Using dementia rating scales in the diagnosis of Alzheimer’s disease

Objective： To study the significance of dementia rating scales in the diagnosis of Alzheimer＇ s disease（AD）. Methods： Probable AD patients（118 cases） diagnosed according to NINCDS-ADRDA criteria and the normal controls（100 cases） were examined with a battery of neuropsychological tests and the dementia severity of AD patients was determined with clinical dementia rating （CDR）. Changed neuropsychological characteristics of different AD dementia severities were analyzed. The discriminant analysis and ROC curve analysis were perfomed to analyze the specificity, the sensitivity, and the general accuracy of various dementia rating scales in the diagnosis of AD, and the area under the ROC curve. Results： The total cognition function in mild （CDR = 1 ）, moderate（CDR = 2） and severe stages（CDR=3） of AD had an obvious trend of continuous decline, with the MMSE values 17.44±2.64, 13.90±4.32, and 5.50 ± 3.90 respectively. The trend of decline of the verbal fluency function in AD was same as that of total cognition function. The visuospatial function was reduced in early stage of AD （CDR = 1 ） and completely lost in moderate and severe AD. Delay memory function began to show decline in the early stage of AD, and the decline turned apparent in moderate and severe AD. Immediate memory function showed unchanged in early stage of AD, while showed decline in moderate AD, and the decline became very quick in severe AD. The impairment of daily living ability and social activity function developed with the severity degree of AD. But the decline of social activity function was very quick in moderate stage of AD. In general, the leading scale to diagnose AD was FOM, followed by RVR, POD, MMSE, BD,ADL and DS. When MMSE was combined with one or more of FOM, RVR, BD, DS, the general accuracy in distinguishing AD from the normal controls was improved. Conclusion： Neuropsychological test is useful in the diagnosis of AD, especially in the early stage. The validity is improved when dementia rating scales are combined correctly.

Virtual Cognitive Screenings and Interviews of Patients with Neurodegenerative Conditions Associated with Alzheimer’s Disease and Parkinson’s Disease

The current pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), commonly referred to as COVID-19, brings myriad challenges to research conducted among those more susceptible to the virus. According to the United States (US) Centers for Disease Control (CDC), eight out of ten re-ported COVID-19 deaths are among people > 65 years of age and older. Nonetheless, researchers must continue the crucial work of investigating and understanding diseases that affect the elderly. The focus of this white paper is to assess the challenges associated with research within the elderly population with neurocognitive conditions. Specifically, this paper addresses the need for the standardized administration of performance measures (e.g., neurocognitive assessments) among a dementia population while ensuring the physical safety of participants. Consideration is given to the administration of performance measures and the availability and feasibility of administering these measures remotely to a population that may have difficulty using novel technologies. In implementing remote research assessments, it is suggested that researchers fol-low a GAMMA approach by: 1) establishing clear Guidance on remote visit expectations and processes;2) establishing Appropriate exclusionary criteria in the development of the study design;3) providing subjects Appropriate study Materials for visual processing;4) incorporating Multiple data sources in the overall study design (e.g., caregiver input);and 5) Acknowledging that there will be study limitations as researchers use emerging technology with this patient population, and using mitigation strategies for these limitations where possible.

EEG Analysis of the Contribution of Music Therapy and Virtual Reality to the Improvement of Cognition in Alzheimer’s Disease

Alzheimer’s disease is the most common form of dementia, affecting nearly 9.9 million new people every year. The disease provokes important memory and cognitive impairment, eventually causing individuals to forget their loved ones and rendering them completely dependent on their caretakers. Alzheimer’s patients typically experience more negative emotions, such as frustration and apathy, than healthy older adults. There is currently no cure for the disease. Our research group explores how the integration of virtual reality (VR) and an EEG-based intelligent agent in music therapy can alleviate psychological and cognitive symptoms of the disease. We propose a theory explaining how, through activation of the brain reward system, music can reduce negative emotions, increase positive emotions and as a result increase performance on cognitive tasks. The results of our experimental study concord with our theory: emotional states of participants are improved, as per recorded through EEG, and performances on memory tasks show improvement following the intervention. We believe that the combination of EEG brain assessment, VR and music therapy is a promising method for emotional states and cognitive symptoms of Alzheimer’s disease.

