痴呆患者的自知力损害

The insight impairment of dementia patients

目的对轻中度痴呆患者的自知力损害情况进行初步研究。方法轻中度痴呆患者66例,对照组20例,采用痴呆病觉缺失问卷(AQ-D)对受检者及其知情者进行问卷调查。自知力损害得分以AQ-Dd表示。结果痴呆组患者自知力损害明显。AQ-Dd得分与简短精神状态量表(MMSE)、日常生活活动能力量表(ADL)、临床痴呆评定量表(CDR)得分具有显著相关性,其相关系数分别为:r=-0.511(P<0.01),r=0.174(P<0.05),r=0.389(P<0.01)。但自知力损害与性别、年龄、受教育年限和抑郁无显著相关性。结论痴呆患者自知力损害比较常见,疾病的严重程度与自知力损害密切相关,随着痴呆的加重,自知力损害程度也加重。不同类型的痴呆患者自知力损害无显著性差异。

Objective To evaluate the insight impairment in mild and moderate dementia patients. Methods Sixty-six dementia patients （mild and moderate degrees） and 20 controls were assessed with Anosognosia Question- naire- Dementia （AQ-D）. The scores of subjects＇ insight impairment were expressed in AQ-Dd（Anosognosia Questionnaire-Dementia difference）. Results The insight impairment of dementia patients was prominent. The score of AQ-Dd was significantly correlated with the score of MMSE（Mini-Mental State Examination）, ADL（Activities of Daily Living Scale）, and CDR（Clinical Dementia Rating Scale）. The correlation coefficients were -0. 511 （P〈0.01）, 0. 174 （P〈0.05） and 0. 389 （P〈0.01）, respectively. The insight impairment did not correlate with gender, age, educational level and dysthymia. Conclusion Insight impairment was common in dementia patients, even in early dementia ones. In this group of dementia patients, 38% had insight impairment. The severity of dementia closely correlated with insight impairment, and the impairment became severer with the deterioration of dementia. The degree of insight impairment between different types of dementia was not different.