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| DC 欄位 | 值 | 語言 |
|---|---|---|
| dc.contributor.advisor | 黃宗正(Tzung-Jeng Hwang) | |
| dc.contributor.author | Yu-Chung Su | en |
| dc.contributor.author | 蘇佑忠 | zh_TW |
| dc.date.accessioned | 2021-06-16T07:12:52Z | - |
| dc.date.available | 2025-07-16 | |
| dc.date.copyright | 2020-07-20 | |
| dc.date.issued | 2020 | |
| dc.date.submitted | 2020-07-16 | |
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| dc.identifier.uri | http://tdr.lib.ntu.edu.tw/jspui/handle/123456789/57938 | - |
| dc.description.abstract | 背景：過去研究指出非失智症者出現神經精神症狀（NPS）與將來認知退化以及罹患失智症風險有關。輕度行為障礙（MBI）是失智症前驅症狀的新觀點，其描述在晚年持續出現的神經精神症狀。尚未有研究指出臺灣的MBI盛行率與臨床特徵。目的：調查MBI在臺灣非失智症群組之盛行率，並檢驗MBI與認知障礙的關聯及未來罹患失智症的風險。方法：本研究群組包含69名認知功能正常老年受試者與101名輕度認知功能障礙（MCI）病人並持續追蹤六年。使用NPI修正MBI之操作型定義。運用潛在剖面分析（LPA）同時考量NPS與認知功能將受試者分為不同類別。並以Cox比例風險模型探討MBI／非MBI與潛在類別的不同對於將來罹患失智風險之風險。結果：MBI在非失智族群的流行率為9.4%，在MCI族群為14.29%。MBI患者在MMSE、複雜注意力等認知功能測驗表現皆顯著低於非MBI受試者。風險分析納入143名完成MBI測量與至少有一次追蹤者，在六年的追蹤期間，有38位（26.57%）受試者轉變為失智症。然而，Cox比例風險結果顯示MBI患者與非MBI受試者之間罹患失智症的風險並無顯著差異。LPA納入169名受試者，並辨識出四種不同NPS嚴重度與認知功能表現之類別。在四種類別中，轉變為失智症危險比與認知功能受損嚴重程度有增加趨勢。此外，結合類別一、二、四後，NPI 分數與認知功能有顯著關聯性，且在此結合類別中，MBI的預測轉變為失智風險效力也達到顯著。結論：在臨床非失智症群組中，MBI與認知受損有關。但其對於預測將來轉變為失智症（特別是阿茲海默型失智症與血管型失智症）之預測力可能僅限於部分族群。 | zh_TW |
| dc.description.abstract | Background: Previous studies show the presence of neuropsychiatric symptoms (NPS) in non-demented subjects may be associated with an increased risk of progression to dementia. Recently, a new concept, the mild behavioral impairment (MBI), describes the emergence of clinically meaningful NPS in pre-dementia state. It is not clear about the prevalence and clinical characteristics of MBI in Taiwan. Objective: To estimate the prevalence of MBI in a non-demented cohort, and examine whether the presence of MBI was related to cognitive impairment and risk for dementia. Methods: The clinical cohort consisted of 170 participants with cognitively normal (n = 69) or mild cognitive impairment (MCI) (n = 101). MBI was defined with a modified operational definition based on the NPI. Latent profile analysis (LPA) was applied by taking into account of NPS and cognitive function together. Cox proportional hazards model was performed to determine whether MBI or baseline latent profile membership could increase future risk of dementia. Results: The prevalence of MBI was 9.4% among the non-demented cohort and 14.29 % in the MCI sample. Participants with MBI performed worse in MMSE and complex attention compared to those without MBI. Among the 143 participants with a complete MBI measurement and at least one follow-up visit, 38 (26.57%) converted to dementia during follow-up. MBI was not associated with increased risk for future dementia. LPA identified four classes composed of different severity of NPS and cognitive function. Among the four classes, the hazard of conversion to dementia increased as a trend of the severity of the cognitive function but not NPS. There was a significant association between NPS severity and cognitive function among the merged group composed of classes 1, 2, and 4, and MBI became a significant risk factor for future dementia in this merged group. Conclusion: MBI may be associated with cognitive impairment in the non-demented population, but regarding the risk prediction for future dementia (especially Alzheimer's disease and vascular dementia), its clinical utility may be only limited to a subset of population. | en |
| dc.description.provenance | Made available in DSpace on 2021-06-16T07:12:52Z (GMT). No. of bitstreams: 1 U0001-1507202021530700.pdf: 1727879 bytes, checksum: 46455149711fb9e29baf848a6cca3b48 (MD5) Previous issue date: 2020 | en |
