CAJ | 학술논문

目的明确神经心理学单项指标对轻度认知损害(MCI)和阿尔茨海默病(AD)诊断的意义. 方法用多层随机整群抽样方法抽样,采用筛查和确诊两阶段法进行调查,实查北京市东直门附近老年人676例.采用简易精神状态检查(MMSE)等神经心理学测评工具对老年人进行认知功能评估,采用AD的诊断标准筛查出认知正常(NCS)组213例(31.5％),AD组167例(24.7％),遗忘型轻度认知损害(aMCI)组186例(27.5％),非AD型痴呆患者110例(16.3％). 结果 AD、aMCI与NCS平均MMSE得分分别为(23.0±5.9)分、(25.9±2.6)分、(28.1±1.7)分.AD与aMCI、AD与NCS、aMCI与NCS间比较MMSE总分下降(均P＜0.01)；AD与aMCI和NCS比较,时间定向、注意计算力、即刻回忆-延迟回忆平均分均降低(均P＜0.01)；aMCI与NCS比较,注意和计算力评分降低(P＜0.01);AD、aMCI与NCS平均故事延迟回忆得分为(15.7±11.7)分、(7.6±4.9)分、(26.5±9.3)分,AD与aMCI、AD与NCS、aMCI与NCS比较,故事延迟回忆得分下降(P＜0.01);AD和aMCI与NCS比较临床痴呆评定升高(P＜0.01),画钟实验得分降低(P＜0.01). 结论神经心理学测评工具无论综合认知功能量表如MMSE还是单项指标如故事延迟回忆对诊断MCI和AD具有肯定的意义.
목적 명학신경심이학단항지표대경도인지손해(MCI)화아이자해묵병(AD)진단적의의. 방법 용다층수궤정군추양방법추양,채용사사화학진량계단법진행조사,실사북경시동직문부근노년인676례.채용간역정신상태검사(MMSE)등신경심이학측평공구대노년인진행인지공능평고,채용AD적진단표준사사출인지정상(NCS)조213례(31.5％),AD조167례(24.7％),유망형경도인지손해(aMCI)조186례(27.5％),비AD형치태환자110례(16.3％). 결과 AD、aMCI여NCS평균MMSE득분분별위(23.0±5.9)분、(25.9±2.6)분、(28.1±1.7)분.AD여aMCI、AD여NCS、aMCI여NCS간비교MMSE총분하강(균P＜0.01)；AD여aMCI화NCS비교,시간정향、주의계산력、즉각회억-연지회억평균분균강저(균P＜0.01)；aMCI여NCS비교,주의화계산력평분강저(P＜0.01);AD、aMCI여NCS평균고사연지회억득분위(15.7±11.7)분、(7.6±4.9)분、(26.5±9.3)분,AD여aMCI、AD여NCS、aMCI여NCS비교,고사연지회억득분하강(P＜0.01);AD화aMCI여NCS비교림상치태평정승고(P＜0.01),화종실험득분강저(P＜0.01). 결론 신경심이학측평공구무론종합인지공능량표여MMSE환시단항지표여고사연지회억대진단MCI화AD구유긍정적의의.
Objective To identify the significance of neuropsychological single-item scales in the diagnosis of mild cognitive impairment (MCI) and Alzheimer's disease (AD).Methods A total of 676 elderly people living around Dongzhimen district in Beijing were recruited using multistage sampling method.Cognitive function was assessed by minimum mental state examination (MMSE)and other scales.MCI was diagnosed based on the criteria proposed by Petersen (1999),and AD was diagnosed based on the NINCDS-ADRDA.Subjects were divided into normal cognitive group (n=213 cases,31.5％),Alzheimer's disease (AD) group (n=167 cases,24.7％),amnestic mild cognitive impairment (aMCI) group (n=186 cases,27.5 ％) and non-AD dementia group (110 cases,16.3 ％).Results The MMSE scores in AD,aMCI and normal groups were 23.0 ± 5.9,25.9±2.6,8.1 ± 1.7,respectively.There were significant differences in MMSE scores between AD,aMCI and NC groups separately (all P＜0.01).Compared with MCI and NC group,th scores of time orientation,attention,calculation and immediate recall and delayed recall were significantly decreased in AD group (all P＜0.01).Comparing with normal group,the scores of attention and calculation were reduced in aMCI group (both P＜0.01).The delayed story recall (DSR) scores in AD,aMCI and NC groups were 15.7 ± 11.7,7.6 ± 4.9,26.5 ± 9.3,respectively.There were significant differences in mean DSR scores between AD,aMCI and NC groups separately (all P＜0.01).Compared with normal group,the clinical dementia rating (CDR) scores were higher and the mean clock drawing task (CDT)scores were lower in AD and aMCI groups (both P＜0.01).Conclusions Both neuropsychological assessment tools such as MMSE and single-item scales such as delayed story recall have the certain significance in the diagnosis of MCI and AD.