Stroop色词测验在早期识别阿尔茨海默病中的作用

Application of Stroop color-word test on Chinese elderly patients with mild cogn itive impairment and mild Alzheimer's dementia

目的评估中文版Stroop色词测验(CWT)在识别轻度认知功能损害(MCI)与轻度阿尔茨海默病(AD)中的作用。方法正常老人94名,遗忘型MCI组86名和轻度AD组51名完成包括简易智力状态检查量表(MMSE)和CWT在内的8种神经心理测验。正常老人、MCI和轻度AD组的MMSE总分分别为(28.2±1.5)分、(26.9±1.9)分和(20.1±2.5)分。CWT由3张卡片、每张50字、4种颜色组成。分析指标包括完成每张卡片的耗时数、正确阅读数和干扰量(SIE)。结果SIE与反映执行功能的连线测验、言语流畅性测验有显著的相关性。不管是正常老人还是认知损害患者,读字(卡片A)均快于颜色命名(卡片B)。以卡片C正确数39个为分界,识别轻度AD的敏感性为80.4%,特异性为86.2%。根据SIE指标发现轻度AD患者在处理速度和正确性的关系方面与MCI组的应答策略不同。结论中文版CWT适合在中国老人中应用,有助于早期识别AD,MCI患者和轻度AD患者针对干扰作用的不同表现。

Objective To investigate the applicability of Chinese version Stroop color-word test (CWT) in Chinese elderly patients with mild cognitive i mpairment (MCI) and Alzheimer's dementia (AD). Methods 94 normal elders, 86 amnestic MCI patients and 51 patients with mild AD accepted 8 neuropsychological tests including CWT, mini-mental state examination (MMSE) and Auditory Verbal L earning Test, etc. MMSE total score of the 3 groups were 28.2±1.5, 26.9±1.9 an d 20.1±2.5, respectively. All participants whose education was above junior hig h school accomplished cranial CT or MRI scan. CWT was consisted of 3 cards with 50 characters and 4 colors each card. The analyzed indexes are composed of every card's reading time, correct number and Stroop interference effects (SIE). R esults Correct score of SIE were found to be significant factor affecting ove rall scores of Trail Making Test and Word Fluency Test in normal elderly group. Word reading was faster than color naming among 3 groups. The sensitivity and th e specificity were respectively 80.4% and 86.2% with the boundary of reading cor rect score (39) of card C. Difference for speed-accuracy tradeoff was found betw een MCI and mild AD. Conclusion The modified CWT is applicable for the Chi nese population. Low correct score of CWT occurred in the patients with MCI and mild AD. There was different interference effect between MCI and mild AD.