CAJ | 학술논문

目的比较帕金森病痴呆(PDD)和阿尔茨海默病(AD)患者认知功能损害和精神行为症状的特征.方法本研究为前瞻性病例对照研究,选取2009年7月至2011年7月在宣武医院记忆门诊和运动障碍门诊就诊的AD(59例)和PDD(52例)患者,按照临床痴呆评分量表(CDR)分为轻度痴呆组和中重度痴呆组.应用世界卫生组织-加利福尼亚洛杉矶大学听觉词语学习测验(WHO-UCLA AVLT)、画钟测验(CDT)、神经精神问卷(NPI)等量表对同等痴呆程度的AD和PDD患者的认知功能和精神行为症状等方面进行评估.采用独立样本t检验,多变量变异数分析、x2检验、Mann-WhitneyU检验等方法进行统计学分析.结果 AD与PDD患者即刻记忆、长时记忆以及再认三方面得分差异无统计学意义(P＞0.05)；两组PDD患者CDT得分均较AD患者显著偏低(轻度组:P＜0.001,中重度组:P=0.027)；超过70％的PDD患者出现至少一项精神行为症状,其中轻度痴呆组PDD患者精神行为症状的出现频率[71.40％ (25/35)]及NPI得分[(8.4±9.8)分]均高于AD患者[频率43.2％ (16/37),得分(5.7±11.9)分](P =0.016,0.019).结论 PDD患者在视空间能力、执行功能等方面的损害重于AD患者.轻度痴呆组中,PDD患者精神行为异常较AD患者更为突出.
목적 비교파금삼병치태(PDD)화아이자해묵병(AD)환자인지공능손해화정신행위증상적특정.방법 본연구위전첨성병례대조연구,선취2009년7월지2011년7월재선무의원기억문진화운동장애문진취진적AD(59례)화PDD(52례)환자,안조림상치태평분량표(CDR)분위경도치태조화중중도치태조.응용세계위생조직-가리복니아락삼기대학은각사어학습측험(WHO-UCLA AVLT)、화종측험(CDT)、신경정신문권(NPI)등량표대동등치태정도적AD화PDD환자적인지공능화정신행위증상등방면진행평고.채용독립양본t검험,다변량변이수분석、x2검험、Mann-WhitneyU검험등방법진행통계학분석.결과 AD여PDD환자즉각기억、장시기억이급재인삼방면득분차이무통계학의의(P＞0.05)；량조PDD환자CDT득분균교AD환자현저편저(경도조:P＜0.001,중중도조:P=0.027)；초과70％적PDD환자출현지소일항정신행위증상,기중경도치태조PDD환자정신행위증상적출현빈솔[71.40％ (25/35)]급NPI득분[(8.4±9.8)분]균고우AD환자[빈솔43.2％ (16/37),득분(5.7±11.9)분](P =0.016,0.019).결론 PDD환자재시공간능력、집행공능등방면적손해중우AD환자.경도치태조중,PDD환자정신행위이상교AD환자경위돌출.
Objective To compare the cognitive functions and neuropsychiatric symptoms of Parkinson's disease dementia (PDD) versus Alzheimer's disease (AD).Methods Patients fulfilling the diagnostic and statistical manual of mental disorders,4th edition (DSM-Ⅳ) dementia diagnosis criteria were recruited into this case-control study.AD patients were diagnosed with the criteria of National Institute of Neurologic and Communicative Disorders and Stroke and Alzheimer's Disease and Related Disorders Association (NINCDS-ADRDA) while PDD was based upon the standards of Movement Disorder Society (MDS) Task Force.According to clinical dementia rating (CDR) score,they were divided into mild dementia (CDR score =0.5/1) and moderate-to-severe dementia groups (CDR score =2/3).World Health Organization-University of California,Los Angeles,auditory verbal learning test (WHO-UCLA AVLT),clock drawing test (CDT) and neuropsychiatric inventory (NPI) were performed.Results No significant difference in immediate memory,delayed memory or long-delayed recognition score was observed between PDD and AD patients (P ＞ 0.05).CDT score was significantly lower in PDD patients (mild dementia group:0.9 ± 0.9 ; moderate-to-severe dementia group:0.6 ± 0.9) than that of AD patients (mild dementia group:1.5 ± 0.7,P ＜ 0.001 ; moderate-to-severe dementia group:1.1 ± 0.6,P =0.027) and this difference was more significant in mild dementia group.More than 70％ of PDD patients reported at least one neuropsychiatric symptom.And also,in mild dementia group,compared with AD patients (frequency:43.2％ (16/37),NPI score =5.7 ± 11.9),a higher frequency of neuropsychiatric symptoms and higher NPI scores were observed in PDD patients (frequency:71.40％ (25/35),NPI score =8.4 ± 9.8).Conclusion More severe impairment in visuospatial ability and executive function was present in PDD patients compared with AD patients.And neuropsychiatric symptoms were more common and severe in PDD patients.