Differences in Cerebral Angioarchitectonics in Alzheimer’s Disease in Comparison with Other Neurodegenerative and Ischemic Lesions

Introduction: The research focuses on the clinical study of cerebral angioarchitectonics and microcirculation disorders in the development of Alzheimer’s disease (AD) in comparison with other neurodegenerative and ischemic lesions. Materials and methods: 1117 patients with different types and stages of neurodegenerative and ischemic lesions were examined, 93 of whom (8.33%) had different stages of AD—Test Group;1024 (91.67%) had cerebral atherosclerosis, Binswanger disease (BD), vascular Parkinsonism (VP)—Control Group. The examination included definition of CDR, MMSE, cerebral CT, MRI, cerebral sciagraphy (SG), rheoencephalography (REG), morphometric detection of AD stages with TDR, and cerebral multi-gated angiography (MUGA). Results: In all patients with AD, regardless of the disease stage, specific сerebral small vessel disease (CSVD), manifested by dyscirculatory angiopathy of Alzheimer’s type (DAAT), was detected in the temporal and fronto-parietal areas. Conclusions: DAAT is an AD-specific lesion of cerebral microvessels that changes hemodynamics, causes cerebral hypoxia, and contributes to impaired amyloid beta metabolism. The combination of deposition of amyloid beta in the cerebral tissue and vascular wall, as well as specific disorders of microcirculation, cause neurodegeneration and AD development. Patients with other neurodegenerative and ischemic lesions had no DAAT manifestations.

Optimizing Alzheimer’s Disease Therapy Using a Neural Intelligent Agent-Based Platform

Alzheimer’s disease affects millions of persons every year. Negative emotions such as stress and frustration have a negative impact on memory function and Alzheimer's patients experience more negative emotions than healthy adults. Non-pharmacological treatment such as immersion in virtual environments could help Alzheimer patients by reducing their negative emotions, but it has restrictions and requirements. In this work, we present three virtual reality relaxing systems in which the patients are immersed in relaxing environments. We propose to use intelligent agents in order to adapt the relaxing environment to each participant and optimize its relaxation effect. The intelligent agents track the emotions of patients using electroencephalography as input in order to adapt the environments. We designed each system with different levels of intelligence in order to analyze the impact of the adaptation on the patients. Experiments were performed for each system on participants with subjective cognitive decline. Results show that these relaxing systems can reduce negative emotions and improve participants’ memory performance. The positive effects on affective state and memory persisted for a longer period of time and were generally more effective for the systems with more intelligence. We believe that the combination of a relaxing environment, virtual reality, intelligent agents for adapting the environment, and brain assessment is a promising method for helping Alzheimer’s patients.

A new direction for Alzheimer's research

Despite decades of research, at present there is no curative therapy for Alzheimer＇s disease. Changes in the way new drugs are tested appear to be necessary. Three changes are presented here and will be discussed. The first change is that Alzheimer＇s disease must be considered a disease of four major pathological processes, not one. The four processes are： 1） vascular hy- poperfusion of the brain with associated mitochondrial dysfunction, 2） destructive protein inclusions, 3） uncontrolled oxidative stress, and 4） proinflammatory immune processes second- ary to microglial and astrocytic dysfunction in the brain. The second change recommended is to alter the standard cognitive measurement tools used to quantify mental decline in test patients. Specifically the Dementia Severity Rating Scale （DSRS） should supersede Mini-Mental State Examination （MMSE） and other popular tests, and a measurement scale developed in research should be used to produce a linear and non-irregular baseline. Finally, accepting the concept that four etiologies cause Alzheimer＇s disease leads to the last necessary change, that new thera- pies must be employed directed against all four causes, likely as a combination. There are drugs ready to be employed in such a combinations which are available and used clinically for other purposes so can be used ＂offlabel＂ and one such combination is suggested.

