老年痴呆患者的记忆缺陷

Memory impairment in the elderly with dementia

目的:记忆缺陷在老年痴呆中出现最早并且极为突出,探讨不同类型的痴呆的记忆特征,有助于认识老年期精神疾病中记忆缺陷的发展和变化过程。资料来源:应用计算机检索Medline1999-01/2004-12与老年痴呆的记忆研究相关文献,检索词“Alzheimerdisease,Parkinsondisease,vasculardementia,semanticmemory,episodicmemory”等,并限定文章语言种类为English,分别进行检索并提炼。资料选择:检索到300余篇资料进行初审,纳入标准:①随机对照实验。②研究对象年龄≥65岁。③阿尔茨海默病、帕金森氏病、血管性痴呆三种主要导致痴呆的疾病的文献。排除标准:①实验设计有缺陷。②其他老年期精神障碍的文献。③综述文献、Meta分析类文献、重复研究。资料提炼:共收集到50余篇关于老年痴呆记忆研究相关的文章。研究内容相似的,以实验设计较好并发表在权威杂志者优先。对最终入选的14篇文献进行分析。资料综合:阿尔茨海默病早期以情景记忆缺陷为主,中期语义记忆缺陷较突出,晚期涉及到明显的内隐记忆缺陷;帕金森病主要为工作记忆缺陷;血管性痴呆在肯定多种记忆缺陷的基础上,有待深入研究。结论:老年痴呆存在多个方面的记忆缺陷,且其特点随病情的发展而变化。不同的病种存在不同类型的记忆缺陷。研究老年痴呆的记忆缺陷及动态变化,有助于推动人类记忆研究。

OBJECTIVE： Memory impairment is the earliest and the most frequent symptom in elderly patients with dementia. This paper aimed to investigate the memory characteristics of dementia with various types so as to help to cognize the progress and changes of memory impairment in mental diseases of elderly people. DATA SOURCES： A computer-based search for the articles about memory of senile dementia between January 1999 and December 2004 were performed in Medline database by using the keywords “Alzheimer disease, Parkinson disease, vascular dementia, semantic memory, episodic memory”, and the language was limited to English. STUDY SELECTION： More than 300 articles were searched and checked up primarily according to the inclusion criteria： ①Randomized controlled trials, ②The participants must be older than 65 years old, ③ The articles about dementia induced by Alzhelmer disease, Parkinson disease and vascular disease; and to the exclusion criteria： ①Articles with shortcomings in experimental design, ②Studies on other mental disorders in elderly people, ③reviews, Meta analytic and repeated studies. DATA EXTRACTION： Over 50 related articles to memory in patients with senile dementia were selected. Only articles published in authorized journals and designed better were selected if the studies were similar in their content. Finally 14 articles were selected for further analysis. DATA SYNTHESIS： As to Alzheimer disease, episodic memory impairment was the essential symptom at its early stage, then the semantic memory impairment was obvious in the middle period, and implicit memory would be impaired at its late stage. Impaired working memory characterized the clinical feature of Parkinson disease, and vascular dementia showed impairment in several kind of memory. So they should be studied further. CONCLUSION： Several protests of memory are impaired in elderly peoples with dementia, and characteristics of dementia change with its progress. Memory impairment is various in different types of dementia. It is helpful to advance the studies on human memories by investigating the memory impairment and its dynamic changes in elderly patients with dementia.