老年轻度认知功能障碍的差异性研究

Heterogeneity among elderly patients with mild cognitive impairment

目的探讨老年轻度认知功能障碍(mild cognitive impairment,MCI)患者在认知功能表现上的异质性及其与痴呆转归的相关性。方法以全套中国修订韦氏记忆量表和韦氏成人智力量表为评估工具,对56例老年MCI患者进行全面神经心理学检测,通过聚类分析评价其在认知领域中的差异性,并探讨其可能的痴呆转归。结果聚类分析共产生6类MCI患者,其中类别1、3表现为包括记忆功能的多个认知领域损害,类别2、6表现为不包括记忆功能的多个认知领域损害,类别4、5以记忆损害为主。进一步对6类MCI患者的神经心理特征分析提示其存在不同痴呆转归的认知损害特点。结论 MCI患者在其总体认知水平上存在明显差异,神经心理学检查在预测不同MCI患者痴呆转归方面可能具有帮助。

Objective To investigate the heterogeneity of cognitive function in elderly patients with mild cognitive imp- airment （MCI）. Methods A clinical sample of 56 older adults diagnosed with MCI was examined by Wechsler Memory Scale- Chinese Revised Version （WMS-RC） and Wechsler Adult Intelligence Scale- Chinese Revised Version （WAIS-RC）. A cluster analysis was performed to assess the heterogeneity of neuropsychological characteristics in this group of elderly pa- tients with MCI, and subsequently to discuss the possible conversion to dementia in all subtypes. Results Six new subgroups were produced by cluster analysis. Group 1 and 2 showed an impairment of multiple cognitive domains including memory. Group 2 and 6 showed an impairment of multiple cognitive domains but without memory deficits. And group 4, group 5 characterized by the presence of isolated memory impairment. Further analysis on the neuropsychological features between these 6 subgroups of MCI was performed, and it has been assumed that each MCI subtype is associated with an increased risk for a particular type of dementia. Conclusions MCI represents a condition with heterogeneity of neuropsychological characteristics in elderly patients. Neuropsychological tests may be useful to predict the conversion from MCI to dementia.