Evaluation of retinal and choroidal changes in patients with Alzheimer’s type dementia using optical coherence tomography angiography

AIM:To evaluate the changes in fundus parameters in patients with Alzheimer’s type dementia(ATD)using optical coherence tomography angiography(OCTA),to record flash electroretinograms(ERG)using the RETeval system and to explore changes in retinal function.METHODS:Twenty-nine patients with ATD and 26 age-matched normal subjects were enrolled.All subjects underwent OCTA scans to analyse the superficial retinal vessel parameters in the macular area,including the vessel length density,the vessel perfusion density and the area of foveal avascular zone(FAZ),as well as the choroidal thickness.The differences between the patients with ATD and the normal control group were compared and explored the relevant factors affecting vessel parameters.We also recorded the flash ERGs using the RETeval system and intended to explore changes in retinal function by analysing the ERG image amplitude in patients with ATD.RESULTS:The vessel parameters[Pvessel length density=0.005 and Pvessel perfusion density=0.006]and average choroid thickness(P<0.001)in the macular area of the ATD group was less than the control group.The FAZ area was statistically significantly enlarged in the ATD group(P<0.001).These parameters were correlated with the Mini-Mental State Examination(MMSE)score and the Montreal Cognitive Assessment(MoCA).CONCLUSION:Patients with ATD exhibit decreases in the parameters associated with fundus.In addition,these indicators significantly correlate with the MMSE score and the MoCA score.OCTA may be an adjunct tool with strong potential to track changes in the diagnosis and monitoring the progression of the disease.

A longitudinal assessment of retinal function and structure in the APP/PS1 transgenic mouse model of Alzheimer’s disease

Background:A great body of evidence suggests that there are retinal functional and structural changes that occur in Alzheimer’s disease(AD).However,whether such changes are primary or secondary remains to be elucidated.We studied a range of retinal functional and structural parameters in association with AD-specific pathophysiological markers in the double transgenic APP/PS1 and control mice across age.Methods:Electroretinogram(ERG)and optical coherence tomography(OCT)was performed in APP/PS1 and wild type(WT)control mice every 3 months from 3 to 12 months of age.For functional assessment,the a-and b-wave of the ERG,amplitude of oscillatory potentials(OP)and the positive scotopic threshold response(pSTR)were quantified at each time point.For structural assessment,the inner and outer retinal thickness was segmented and measured from OCT scans.Episodic memory was evaluated at 6,9 and 12 months of age using the novel object recognition test.Amyloid beta(Aβ)distribution in the hippocampus and the retina were visualised at 3,6 and 12 months of age.Interand intra-group analysis was performed to study rate of change for each parameter between the two groups.Results:Inter-group analysis revealed a significant difference in b-wave and OPs of APP/PS1 compared to WT controls starting from 3 months(p<0.001).There was also a significant difference in the amplitude of pSTR between the two groups starting from 6 months(p<0.001).Furthermore,a significant difference in the inner retinal thickness,between the two groups,was observed starting from 9 months(p<0.001).Conclusions:We observed an age-related decline in retinal functional and structural parameters in both APP/PS1 and WT controls,however,inter-group analysis revealed that inner retinal functional and structural decline is exacerbated in APP/PS1 mice,and that retinal functional changes precede structural changes in this strain.Further studies are required to confirm whether such phenomenon occurs in humans and if studying retinal functional changes can aid-in early assessment of AD.

