老年性痴呆和轻度认知障碍患者时间地点定向力受损情况探讨

Temporal and Spatial Disorientation in Patients with Alzheimer's Disease and Mild Cognitive Impairment

目的:了解老年性痴呆(AD)患者和轻度认知障碍(MCI)患者的时间地点定向力的受损情况。方法:收集51例AD患者、9例MCI患者和26例正常老人,进行MMSE检查,针对MMSE的总分和时间地点定向10个分项进行分析。结果:MCI组和对照组之间时间定向分、地点定向分、定向力总分无显著差异。MCI患者和轻度AD的时间定向分有显著性差异。轻度与中度AD之间比较,年份、月份、星期、街道和楼层这几个分项的回答正确率有差异。中度与重度AD之间比较,季度、省市、区、街道层、所在地这几个分项的回答正确率有显著差异。结论:随着认知障碍的进展AD和MCI患者的定向力受损也是逐渐加重。在早期认知减退的情况下,个体的时间定向力受损会较地点定向力更为明显。对于认知下降的患者,时间定向力是一个敏感的指标。随着病情的进展,患者的地点定向受损越来越明显。未发现某些分项较其他分项更为敏感。

Objective To explore spatial and temporal disorientation in patients with Alzheimer＇s disease（AD） and mild cognitive impairment（MCI）.Methods 51 AD patients,9 MCI patients and 26 healthy elders （controls） were given the MMSE test.MMSE total score and 10 subset of MMSE items including temporal orientation and spatial orientation were analysed.Results There was no significant difference between MCI and controls in temporal,spatial orientation and MMSE total score.There was no significant difference between MCI and mild AD in spatial orientation.There was significant difference in item of year,month,week,street and floor between mild and moderate AD.There was significant difference in item of season,province,strict,street and place between moderate and severe AD.Conclusions With the cognitive impairment going on,orientation in AD and MCI patients declined gradually.The decline of temporal orientation is more markedly in early stage,while in later stage impairment of spatial orientation became more and more evident.No special items were found to be more sensitive than others.