摘要
目的研究Alzheimer病(AD)患者发病前后认知功能的改变及发病预测因子。方法于2004年对46例AD患者(2000年未发病)及167名正常老年人(正常对照组)采用简易精神状态检查(MMSE)量表进行检查,并与2000年的检查结果比较。用Logistic多元回归分析寻找AD预测因子。结果AD组2000年的MMSE量表执行、时间定向、空间定向、延迟记忆、计算、注意亚项以及总分显著低于正常对照组(P<0.05~0.01),阅读、命名、识记、构图、书写得分与正常对照组差异无统计学意义;2004年仅命名得分与正常对照组差异无统计学意义,其他各项得分均显著低于正常对照组(P<0.05~0.01)。AD组2004年MMSE的命名、构图、时间定向、空间定向得分和总分显著低于2000年(均P<0.05)。正常对照组2004年命名、构图、时间定向得分显著低于2000年(均P<0.05),其余各亚项以及总分与2000年差异无统计学意义。将两组2000年与2004年MMSE得分的差值进行秩和检验,AD组识记、时间定向、空间定向和延迟记忆得分差值平均秩次显著大于正常对照组(均P<0.05);AD组以上亚项得分的下降程度大于正常对照组。Logistic多元回归分析,空间定向和延迟记忆亚项的OR值分别为2.12和1.49(P<0.001,P<0.05),为AD独立的预测因子。结论AD患者在临床发病之前其时间定向、空间定向、延迟记忆、计算、注意、执行得分已经明显降低;发病后又出现命名、构图得分下降。老年人MMSE空间定向和延迟记忆得分下降是提示有发生AD危险的预测因子。
Objective To investigate the change of cognition function and predictor factors in the patients with Alzheimer's disease (AD) before and after onset. Methods 46 AD patients who were not demented in 2000 and 167 normal old people (normal control group) were examed with the mini-mental state examination (MMSE) in 2004, compared with those in 2000. The cognitive predictor of AD was found with Logistic regression analyses. Results Compared with the normal control group, the total score of the MMSE and these subscales: orientation to time, orientation to place, delayed memory, calculation, attention and following commands in AD group in 2000 were decline( P 〈0. 05 -0. 01 ). In 2004, the total score and most subscales except naming in AD group were decline compared with the normal control group(P 〈0. 05 -0.01 ). Compared with in 2000, AD group in 2004 exhibited on naming, design copy, orientation to time and place and the total score were significative decline( all P 〈0.05 ), while the normal control group exhibited decline only on naming, design copy and orientation to time (all P 〈 0.05 ). The rates of decline in immediate memory, orientation to time, orientation to place, delayed memory and total score were faster in AD group than those in normal control group ( P 〈 0. 05 ). Logistic regression analyses indicated the OR of rientation to place was 2.12( P 〈0. 001 ) , the OR of delayed memory was 1.49( P 〈0.05 ). Rientation to place and delayed memory may be cognitive predictors of future development to AD. Conclusions The preclinical AD patients present cognitive deficits in orientation to time, orientation to place, delayed memory, calculation, attention and following commands. After onset of become AD, they present decline in naming, design copy too. Orientation to place and delayed memory may be the cognitive predictors of future development to AD.
出处
《临床神经病学杂志》
CAS
北大核心
2008年第2期91-93,共3页
Journal of Clinical Neurology