Tiaobu Xinshen Recipe (调补心肾方) Improved Mild Cognitive Impairment of Alzheimer’s Disease Patients with Xin (Heart) and Shen (Kidney) Deficiency

Objective: To observe the intervention effects of Tiaobu Xinshen Recipe(调补心肾方, TXR) on patients with mild cognitive impairment caused by Alzheimer’s disease(MCI-AD). Methods: Totally 88 MCI-AD patients with syndrome of Xin(Heart) and Shen(Kidney) deficiency were assigned to the experimental group(47 cases, treated with TXR) and the control group(41 cases, treated with donepezil hydrochloride) using a random number table. Final recruited qualified patients were 44 cases in the experimental group and 39 cases in the control group. The therapeutic course was 12 weeks. Neuropsychological scales [mini mental state examination(MMSE) and Montreal cognitive assessment(MoCA)], and Chinese medicine(CM) dementia syndromes scales were performed in all patients, and results were compared between groups or intra-group before and after treatment. Results: MMSE and Mo CA scores of the two groups were increased after treatment compared with those before treatment(P<0.05). But there was no statistical difference in MMSE or MOCA scores after treatment between the two groups(P>0.05). CM dementia syndrome score was significantly decreased after treatment in the experimental group compared with the control group(P<0.01). Visual spatial and executive function scores and delayed recall scores of the two groups were increased compared with those before treatment(P<0.01). Conclusion: TXR could effectively improve cognitive impairment of MCI-AD patients with syndrome of Xin and Shen deficiency.

轻度认知功能障碍、轻度阿尔茨海默病和正常对照老人的ADAS-Cog中文版评分比较

目的:比较阿尔茨海默病评定量表认知分量表(Alzheimer's Disease Assessment Scale-cognitive subscale,ADAS-Cog)中文版在轻度认知功能损害(Mild Cognitive Impairment,MCI)、正常对照、轻度阿尔茨海默病(Alzheimer's disease,AD)三组老人的评分,分析ADAS-Cog中文版对MCI的区分能力。方法:选择轻度AD患者(n=40)、MCI患者(n=40)、正常对照(NC,n=50)三组老人,采用ADAS-Cog进行评估。结果:不同性别、年龄、受教育年限对ADAS-Cog总分的影响无统计学意义。MCI组的单词回忆、意向性练习、定向力、单词辨认、语言表达、找词能力、语言理解项与ADAS-Cog总分均低于轻度AD组[如ADAS-Cog总分(9.85±8.70)vs.(11.83±5.31),均P<0.05]。MCI组测验指令回忆与ADAS-Cog总分均高于正常对照组[(1.05±0.88)vs.(0.40±0.61),(11.83±5.31)vs.(7.94±3.80);均P<0.01]。轻度AD组除物体命名项外,其他各项与ADAS-Cog总分均高于正常对照组[如ADAS-Cog总分(11.83±5.31)vs.(7.94±3.80),P<0.01]。ADAS-Cog总分区分MCI与轻度AD的曲线下面积(AUC)为0.781,敏感度为85.0%,特异度为60.0%。ADAS-Cog总分区分MCI与正常对照的AUC值为0.719,敏感度为70.0%,特异度为66.0%。结论:轻度认知功能损害的阿尔茨海默病评定量表认知分量表中文版总评分与12子项目评分范围都在轻度阿尔茨海默病与正常对照之间,总评分与部分子项目三组差异较明显。该量表对轻度认知功能损害的区分度一般。

ADAS评估阿尔茨海默病的认知功能研究

目的 分析不同严重度的阿尔茨海默病(AD)患者的认知缺损特征。方法 符合DSM-Ⅳ与NINCDS-ADRDA制定的可能AD诊断标准的AD患者68例,其中轻、中、重度AD分别为27、25和16例。选择正常老人69例作为对照组。采用简明精神状态量表(MMSE)和ADAS-cog评定认知功能。结果 轻度AD组的ADAS-cog总分平均19分,中度AD组34分,重度AD组为46分,ADAS-cog总分变化比MMSE总分能更精确地反映AD患者认知功能的变化。根据项目分变化分析,轻一中度AD以记忆损害为主,重度以语言损害为主。记忆损害在中一重度期间有一个平台期,衰退减速。结论 ADAS-cog可以有效地反映AD的认知缺损,这使它可以作为抗痴呆药物疗效的判定工具,但它的缺点(如被试必须有一定的阅读能力)限制了它在国内的推广应用。

