快速认知筛查测验在检测轻度认知损害中的应用研究(英文)

目的轻度认知损害(mild cognitive impairment,MCI)可根据认知表现分为遗忘型MCI(aMCI)和非遗忘型MCI(naMCI)。本研究旨在编制快速认知筛查测验(quick cognitive screening test,QCST)便于快速全面地识别MCI,为进一步研究提供依据。方法符合MCI操作性诊断标准的MCI组121例、符合DSM-Ⅳ有关痴呆诊断标准的阿尔茨海默病(AD)组79例和正常老年人组186例,参与了QCST和标准化全套神经心理测验。参与者教育程度均在5年或以上,年龄55-85岁。QCST项目包括即刻记忆、延迟回忆、命名、动物流畅性、相似性、彩色连线B、画钟、手指结构、数字广度等9个分测验,每个分测验满分10分,总分90分,耗时10-15分钟。结果MCI组、AD组和正常老年人组QCST总分分别为(58.13±8.18)、(44.53±10.54)和(72.92±6.85)分。制定教育程度在5-8年、9-12年、高于13年3个组别的QCST总分的划界分分别为63、65和68分。QCST识别MCI的敏感性为87.6%,其中识别aMCI-s、aMCI-m和naMCI的敏感性分别...     

中文修订版智能筛查检测在阿尔茨海默病和轻度认知损害评估中的作用

目的:探讨智能筛查测验(CASI)在不同严重度的阿尔茨海默病(AD)患者中的表现及与MMSE总分的关系。方法:使用2.0版本的CASI、MMSE及临床痴呆量表等对30名正常中老年人、20例轻度认知损害(MCI)和53例不同严重度的AD患者(20例轻度、19例中度、14例重度)进行评估。结果:根据CASI因子分分析发现,MCI组新记忆和概念判断受损、完成测验的耗时数延长,AD组在从轻至重度组中依次出现定向障碍、心算障碍,直到所有因子分均显著减退。除"概判"因子外,其余因子分都随着病情严重度而逐渐降低。除了重度AD组以外,MCI组、轻度AD组和中度AD组均较前一组下降约10分。CASI总分以≤85分为界:识别MCI的敏感度为70.6%;识别轻度AD的敏感度为82.7%;特异度均为73.9%。对于大学及以上文化者,CASI难度过低,容易出现假阴性。结论:CASI可有效判断AD认知损害的严重度,并能从组成项目中获得MMSE总分。     

两种轻度认知损害患者的神经心理学功能比较

背景区别轻度认知损害（mildcognitiveimpairment,MCI）的两种亚型,即遗忘型轻度认知损害（alTlnesticmildcogni—tiveimpairment,aMCI）和小血管型轻度认知损害（MCIassociatedwithsmallvesseldiseases,sv-MCI）将有利于延缓和预防MCI进展为阿尔茨海默病性痴呆和血管性痴呆。目的识别并区分区aMCI与sv-MCI的神经心理学特征。方法从宣武医院神经科门诊就诊患者或在北京社区进行的一项入户调查中选择符合入组标准的被试。根据Pe—tersen诊断标准筛选aMCI患者50例,根据Hachinski诊断标准筛选sv-MCI患者65例。以上两组患者和49名55岁以上没有认知障碍的社区被试一同接受简明精神状态量表（MiniMentalStateExamination,MMSE）检查及画钟测验（ClockDrawingTest,CDT）与听觉词语学习测验（AuditoryVerbalLearningTest,AVLT,评定即刻记忆、延迟回忆和延迟再认能力）。采用单因素方差分析法比较3组被试各项测验的平均得分,如果结果存在明显差异,再进行多个样本两两比较的Tukey法检验。结果aMCI组和SV．MCI组5项测验平均得分均明显低于健康对照组。aMCI组AVLT即刻记忆、延迟回忆和延迟再认测验得分均低于SV．MCI组。在校正了年龄、性别、受教育年限后,上述差异仍旧存在。结论实验结果与既往结果一致,与SV—MCI患者相比,aMCI患者记忆损害更加明显。记忆相关的评估测验,尤其是AVLT,或将有助于区别这两种MCI亚型。     

