rate was 18.17%. MCI reversion was associated with an 89.6% lower risk of AD dementia (HR = 0.104, 95% confidence interval = [0.033, 0.335], p < 0.001) than stable MCI. No significant difference in incident AD risk was found between MCI reverters and stable NC (p = 0.533). Compared to stable MCI, reverters exhibited slower decreases in cognitive performance (false discovery rate corrected p value [FDR-Q] < 0.050), brain volumes (FDR-Q < 0.050), brain metabolism (FDR-Q < 0.001), and levels of cerebrospinal fluid β-amyloid_1-42 (FDR-Q = 0.008). The above-mentioned differences were not found between MCI reverters and stable NC (FDR-Q > 0.050).

Conclusions: Reversion from MCI to NC predicts a favorable prognosis of pathological, neurodegenerative, and cognitive trajectory.

查看原文本刊更多论文

纵向研究MCI患者恢复正常认知的临床和病理预后。

背景：轻度认知障碍（MCI）向正常认知障碍（NC）逆转的预后存在争议。我们的目标是描述认知、神经影像学和病理生物标志物的预后特征，以及MCI逆转者患阿尔茨海默病（AD）痴呆的风险。方法：共796例非痴呆患者（平均年龄73.3岁，女性54.4%,MCI = 55.7%），根据2年诊断变化分为MCI恢复者（n = 109）、稳定型MCI （n = 334）和稳定型NC (n = 353)，随访6年。采用Cox比例风险回归模型评估AD痴呆风险。采用线性混合效应模型评估三组患者认知评分、脑容量、脑代谢和AD生物标志物变化率的差异。结果：2年MCI复发率为18.17%。MCI逆转与AD痴呆风险降低89.6%相关(HR = 0.104, 95%可信区间= [0.033,0.335],p 1-42 （FDR-Q = 0.008）。上述差异在MCI可逆器和稳定NC之间没有发现（FDR-Q > 0.050）。结论：从MCI到NC的逆转预示着病理、神经退行性和认知轨迹的良好预后。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

BMC Medicine 医学-医学：内科

CiteScore

13.10

自引率

1.10%

发文量

435

审稿时长

4-8 weeks

期刊介绍： BMC Medicine is an open access, transparent peer-reviewed general medical journal. It is the flagship journal of the BMC series and publishes outstanding and influential research in various areas including clinical practice, translational medicine, medical and health advances, public health, global health, policy, and general topics of interest to the biomedical and sociomedical professional communities. In addition to research articles, the journal also publishes stimulating debates, reviews, unique forum articles, and concise tutorials. All articles published in BMC Medicine are included in various databases such as Biological Abstracts, BIOSIS, CAS, Citebase, Current contents, DOAJ, Embase, MEDLINE, PubMed, Science Citation Index Expanded, OAIster, SCImago, Scopus, SOCOLAR, and Zetoc.