阿尔茨海默病患者淡漠综合征的临床评价研究

Study of clinical assessment on apathetic syndrome of Alzheimer's disease

目的评价阿尔茨海默病(Alzheimer’s disease,AD)患者应用淡漠评估量表临床医师评定版(apathy evaluation scale-clinician administered,AES-C)评估的价值,探讨阿尔茨海默病患者淡漠症状的影响因素。方法选取26例阿尔茨海默病患者为研究组(n=26),同时选择26例正常对照组(n=26)。对2组分别进行以淡漠评估量表(AES-C)为主的多个量表评定。收集患者年龄、性别、文化程度等一般资料,评估AES-C量表的内部一致性。通过单因素分析相关影响因素,探讨AES-C得分和认知功能损害的联系。结果年龄、文化程度相关系数分别为0.169和-0.162(P<0.05),表明AES-C与年龄呈弱正相关,与文化程度呈弱负相关;研究组患者中淡漠症状的存在与认知功能的定向力、记忆力、执行能力及总体水平呈负相关(P<0.05);研究组和对照组AES-C与GDS得分之间的相关系数为0.423,二者存在弱相关,差异具有统计学意义(r=0.423,P<0.05)。结论淡漠评估量表可靠性较好,可用于评估阿尔茨海默病淡漠症状。淡漠在阿尔茨海默病患者中普遍存在,淡漠症状的严重程度与认知功能损害呈显著相关,这些患者的认知功能损害程度也越严重。阿尔茨海默病患者的淡漠发生可能与认知功能减退、年龄和抑郁症状等多种因素相关。

Objective To evaluate the effect of apathy evaluation scale-clinician administered(AES-C)on patients with Alzheimer's disease and to explore the affecting factors for apathetic symptom.Methods A total of 26 cases meeting the prognosis of Alzheimer's disease were selected as study group,and at the same moment 26 healthy persons were selected as control group.A great many scales mainly including AES-C were used to assess apathetic symptom in the two groups.We gathered clinical data containing age,gender,education and so on to estimate the internal consistency of AES-C.According to the application of statistical software,we performed the analysis of affecting factors by univariate analysis and explored the relationship between AES-C scores and cognitive impairment.Results AES-C scores had outstanding correlations with age and education,and the correlation coefficients of them were 0.169and-0.162(all P<0.05),which showed that AES-C scores were weakly positively correlated with age and negatively correlated with education.In the study group,apathetic symptom was negatively correlated with the cognitive function,memory,executive ability and overall level(all P <0.05).The correlation coefficient between AES-C and GDS score was0.423,and there was a weak correlation and the difference was statistically significant(r=0.423,P<0.05).Conclusion Apathy evaluation scale which is applied to evaluate apathetic symptom has better reliability.The occurrence of apathetic symptom may be related to cognitive dysfunction,age,depression and other factors.