物体记忆测验的北京老年常模及其在轻度认知损害流行病学筛查中的应用

目的建立Fuld物体记忆测验(Fuld object memory evaluation,FOM)量表的北京城乡老年人常模,并分析其在筛查轻度认知损害(mild cognmve impairment,MCI)中的作用。方法采用随机分层抽样方法选取北京城乡60岁及以上居民715名,其中健康人504名(男230名,女274名)及MCI患者211例(男94例,女117例),对其进行FOM测验和其他多种神经心理量表检查。神经内科医师结合临床和纵向资料根据相应诊断标准明确诊断,然后对数据进行统计学分析。结果老年人常模各年龄段界限值:60～70岁15分,70岁以上组14分;首次回忆得分筛查MCI的界限值为6分。结论 FOM能检出患者以记忆为主的认知功能障碍,操作简便,敏感度适中,可作为临床和流行病学筛查MCI的有效工具。     

部分前循环脑梗死与遗忘型轻度认知功能损害患者认知功能的对比研究

目的 比较部分前循环脑梗死(partial anterior circulation infact,PACI)和遗忘型轻度认知损害(amnesic mild cognitive impairment,aMCI)患者的认知损害的特点.方法 选择29例符合牛津社区卒中项目(Oxford Community Stroke Droject,OCSP)分型的PACI患者,35例符合Petersen 诊断标准的aMCI患者,以及60例健康老年人为对照组,采用认知功能筛选测验-C2.1(Cognitive Ability Screening Instrument-C2.1,CASI)评定认知功能.结果 PACI组(86.28±12.04)和aMCI组(89.86±6.03)的CASI总分均比正常对照组(95.57±3.44)低,差异具有统计学意义[F(2)=8.547,P<0.05],而PACI组与aMCI组间无统计学差异.在CASI分领域方面,与对照组相比,PACI组在心算力(P=0.000)和定向力(P=0.021)两方面均较差;与aMCI组比较,PACI组的心算力(P=0.000)较aMCI组差,而短时记忆(P=0.016)和思维流畅性(P=0.005)方面则较好.aMCI组与对照组相比,在短时记忆(P=0.000)、抽象与判断能力(P=0.013)和思维流畅性(P=0.001)方面均较差.结论 PACI患者存在认知损害,尤其在心算力和定向力方面,与aMCI患者相比,可能更好地保留了执行功能,推测缺血性脑卒中与神经退行性变引起的认知损害可能涉及不同认知领域.     

静息态功能磁共振技术在阿尔茨海默病和轻度认知功能损害中的应用

静息态功能磁共振成像技术(rs-fMRI)作为一种先进的测量静息状态下脑部自发神经活动的方法,已广泛应用于阿尔茨海默病(AD)和轻度认知功能损害(MCI)的研究.近年来,采用包括功能连接、局部一致性、低频振幅及全脑图理论等分析方法进行研究,发现AD和MCI的脑区内及脑区间功能活动均有不同程度的改变,以默认网络(DMN)最为显著.本文将对近年来rs-fMRI在AD和MCI两方面的研究进展进行综述.     

Stroop色词测验在不同严重度的阿尔茨海默病中的表现

Stroop色词测验（Stroop color-word Test,CWT）是1935年Stroop首先使用的.国内已经有研究证实中版CWT能有效地识别轻度痴呆患,对轻度认知损害（Mild cognitive impairment,MCI）也有一定的辅助诊断价值.我们采用CWT评估不同严重度的阿尔茨海默病（Alzheimer＇s dementia,AD）患,分析CWT对于AD严重度的判断作用.     

