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Abstract：
BACKGROUND: Cognitive impairment is the hallmark of Alzheimer\'s disease (AD) and related dementias. However, motor decline has been recently described as a prodromal state that can help to detect at-risk individuals. Similarly, sensory changes, sleep and behavior disturbances, and frailty have been associated with higher risk of developing dementia. These clinical findings, together with the recognition that AD pathology precedes the diagnosis by many years, raises the possibility that non-cognitive changes may be early and non-invasive markers for AD or, even more provocatively, that treating non-cognitive aspects may help to prevent or treat AD and related dementias.
METHODS: A subcommittee of the Canadian Consensus Conference on Diagnosis and Treatment of Dementia reviewed areas of emerging evidence for non-cognitive markers of dementia. We examined the literature for five non-cognitive domains associated with future dementia: motor, sensory (hearing, vision, olfaction), neuro-behavioral, frailty, and sleep. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assign the strength of the evidence and quality of the recommendations. We provide recommendations to primary care clinics and to specialized memory clinics, answering the following main questions: (1) What are the non-cognitive and functional changes associated with risk of developing dementia? and (2) What is the evidence that sensory, motor, behavioral, sleep, and frailty markers can serve as potential predictors of dementia?
RESULTS: Evidence supported that gait speed, dual-task gait speed, grip strength, frailty, neuropsychiatric symptoms, sleep measures, and hearing loss are predictors of dementia. There was insufficient evidence for recommending assessing olfactory and vision impairments as a predictor of dementia.
CONCLUSIONS: Non-cognitive markers can assist in identifying people at risk for cognitive decline or dementia. These non-cognitive markers may represent prodromal symptoms and several of them are potentially amenable to treatment that might delay the onset of cognitive decline.
METHODS: A subcommittee of the Canadian Consensus Conference on Diagnosis and Treatment of Dementia reviewed areas of emerging evidence for non-cognitive markers of dementia. We examined the literature for five non-cognitive domains associated with future dementia: motor, sensory (hearing, vision, olfaction), neuro-behavioral, frailty, and sleep. The Grading of Recommendations Assessment, Development, and Evaluation system was used to assign the strength of the evidence and quality of the recommendations. We provide recommendations to primary care clinics and to specialized memory clinics, answering the following main questions: (1) What are the non-cognitive and functional changes associated with risk of developing dementia? and (2) What is the evidence that sensory, motor, behavioral, sleep, and frailty markers can serve as potential predictors of dementia?
RESULTS: Evidence supported that gait speed, dual-task gait speed, grip strength, frailty, neuropsychiatric symptoms, sleep measures, and hearing loss are predictors of dementia. There was insufficient evidence for recommending assessing olfactory and vision impairments as a predictor of dementia.
CONCLUSIONS: Non-cognitive markers can assist in identifying people at risk for cognitive decline or dementia. These non-cognitive markers may represent prodromal symptoms and several of them are potentially amenable to treatment that might delay the onset of cognitive decline.
摘要：
■认知障碍是阿尔茨海默病（AD）和相关痴呆的标志。然而,运动衰退最近被描述为一种前驱状态，可以帮助检测有风险的个体。同样，感官变化，睡眠和行为障碍，和虚弱与患痴呆症的风险更高有关。这些临床发现，再加上人们认识到AD病理学比诊断早了很多年，提高了非认知变化可能是AD的早期和非侵入性标志物的可能性，更具有挑衅性,治疗非认知方面可能有助于预防或治疗AD和相关痴呆。
■加拿大痴呆症诊断和治疗共识会议的一个小组委员会审查了痴呆症非认知标志物的新兴证据领域。我们检查了与未来痴呆症相关的五个非认知领域的文献：运动，感官(听觉，愿景,嗅觉)，神经行为,脆弱,和睡眠。建议评估的分级，发展,并使用评估系统来分配证据的强度和建议的质量。我们向初级保健诊所和专门的记忆诊所提供建议，回答以下主要问题：（1）与患痴呆症风险相关的非认知和功能变化是什么？（2）感官，电机,行为，睡眠,和虚弱标记可以作为痴呆的潜在预测因子？
■证据支持步态速度，双任务步态速度，握力,脆弱,神经精神症状,睡眠措施，听力损失是痴呆的预测因子.没有足够的证据建议评估嗅觉和视力障碍作为痴呆的预测因子。
■非认知标记可以帮助识别有认知能力下降或痴呆风险的人。这些非认知标记可能代表前驱症状，其中一些可能适合于可能延迟认知下降发作的治疗。
■加拿大痴呆症诊断和治疗共识会议的一个小组委员会审查了痴呆症非认知标志物的新兴证据领域。我们检查了与未来痴呆症相关的五个非认知领域的文献：运动，感官(听觉，愿景,嗅觉)，神经行为,脆弱,和睡眠。建议评估的分级，发展,并使用评估系统来分配证据的强度和建议的质量。我们向初级保健诊所和专门的记忆诊所提供建议，回答以下主要问题：（1）与患痴呆症风险相关的非认知和功能变化是什么？（2）感官，电机,行为，睡眠,和虚弱标记可以作为痴呆的潜在预测因子？
■证据支持步态速度，双任务步态速度，握力,脆弱,神经精神症状,睡眠措施，听力损失是痴呆的预测因子.没有足够的证据建议评估嗅觉和视力障碍作为痴呆的预测因子。
■非认知标记可以帮助识别有认知能力下降或痴呆风险的人。这些非认知标记可能代表前驱症状，其中一些可能适合于可能延迟认知下降发作的治疗。
