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E-ISSN : 2733-4538
본 연구는 경도인지장애(Mild cognitive impairment)를 발병 연령을 기준으로 조기발현 경도인지장애(EOMCI)와 지연발현 경도인지장애(LOMCI)로 구분하여 신경심리학적 특징과 치매로의 진행률을 알아보고자 하였다. 조기발현 경도인지장애 환자 59명과 지연발현 경도인지장애 환자 91명을 대상으로 초기 신경심리학적 특징을 비교해본 결과, EOMCI가 LOMCI에 비해 대면 이름대기 능력, 의미적 단어 유창성이 높은 것으로 나타났다. 추적 신경심리평가를 통해 두 집단의 인지 기능의 변화와 치매로의 진행률을 살펴본 결과, EOMCI는 기억력을 평가하는 레이 복합 도형 검사의 즉각 회상에서 호전되는 수행을 보인 반면, LOMCI는 더욱 저하된 수행을 보였다. 치매로의 연간 진행률(Annual conversion rate)은 EOMCI가 9.8%, LOMCI가 17.5%로 나타났다. 또한 치매로의 진행을 예측하기 위해 치매로의 진행 유무에 따라 초기 신경심리 평가를 비교해본 결과, 두 집단에서 모두 치매로 진행한 집단이 진행하지 않은 집단에 비해 기억 과제에서 저조한 수행을 나타냈고, EOMCI 중 치매로 진행한 집단은 기억력 뿐만 아니라 의미적 단어 유창성도 유의하게 낮은 것으로 나타났다. 따라서, EOMCI와 LOMCI는 신경심리학적으로 다른 특징을 나타내는 집단이며, 특히 EOMCI는 인지 기능 장애가 상대적으로 적고 치매로의 진행률이 낮았으며, 정상 인지 기능으로 회귀되는 경우가 많은 바, EOAD의 전단계로 해석하기보다 우울증과 또는 기타 문제로 인해 인지 기능 장애가 초래된 환자들이 포함된 이질적인 집단일 가능성이 시사된다. 끝으로 본 연구의 의의와 제한점을 논의하였다.
The purpose of this study was to investigate the differences in neuropsychological characteristics and the conversion rate to dementia between early onset MCI (EOMCI) and late onset MCI (LOMCI) patients. We enrolled 150 patients with MCI (59 EOMCI, 91 LOMCI). At baseline, EOMCI obtained significantly higher scores in confrontational naming and semantic word fluency test than LOMCI. Compared to baseline, the follow-up data showed that the immediate recall score for visual memory was improved in EOMCI but declined in LOMCI. The annual conversion rate was 9.8% in EOMCI and 17.5% in LOMCI. To predict the conversion from MCI to dementia, we also compared the baseline neuropsychological data between converters and non-converters within the groups. The converters performed significantly low in memory tests in both MCI groups and the EOMCI converters showed additional impairment in semantic word fluency. This study suggests that EOMCI may differ from LOMCI in terms of patterns of cognitive impairment and that EOMCI may be a heterogeneous group, which includes patients with not only a prodromal state of EOAD but also cognitive impairment due to various problems such as depression.
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