重复经颅磁刺激联合认知训练对阿尔茨海默病患者血清炎症因子及T淋巴细胞亚群的影响

目的探讨重复经颅磁刺激(rTMS)联合计算机认知训练(CCT)对阿尔茨海默病(AD)患者血清炎症因子及T淋巴细胞亚群的影响。方法选取2020年10月至2022年5月在郑州大学第二附属医院治疗且符合纳入标准的76例轻度AD患者作为研究对象,采用随机数字表法将其分为治疗组和对照组,每组各38例。治疗组患者采用rTMS联合CCT治疗,对照组患者采用经颅磁伪刺激联合CCT治疗。治疗后采用简易智能精神状态量表(MMSE)及阿尔茨海默病认知功能评定量表(ADAS-COG)比较两组患者治疗前后的认知功能,并比较两组患者治疗前后的白介素-6(IL-6)、肿瘤坏死因子-α(TNF-α)、γ干扰素(IFN-γ)、杀伤T细胞(TC)、辅助T细胞(TH)及调节性T细胞(Tregs)水平。结果治疗组患者治疗后的IL-6、TNF-α水平低于对照组,差异有统计学意义(P<0.05)。治疗组患者治疗后的TH、Tregs水平高于对照组,差异有统计学意义(P<0.05)。治疗组患者治疗后的ADAS-COG评分低于对照组,MMSE评分高于对照组,差异有统计学意义(P<0.05)。治疗后两组患者的IFN-γ、TC水平比较,差异无统计学意义(P>0.05)。治疗后,治疗组患者的IL-6、TNF-α水平低于本组治疗前,对照组患者的IL-6水平低于本组治疗前,差异有统计学意义(P<0.05)。治疗后,治疗组患者的TH、Tregs水平高于本组治疗前,差异有统计学意义(P<0.05)。治疗后,两组患者的ADAS-COG评分均低于本组治疗前,MMSE评分均高于本组治疗前,差异有统计学意义(P<0.05)。结论rTMS联合CCT能够降低AD患者血清IL-6、TNF-α,提高血清TH、Tregs水平,改善认知功能。

帕金森病患者的营养状况与病情严重程度的临床研究

目的初筛帕金森病(PD)患者的营养状况,进一步评估PD患者营养状况与病情严重程度的关系,为临床医生干预PD患者的营养状况提供依据。方法选取2019年2月至2021年2月在该院就诊的210例PD患者作为PD组,另选取同期该院180例健康体检者作为对照组。采用实验室营养指标、微型营养评估精法(MNA-SF)、PD分级评分量表(H-Y)及统一帕金森病评定量表(UPDRS)第三部分量表调查PD患者的营养状况及其与病情严重程度的关系,并分析MNA-SF评分与UPDRS第三部分量表评分之间的相关性。结果PD组清蛋白、血红蛋白水平及MNA-SF评分均低于对照组,差异均有统计学意义(P<0.05)。PD患者MNA-SF评分随着H-Y分级增高而降低。PD患者MNA-SF评分与UPDRS第三部分量表评分呈负相关(r=-0.54,P<0.05)。结论PD患者营养不良发生率很高,且与病情严重程度相互影响,在临床工作中应重视PD患者的营养状况,对PD合并营养不良的患者应提供营养支持。

阿尔茨海默病病人功能性沟通障碍评估与干预措施的研究进展

对阿尔茨海默病病人功能性沟通障碍的评估、干预方法及实施现状进行综述,旨在提高阿尔茨海默病病人功能性沟通能力及其生活质量。

认知障碍初步评价表在中重度阿尔茨海默病中的初步应用

目的 :探讨认知障碍初步评价表(cognitive-12,COG-12)区分中、重度度阿尔茨海默病(Alzheime’s disease,AD)的能力。方法:61例中度和55例重度阿尔茨海默病患者为研究对象,对所有对象进行COG-12、AD8、MMSE及CDR测试。结果:重度AD患者COG-12、AD8、MMSE总分明显高于中度AD。多元回归分析提示COG-12评分不受被试者年龄及受教育年限的影响。COG-12能有效区分中、重度AD,敏感度为90.9%,特异度为70.5%。结论:COG-12对中、重度AD具有较好的区分能力。

