阿尔茨海默病患者日常生活能力下降影响因素分析

To analysethe factors affecting the decline in the level of activities of daily living in patients with Alzheimer’s disease

目的:对影响轻中度阿尔茨海默病患者日常生活能力下降的因素进行分析。方法:对64例轻中度阿尔茨海默病患者进行16周的随访调查,调查开始及16周后均行简易智能状态量表(MMSE)、蒙特利尔认知评估量表(MoCA)、日常生活能力量表(ADCS-ADL)、阿尔茨海默病评价量表-认知分量表(ADAS-cog)等评估。结果:未用药组入组前MMSE评分、MoCA评分、ADCS-ADL评分及ADAS-cog评分分别为20.50±3.53分、18.67±7.01分、17.50±11.73分及45.17±4.28分,16周观察期后分别为18.25±6.23分、17.92±6.96分、18.67±12.23分及43.67±7.72分,均有恶化趋势,但前后差异没有统计学意义;单用药组入组前MMSE评分、MoCA评分、ADCS-ADL评分及ADAS-cog评分分别为19.50±4.50分、17.30±5.47分、16.13±9.24分及46.50±5.59分,16周观察期后分别为22.73±4.88分、17.83±6.34分、14.50±8.20分及48.58±5.63分,在MMSE评分、ADAS-cog评分和ADCS-ADL评分较前有改善,差异有统计学意义;联用药组入组前MMSE评分、MoCA评分、ADCS-ADL评分及ADAS-cog评分分别为18.75±2.63分、18.58±5.02分、19.08±18.00分及42.58±6.59分,16周观察期后分别为24.83±6.22分、19.67±4.10分、16.42±15.54分及48.00±5.83分,16周后的评分较入组前的评分均有改善,差异有统计学意义。多元线性回归分析显示,受教育程度、基础ADCS-ADL评分、抗痴呆治疗方案及照料对于ADCS-ADL评分变化有影响,P<0.05。结论:尽早联合应用抗痴呆类药物及加强照料具有改善AD患者日常生活能力的作用,而受教育程度也在其中起到积极的作用。

Objective To analyze the factors influencing the decline of Ability of daily life in patients with mild to moderate Alzheimer’s disease.Methods 64 patients with mild to moderate Alzheimer’s disease were followed up for 16 weeks.MMSE,MoCA,ADCS-ADL and ADAS-cog were assessed at the beginning and after 16 weeks.Results In the group without anti dementia drugs,MMSE score,MoCA score,ADCS-ADL score and ADAS-cog score were 20.50±3.53,18.67±7.01,17.50±11.73 and 45.17±4.28,respectively.After 16 weeks of observation,they were 18.25±6.23,17.92±6.96,18.67±12.23 and 43.67±7.72,respectively,all with deterioration trend,but there was no statistical significance before and after the observation;In thegroup treated with single anti dementia drug,the MMSE score,MoCA score,ADCS-ADL score and ADAS-cog score were 19.50±4.50,17.30±5.47,16.13±9.24 and 46.50±5.59,respectively,and they were 22.73±4.88,17.83±6.34,14.50±8.20 and 48.58±5.63 after 16 weeks of observation.There were significant differences in MMSE score,ADAS-cog score and ADCS-ADL score;The MMSE score,MoCA score,ADCS-ADL score and ADAS-cog score were 18.75±2.63,18.58±5.02,19.08±18.00 and 42.58±6.59 respectively in the combination group,and they were 24.83±6.22,19.67±4.10,16.42±15.54 and 48.00±5.83 respectively after 16 weeks of observation,the score was improved and the difference was statistically significant.Multiple linear regression analysis showed that education level,basic ADCS-ADL score,anti dementia treatment plan and care had influence on ADCS-ADL score(P<0.05).Conclusions Early combination of anti dementia drugs and intensive care can improve the ability of daily life of AD patients,and education also plays a positive role.