HKU-AHMU成套量表在不同年龄健康人群中的应用

Age-related differences in HKU-AHMU neuropsychological assessment among healthy crowds

目的探讨年龄相关认知功能变化并建立适用于国人的成套神经心理学量表。方法2018年4月至2020年12月采用横断面研究和年龄分层抽样方法,招募安徽省合肥市及周边乡镇社区496例健康受试者,并根据年龄分组(每10岁为一组),采用香港大学-安徽医科大学共同建立的成套神经心理学测验(简称HKU-AHMU成套量表)评估认知功能,该成套量表涵盖注意与执行功能[包括数字广度测验(DST)、气球叉掉测验(BT)、数字警觉测验(DVT)、符号数字转换测验(SDMT)、数字颜色连线测验(CTT)和Stroop色词测验(SCWT)]、记忆功能[包括中文Rey听觉-词汇学习测验(C-RAVLT)和Ruff路线学习测验(RULIT)]、视空间能力[包括Hooper视觉组织测验(HVOT)和线段方向判定测验(JLOT)]、额叶流畅性[包括词语流畅性测验(VFT)和图形流畅性测验(FFT)]共4个维度。结果最终439例完成HKU-AHMU成套量表测验。各年龄组患者DST正序(H=134.423,P=0.000)和倒序(H=178.474,P=0.000)正确个数,BT-A(H=155.433,P=0.000)和BT-B(H=64.204,P=0.000)反应时间,DVT反应时间(H=224.078,P=0.000)和错误个数(H=92.227,P=0.000),SDMT书写(H=229.057,P=0.000)和口述(H=226.566,P=0.000)正确个数,CTT-A反应时间(H=184.292,P=0.000)、CTT-B反应时间(H=194.624,P=0.000)和错误个数(H=20.699,P=0.001),SCWT点反应时间(H=74.683,P=0.000)、词汇反应时间(H=116.839,P=0.000)和词汇错误个数(H=5.555,P=0.000)、色词反应时间(H=84.786,P=0.000)和色词错误个数(H=12.188,P=0.000),C-RAVLT即刻回忆(F=58.765,P=0.000)、延迟回忆(H=160.660,P=0.000)和再认(H=96.833,P=0.000),RULIT即刻回忆正确(H=104.902,P=0.000)和错误(H=86.966,P=0.000)个数、延迟回忆正确(H=115.839,P=0.000)和错误(H=124.834,P=0.000)个数,HVOT(F=12.186,P=0.000)和JLOT(H=48.597,P=0.000)正确个数,VFT蔬菜水果词汇(H=32.565,P=0.000)和动物词汇(H=55.000,P=0.000),FFT评分(F=64.207,P=0.000)差异均有统计学意义,且随着年龄的增长,注意与执行功能、记忆功能、视空间能力、额叶流畅性这4个认知域功能下降,尤以40岁以上人群显著。结论HKU-AHMU成套量表采用的神经心理学测验适用于内地人群,且随着年龄的增长,认知功能均呈现年龄相关性下降。

Objective To explore age-related changes in cognitive function and establish a complete set of neuropsychological scales suitable for Chinese people.MethodsFrom April 2018 toDecember 2020,a cross-sectional study and age stratified sampling method were used to recruit 496 healthysubjects in Hefei,Anhui and surrounding township communities,and grouped them according to age(each 10 years old as a group).A set of neuropsychological tests jointly established by the University of Hong Kong and Anhui Medical University(Battery for HKU-AHMU)was used to assess cognitive function.The complete set of scales covered attention and executive functions[including Digital Span Test(DST),Balloons Tests(BT),Digital Vigilance Test(DVT),Symbol Digit Modalities Test(SDMT),Color Trail Test(CTT)and Stroop Color-Word Test(SCWT)],memory function[including Chinese Rey Auditory-Verbal Learning Test(C-RAVLT)and Ruff Light Trail Learning Test(RULIT)],visuospatical ability[including Hooper Visual Organization Test(HVOT)and Judgment of Line Orientation Test(JLOT)],frontal fluency[including Verbal Fluency Test(VFT)and Figure Fluency Test(FFT)]having 4 dimensions.Results Among groups,the score of DST-forward(H=134.423,P=0.000)and backward(H=178.474,P=0.000);the reaction times of BT-A(H=155.433,P=0.000)and BT-B(H=64.204,P=0.000);the reaction time(H=224.078,P=0.000)and errors number(H=92.227,P=0.000)of DVT;the score of SDMT writing(H=229.057,P=0.000)and oral(H=226.566,P=0.000);the reaction times of CTT-A(H=184.292,P=0.000)and CTT-B(H=194.624,P=0.000),the errors number of CTT-B(H=20.699,P=0.001);the reaction timesof SCWT-spot(H=74.683,P=0.000),SCWT-word(H=116.839,P=0.000)and SCWT-color word(H=84.786,P=0.000),the errors number of SCWT-word(H=5.555,P=0.000)and SCWT-color word(H=12.188,P=0.000);the score of C-RAVLT-immediate recall(F=58.765,P=0.000),delayed recall(H=160.660,P=0.000)and recognitions(H=96.833,P=0.000);the number of RULIT-immediate recalls correct(H=104.902,P=0.000)and incorrect(H=86.966,P=0.000),the number of delayed recalls correct(H=115.839,P=0.000)and incorrect(H=124.834,P=0.000);the score of HVOT(F=12.186,P=0.000)and JLOT(H=48.597,P=0.000);the score of VFT-vegetable and fruit(H=32.565,P=0.000)and VFT-animal vocabulary(H=55.000,P=0.000);the score of FFT(F=64.207,P=0.000)were significantly different.The four cognitive domains of attention and executive functions,memory function,visuospatial ability,and frontal fluency decreases with age,especially in people over 40 years of age.Conclusions The neuropsychological tests adopted in the Battery for HKU-AHMU are applicable to the mainland population and shows age-related declines in cognitive function with increasing age.