阿尔茨海默病和血管性痴呆患者的认知功能和精神行为症状

目的:比较轻中度阿尔茨海默病(Alzheimer's disease,AD)和血管性痴呆(vascular de-mentia,VD)患者的认知功能损害和精神行为症状的特点。方法:本研究为病例对照研究。选取神经内科老年记忆障碍门诊中就诊的轻中度老年期痴呆患者共115例,均符合美国精神病学会精神障碍诊断和统计手册第四版(Diagnostic and Statistical Manual of Mental disorders,Fourth Edition,DSM-Ⅳ)的痴呆诊断标准。AD组61例,符合NINCDS-ADRDA可能或很可能AD诊断标准;VD组54例,符合NINDS-AIREN可能或很可能VD诊断标准中的皮质下缺血性血管性痴呆。采用简易精神状态评定表(Mini-Mental StateExamination,MMSE),世界卫生组织-加利福尼亚洛杉矶大学听觉词语学习测验(World Health Organiza-tion-University of California,Los Angeles,auditory verbal learning test,WHO-UCLA AVLT),画钟测验(Clock Drawing Test,CDT),神经精神问卷(Neuropsychiatric Inventory,NPI)对两组患者从记忆力、语言、注意力等方面以及妄想、幻觉、激越、抑郁、淡漠、易激惹、异常的运动行为等方面进行评估。结果:AD患者较VD患者MMSE量表中的语言能力,WHO-UCLA AVLT测评中的延迟回忆和长时延迟再认减退明显(均P<0.05),VD患者较AD患者MMSE中的注意力减退明显(P<0.05);NPI量表中,AD患者淡漠、激越、易激惹、异常运动行为明显多于VD患者(P<0.05),抑郁少于VD患者(P<0.05)。结论:AD和VD患者在认知功能损害和精神行为症状方面存在差异,AD患者的语言能力、记忆力较差,而VD患者的注意力较差;AD淡漠、激越、易激惹、异常运动行为多见,VD抑郁多见。临床工作中对痴呆患者的认知功能和精神行为症状测评有助于AD和VD的鉴别。

阿尔茨海默病评定量表中文译本的效度和信度

评价阿尔茨海默病评定量表 (Alzheimer’sDiseaseAssessmentScale ,ADAS)中文译本的效度和信度。方法 :选取 2 0例符合NINCDS ADRDA诊断标准的很可能AD患者为被试 ,两名评定者盲法评定 ,通过评定者间一致性评价量表信度。进行ADAS、MMSE、GDS、ADL和BlessedRoth量表评分 ,通过相关分析考察量表效度。ADAS各条目评分进行相关分析 ,以评价量表内部结构的相关性。结果 :量表各条目的评定者间一致性kappa值均在 0 .75以上 (p <0 .0 5)。ADAS认知部分各条目评分彼此呈高度正相关 (p <0 .0 5) ,非认知部分多数条目评分无显著相关性。不同GDS等级间认知总分、非认知总分及全量表总分存在显著差异。认知部分总分与MMSE总分呈显著负相关 (r=0 .80 3,p <0 .0 1) ,与ADL(r=0 .4 63,p <0 .0 5)及BlessedRoth痴呆量表 (r =0 .4 58,p <0 .0 5)评分均呈显著正相关。非认知部分与MMSE、ADL及Blessed Roth痴呆量表评分无显著相关。ADAS总分与MMSE总分呈显著负相关 (r= 0 .778,p <0 .0 1) ,与Blessed Roth量表 (r =0 .4 4 8,p <0 .0 1)评分呈显著正相关 ,与ADL评分无显著相关。结论 :ADAS具有较好的信度和效度 ,临床上可使用该量表评定AD严重程度。

