Juan Manuel Villalpando, Bernard-Simon Leclerc, Minh Tri Le, Carol Hudon, Aline Bolduc, Marie-Jeanne Kergoat
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引用次数: 0
摘要
阿尔茨海默病是一种进行性疾病,临床前阶段长达数十年。纵向队列研究中的准确分类对于了解疾病进展以及研究之间的可比性和协作至关重要。本系统综述的主要目的是确定和比较以老年人阿尔茨海默病临床连续为中心的前瞻性人群研究队列中使用的诊断标准。对2000年或以后开始的队列研究进行了回顾,随访时间至少为3年,随访对象为居住在该社区的年龄在50至85岁之间的人群。在MEDLINE, Embase, Cochrane, PsycINFO和Web of Science中检索了原始研究。两名独立审稿人同意最终选择28项研究,涵盖25个队列。根据修改后的NIH质量评估工具,由于报告不足,一项研究被三名独立法官确定为具有方法局限性。使用标准化的提取表格从每个纳入的研究中提取数据。总的来说,这些研究只跟踪了不到1500名参与者。结果显示,在25个研究队列中,诊断分类标准的选择趋于一致,特别是对于AD的晚期阶段,而早期阶段的标准则表现出更大的可变性。只有5个队列的研究涉及到疾病的全谱随访。我们的研究可能有助于在阿尔茨海默病的连续体中建立一套统一的临床诊断标准,而不是专门为某项研究制定标准。
A Comparison of Clinical Diagnostic Classification Criteria Used in Longitudinal Cohort Studies of the Alzheimer's Disease Continuum: A Systematic Review.
Alzheimer's is a progressive disease, with a long preclinical phase of many decades. Accurate classification within longitudinal cohort studies is crucial for understanding disease progression and for the comparability and collaboration across studies. The main objective of this systematic review was to identify and compare the diagnostic criteria used in prospective population study cohorts centering on the Alzheimer's disease clinical continuum in older adults. A review was performed of cohort studies started in the year 2000 or later, with a follow-up duration of at least 3 years among people aged between 50 and 85 years old living in the community. Original studies were searched in MEDLINE, Embase, Cochrane, PsycINFO, and Web of Science. Two independent reviewers agreed on the final selection of 28 studies covering 25 cohorts. One study was identified by three independent judges as having methodological limitations due to inadequate reporting as per the modified NIH quality assessment tool. Data was extracted from each included study using a standardized extraction form. In general, the studies followed fewer than 1500 participants. The results showed convergence in the choice of diagnostic classification criteria among the 25 cohorts studied especially for the later stages of AD, while criteria for the earliest stages showed greater variability. Only five cohorts studied were concerned with the follow-up of the full spectrum of the disease. Our study may help to put in place a unified set of clinical diagnostic criteria across the continuum of Alzheimer's disease, rather than criteria developed specifically for a given study.
期刊介绍:
Neuropsychology Review is a quarterly, refereed publication devoted to integrative review papers on substantive content areas in neuropsychology, with particular focus on populations with endogenous or acquired conditions affecting brain and function and on translational research providing a mechanistic understanding of clinical problems. Publication of new data is not the purview of the journal. Articles are written by international specialists in the field, discussing such complex issues as distinctive functional features of central nervous system disease and injury; challenges in early diagnosis; the impact of genes and environment on function; risk factors for functional impairment; treatment efficacy of neuropsychological rehabilitation; the role of neuroimaging, neuroelectrophysiology, and other neurometric modalities in explicating function; clinical trial design; neuropsychological function and its substrates characteristic of normal development and aging; and neuropsychological dysfunction and its substrates in neurological, psychiatric, and medical conditions. The journal''s broad perspective is supported by an outstanding, multidisciplinary editorial review board guided by the aim to provide students and professionals, clinicians and researchers with scholarly articles that critically and objectively summarize and synthesize the strengths and weaknesses in the literature and propose novel hypotheses, methods of analysis, and links to other fields.