| dc.description.tableofcontents | 1. Introduction ............................................................................................................. 1 2. Method .................................................................................................................... 14 2.1. Study design ..................................................................................................... 14 2.2. Inclusion and exclusion criteria ........................................................................ 14 2.3. Assessment of MBI .......................................................................................... 16 2.4. Assessment of neurocognitive function............................................................ 18 2.5. Statistical Analysis ........................................................................................... 19 3. Results ..................................................................................................................... 22 3.1. MBI Prevalence and association with cognitive impairment ........................... 22 3.2. Survival Analysis of MBI ................................................................................. 23 3.3. Latent Profile Analysis ..................................................................................... 25 3.4. The correlation between NPI score and cognitive function among different classes ...................................................................................................................... 27 3.5. Survival Analysis of 4 LPA-generated classes ................................................. 27 4. Discussion ............................................................................................................... 30 4.1. MBI prevalence ................................................................................................ 30 4.2. The relation between MBI and cognitive function ........................................... 31 4.3. MBI as a predictor for future conversion to dementia...................................... 32 4.4. The nature of neuropsychiatric symptoms in the current study ....................... 32 4.5. Use LPA to explore the relationship between NPS, cognitive function, and risk for dementia (AD or VaD) ...................................................................................... 33 4.6.Neurobiological association with MBI and NPS............................................... 37 4.7.Limitations and strengths .................................................................................. 38 5. References .............................................................................................................. 41 Tables .......................................................................................................................... 64 Figures ........................................................................................................................ 74 | |
| dc.language.iso | en | |
| dc.subject | 輕度行為障礙 | zh_TW |
| dc.subject | 輕度認知障礙 | zh_TW |
| dc.subject | 神經精神症狀 | zh_TW |
| dc.subject | 潛在剖面分析 | zh_TW |
| dc.subject | mild behavioral impairment | en |
| dc.subject | mild cognitive impairment | en |
| dc.subject | neuropsychiatric symptoms | en |
| dc.subject | latent profile analysis | en |
| dc.title | 輕度行為障礙在非失智症之前瞻群組研究： 流行率、認知功能受損與失智症風險 | zh_TW |
| dc.title | Mild Behavioral Impairment in a Prospective Non-Demented Cohort: Prevalence, Cognitive Impairment, and Risk for Dementia | en |
| dc.type | Thesis | |
| dc.date.schoolyear | 108-2 | |
| dc.description.degree | 碩士 | |
| dc.contributor.coadvisor | 張玉玲(Yu-Ling Chang) | |
| dc.contributor.oralexamcommittee | 陳達夫(Ta-Fu Chen),傅中玲(Jong-Ling Fuh) | |
| dc.subject.keyword | 輕度行為障礙,輕度認知障礙,神經精神症狀,潛在剖面分析, | zh_TW |
| dc.subject.keyword | mild behavioral impairment,mild cognitive impairment,neuropsychiatric symptoms,latent profile analysis, | en |
| dc.relation.page | 77 | |
| dc.identifier.doi | 10.6342/NTU202001562 | |
| dc.rights.note | 有償授權 | |
| dc.date.accepted | 2020-07-16 | |
| dc.contributor.author-college | 理學院 | zh_TW |
| dc.contributor.author-dept | 心理學研究所 | zh_TW |
| 顯示於系所單位： | 心理學系 | |
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