阿尔茨海默病与轻度认知功能障碍患者精神行为症状比较分析

Comparative Analysis of Behavioral and Psychological Symptoms of Dementia in Patients with Alzheimer’s Disease and Mild Cognitive Impairment

目的通过分析阿尔茨海默病(Alzheimer’s disease,AD)与轻度认知功能障碍(mild cognitive impairment,MCI)患者精神行为症状的异同,为阿尔茨海默病与轻度认知功能障碍的精神行为症状(behavioral and psychological symptoms of dementia,BPSD)诊疗提供指导。方法采用神经精神问卷(neuropsychiatric inventory,NPI)评估来自云南省的71例AD患者、31例MCI患者精神行为症状的发生率、严重程度,并与70例正常对照者比较。结果抑郁、焦虑、易激惹的发生率及严重程度,AD与MCI组比较差异无统计学意义(P>0.05),而MCI组高于正常对照组(P<0.05)。淡漠发生率AD组与MCI组比较差异无统计学意义(P>0.05),淡漠严重程度AD组高于MCI组(P<0.05);而MCI组淡漠发生率及严重程度高于正常对照组(P<0.05)。NPI总分、其余症状发生率或严重程度AD组高于MCI组(P<0.05),而MCI组发生率或严重程度与正常对照组比较差异无统计学意义(P>0.05)。结论AD患者总体BPSD较MCI患者严重,而抑郁、焦虑、易激惹症状在AD与MCI患者之间无差异,MCI处于正常衰老与AD之间的认知变化过渡阶段,伴有这些症状的MCI患者需要重视,及早干预。

Objective To provide the guidance for the management of patients with Alzheimer’s disease(AD)and mild cognitive impairment(MCI)by analyzing the similarities and differences between them.Methods The Neuropsychiatric Inventory(NPI)was used to assess the prevalence and severity of behavioral and psychological symptoms of dementia in 71 patients with AD and 31 patients with MCI from Yunnan Province compared with 70 normal controls.Results The incidence and severity of depression,anxiety,and irritability were not significantly different between the AD and MCI groups(P>0.05),whereas they were higher in the MCI group than in the normal control group(P<0.05).There was no significant difference in the incidence of apathy between AD and MCI groups(P>0.05),and the severity of apathy was higher in the AD group than that in the MCI group(P<0.05).However,the incidence and severity of apathy in the MCI group were higher than those in normal controls(P<0.05).The NPI total score and the incidence or severity of the remaining symptoms were higher in the AD group than in the MCI group(P<0.05),whereas there were no significant differences in the incidence or severity between the MCI group and normal controls(P>0.05).Conclusion The overall BPSD of AD patients is more severe than that of MCI patients,while the symptoms of depression,anxiety,and irritability are not different between AD and MCI patients.MCI is at the transition stage of cognitive changes between normal aging and AD,and MCI patients with these symptoms need to be paid attention to and intervened early.