CAJ | 학술논문

目的：淡漠是一个多维度概念。本实验旨在通过神经心理学检测发现 AD 患者淡漠症状的潜在的支配因素，以及探讨这些潜在因子与其他临床症状的相关性，为淡漠的病因学提供线索。方法①52例淡漠 AD 患者与36例非淡漠 AD 患者分别接受人口学及神经心理学检测并进行两独立样本 t 检验对比；②用Pearson 相关回归分析淡漠与人口学及神经心理学的相关性；③对 AES－C 量表进行主成分因子分析；④多重线性回归模型分析 AES－C 量表派生的因子与认知及 NPI 各子量表的关系。结果淡漠与非淡漠组 AD 患者在性别、年龄、发病年龄、病程、教育程度方面比较，差异无统计学意义（P＞0．05），但淡漠组整体认知水平低于非淡漠组（P＜0．01）；淡漠的严重程度与认知功能，尤其是额叶执行功能呈负相关（r ＝－0．61，P＜0．01）；与照顾者负担正相关（r＝0．66，P＜0．01））。 AES－C 量表派生出2个因子：认知－行为因子与社交淡漠因子，其中前者主要与认知和抑郁相关（R2＝0．50），后者与抑郁与睡眠相关（R2＝0．24）。结论淡漠与整体认知尤其是执行功能关系密切，且会给照顾者带来巨大负担。 AD 患者的淡漠症状可以解离为2个维度因子，而这些因子与不同的临床症状相关，这些相关性可能对淡漠症状的病因学提供重要线索。
목적：담막시일개다유도개념。본실험지재통과신경심이학검측발현 AD 환자담막증상적잠재적지배인소，이급탐토저사잠재인자여기타림상증상적상관성，위담막적병인학제공선색。방법①52례담막 AD 환자여36례비담막 AD 환자분별접수인구학급신경심이학검측병진행량독립양본 t 검험대비；②용Pearson 상관회귀분석담막여인구학급신경심이학적상관성；③대 AES－C 량표진행주성분인자분석；④다중선성회귀모형분석 AES－C 량표파생적인자여인지급 NPI 각자량표적관계。결과담막여비담막조 AD 환자재성별、년령、발병년령、병정、교육정도방면비교，차이무통계학의의（P＞0．05），단담막조정체인지수평저우비담막조（P＜0．01）；담막적엄중정도여인지공능，우기시액협집행공능정부상관（r ＝－0．61，P＜0．01）；여조고자부담정상관（r＝0．66，P＜0．01））。 AES－C 량표파생출2개인자：인지－행위인자여사교담막인자，기중전자주요여인지화억욱상관（R2＝0．50），후자여억욱여수면상관（R2＝0．24）。결론담막여정체인지우기시집행공능관계밀절，차회급조고자대래거대부담。 AD 환자적담막증상가이해리위2개유도인자，이저사인자여불동적림상증상상관，저사상관성가능대담막증상적병인학제공중요선색。
Objective To explore the phenomenology of apathy in a series of AD participants by examining the underlying dimensions of the behaviors and their associated clinical features.Methods We performed a clinical cross-sectional observational study by recruiting 88 patients who met NINCDS-ADRDA criteria for AD.①52 apathy AD patients and 36 AD patients without apathy underwent demographic and neuropsychological testing , then compare the data of two groups in two independent samples t-test; ②Analysis correlation of the apathy with the demographic and neuropsychological score; ③We then took factor analysis to define specific underlying dimensions of apathy; ④Regression models were developed to determine the associated NPI subscores and the derived dimensions.Results There is no significant difference in gender, age, disease of onset, duration of disease, level of education between apathy and non-apathy AD patients (P>0.05) .However, compare to non-apathy group, apathy patients had lower overall cognitive level (P<0.01); the severity of apathy was negatively correlated with decline of cognitive function, <br> especially the frontal executive function(r=-0.61, P<0.01); positively correlated with caregiver burden (r =0.66, P<0.01).AES-C scale derived two factors: cognitive-behavioral factors and social apathy factor, where the former is mainly associated with cognitive and depression ( R 2 =0.50 ), the latter with depression and sleep-related (R2 =0.24).Conclusion Apathy and overall cognitive function especially executive function is closely related which leads to a huge burden to caregivers.