如何检测记忆功能更有助于早期阿尔茨海默病的临床诊断

目的 评价经修订了检测方法和计分方法的逻辑记忆量表在正常人群和阿尔茨海默病 (Alzheimer'sdisease AD )患者中的分布特点、影响因素和诊断效度,确定该量表的修订正常值。方法 病例组 183名 (轻度 AD118名,中度 AD 65名),对照组 1417名 (认知正常 1283名,非痴呆疾病 134名),进行修订了检测方法和计分方法 的 逻 辑 记 忆 量 表 测 定 。 结 果 多 元 线 性 回 归 分 析 证 实 , 受 教 育 水 平 (F =354.36, 标 化 偏 回 归 系 数 =0.46,P =0.0001)对量表总分的影响最为明显;正常组 (P =0.0001)和非痴呆疾病组 (P =0.0001)量表总分随文化程度增高而增高;而 AD 组 (P =0.1365)量表总分则未见此变化趋势。经协方差分析去除受教育水平、年龄、性别、城乡的影 响 后 , 正 常 组 、 非 痴 呆 疾 病 组 、 轻 度 AD 组 和 中 度 AD 组 修 正 得 分 之 间 的 差 异 都 具 有 显 著 性 (P =0.0001;P =0.0059)。检验本量表对 AD 的诊断效度时发现,本研究修订的计分法与传统计分法相比,总分在轻度提高特异性(94.11%)的情况下,大大提高了敏感性 (71.98%);按不同文化程度延迟回忆+再认得分检验对于 AD 的诊断效度显示,量表的敏感性随文化程度的增高而增加。按文盲、小学、初中。

记忆与执行筛查量表鉴别血管性痴呆与阿尔茨海默病的作用

目的探讨记忆与执行筛查量表(MES)鉴别诊断皮质下缺血性血管性痴呆(SIVD)与阿尔茨海默病(AD)的价值。方法回顾性纳入2012年6月至2013年11月首都医科大学附属复兴医院神经内科门诊和病房收治的SIVD和AD患者各50例。选取同期于复兴医院月坛社区体格检查健康者50名为对照组。3组受试者的年龄、性别和教育程度匹配。以简易精神状态量表(MMSE)和MES检测全部受试者并加以比较;记忆与执行评分比值(MES-R)对于SIVD与AD区分度的分析采用受试者工作特征曲线。结果 (1)SIVD组与AD组的MMSE总分差异无统计学意义[(20.6±5.5)分比(20.6±3.3)分,P>0.05]。(2)3组患者MES各指标差异均有统计学意义(均P<0.01)。SIVD组句子记忆1、3、4、5评分均明显高于AD组,差异均有统计学意义(均P<0.05)。执行部分指标:SIVD组左、右手连续动作及指令与动作矛盾刺激评分均低于AD组[(5.1±3.1)分比(7.3±2.1)分,(5.2±3.0)分比(7.7±1.9)分,(3.5±4.4)分比(6.2±4.3)分],差异均有统计学意义(均P<0.01)。SIVD组MES-R值高于AD组(1.2±0.7比0.5±0.2),差异有统计学意义(P<0.01)。(3)MES-R≥0.7时,区分SIVD与AD的敏感度76.7%,特异度为83.3%;而MMSE总分区分SIVD与AD的敏感度为40.0%,特异度仅为0.7%。结论对SIVD与AD患者进行MES测定,反映句子记忆和执行部分的差异,可以较好地区分两种疾病。

以人为中心照护服务测评量表的研究进展

目前以人为中心的照护服务被广泛应用于医疗护理领域,国内外常用的以人为中心照护服务的测评量表主要有两大类:针对老年痴呆症患者的评定量表和用于老年护理的普适性量表。本文就以人为中心照护服务的测评工具在老年护理和痴呆症照护中的应用及研究进展进行综述。应加强以人为中心照护服务测评量表的研究,发展并制定出适合我国国情的量表,才能更好地评价照护服务的质量,同时为制定干预策略提供依据。