INTRODUCTIONProgression to Alzheimer's disease (AD) dementia from normal cognition (NC) can follow different trajectories, with most progressing through a recognizable mild cognitive impairment stage (NC–MCI–AD), while some individuals transition quickly from NC to AD dementia (NC–AD).METHODSWe compared demographic characteristics, health factors, and cognitive and functional assessments across three time points: the first NC visit, the last NC visit, and the first AD dementia visit.RESULTSThe NC–MCI–AD group showed greater impairment in cognitive and functional scores at AD dementia diagnosis, despite maintaining better cognitive function during the NC stage. Analysis of yearly changes revealed negligible differences during NC. However, the yearly change during the AD dementia stage suggested potentially more rapid functional decline in the NC–AD group.DISCUSSIONThese findings highlight the heterogeneity in AD disease progression and emphasize the importance of considering diverse progression patterns in AD research and clinical practice.Highlights We investigated the disease progression difference between patients who converted to Alzheimer's disease (AD) dementia from normal cognition (NC) directly or through the mild cognitive impairment (MCI) stage. We found that the NC–MCI–AD group showed greater impairment in cognitive and functional scores at AD dementia diagnosis. We discovered that the NC–AD group had rapid functional decline once patients were confirmed with AD onset.

中文翻译：

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从正常认知直接转化为阿尔茨海默病痴呆或与中间轻度认知障碍阶段转化


引言从正常认知 （NC） 到阿尔茨海默病 （AD） 痴呆可以遵循不同的轨迹，大多数通过可识别的轻度认知障碍阶段 （NC-MCI-AD） 进展，而有些人从 NC 迅速过渡到 AD 痴呆 （NC-AD）。方法我们比较了三个时间点的人口统计学特征、健康因素以及认知和功能评估：第一次 NC 就诊、最后一次 NC 就诊和第一次 AD 痴呆就诊。结果尽管在 NC 阶段保持了较好的认知功能，但 NC-MCI-AD 组在 AD 痴呆诊断中表现出更大的认知和功能评分受损。对年度变化的分析显示，NC 期间的差异可以忽略不计。然而，AD 痴呆阶段的年度变化表明 NC-AD 组的功能可能更快下降。讨论这些发现突出了 AD 疾病进展的异质性，并强调了在 AD 研究和临床实践中考虑不同进展模式的重要性。亮点 我们调查了从正常认知 （NC） 直接或通过轻度认知障碍 （MCI） 阶段转化为阿尔茨海默病 （AD） 痴呆的患者之间的疾病进展差异。我们发现 NC-MCI-AD 组在 AD 痴呆诊断中表现出更大的认知和功能评分损害。我们发现，一旦患者确诊为 AD 发作，NC-AD 组功能迅速下降。