轻度认知功能损害的老年成套神经心理测验的特点

目的 观察轻度认知功能损害者（MCI）老年成套神经心理测验（NTBE）的特点。方法 采用横断面研究,在上海,北京和江苏等地区取样;样本分为MCI组,正常老人组和阿尔茨海默病（AD）组。结果 NTBE可判断上述3组,准确率高。MCI组与正常组之间：NTBE的绝大多数单项测验成绩有非常显著的差异;MCI组与AD组之间：NTBE的多数单项测绘有显著差异。MCI组的NTBE成绩介于正常组与AD组之间。结论 MCI组有多方面认知功能损害,包括语言,执行,学习和空间结构等。     

老年人轻度认知功能损害的神经心理测验研究

目的;用神经心理测验研究老年人轻度认知功能损害的特点。方法;为横断面比较研究。研究对象分为两组,即有轻度认知功能损害的老年人（ＭＣＩ组）和认知功能正常的老年人（对照组,ＮＣ组）。以世界卫生组织老年认知功能介成套神经心理测验（ＷＨＯ－ＢＣＡＩ）为主要研究工具。     

阿尔茨海默病患者认知功能损害的调查研究

目的 探讨阿尔茨海默病（AD）患者的认知功能损害特征.方法 采用精神状态简易速查表（MMSE）对32例AD患者及32例正常老年人（对照组）进行了测评,并将测评结果加以比较.结果 AD组患者的MMSE总分及各项分测验（除物体命名外）评分均极明显低于正常对照组（P＜0.01）.轻度痴呆组在时间定向、地点定向、语言即刻记忆、注意和计算、短程记忆、阅读理解、言语表达及图形描述等项评分均极明显高于中度痴呆（P＜0.01）.结论 AD患者普遍存在着认知功能损害,且与痴呆的程度有关.     

Adult Norms for the Rey-Osterrieth Complex Figure Test and for Supplemental Recognition and Matching Trials from the Extended Complex Figure Test

The Rey-Osterrieth Complex Figure Test (“the Rey”; Osterrieth, 1944; Rey, 1941) has accumulated a considerable literature as a test of visual-spatial perception/construction and memory. The Extended Complex Figure Test (ECFT; Fastenau, 1996a, in press-a; Fastenau & Manning, 1992) supplements the Rey with Recognition and Matching trials that follow Copy, Immediate Recall, and Delayed Recall. The Rey and ECFT were administered to 211 healthy adults. Age ranged from 30 years to 85 years (M = 62.9, SD = 14.2), education ranged from 12 years to 25 years (M = 14.9, SD = 2.6), 55% were women, and over 95% were Caucasian. Age and education effects were evident on all trials (Multiple R ranged .23 to .50, p &lt; .05), but education explained minimal variance (usually 2-3%) on copy and memory trials. Gender effects were negligible, if present. Age-appropriate norms are presented using Osterrieth's 36-point scoring, overlapping cells, and convenient tables for converting raw scores to scaled scores.     

Adult norms for the Rey-Osterrieth Complex Figure Test and for supplemental recognition and matching trials from the Extended Complex Figure Test

The Rey-Osterrieth Complex Figure Test ("the Rey"; Osterrieth, 1944; Rey, 1941) has accumulated a considerable literature as a test of visual-spatial perception/construction and memory. The Extended Complex Figure Test (ECFT; Fastenau, 1996a, in press-a; Fastenau & Manning, 1992) supplements the Rey with Recognition and Matching trials that follow Copy, Immediate Recall, and Delayed Recall. The Rey and ECFT were administered to 211 healthy adults. Age ranged from 30 years to 85 years (M = 62.9, SD = 14.2), education ranged from 12 years to 25 years (M = 14.9, SD = 2.6), 55% were women, and over 95% were Caucasian. Age and education effects were evident on all trials (Multiple R ranged .23 to .50, p < .05), but education explained minimal variance (usually 2-3%) on copy and memory trials. Gender effects were negligible, if present. Age-appropriate norms are presented using Osterrieth's 36-point scoring, overlapping cells, and convenient tables for converting raw scores to scaled scores.     

Rey Complex Figure Test performance after traumatic brain injury

The influence of factors such as a cerebral injury characteristics, education, perceptual organization skills, and speed of information processing on performance on the Rey Complex Figure Test & Recognition Trial (RCF) was examined by means of hierarchical regression analyses in 100 consecutively referred persons with traumatic brain injury at a median of 2.5 months post-injury. Patients with premorbid (e.g., psychiatric history) or comorbid (e.g. financial compensation seeking) complicating factors were excluded. Perceptual organization skills and the presence of a diffuse intracranial lesion but not education or speed of processing were statistically significant predictors of the variance in RCF variables. A large proportion of the sample improved by at least a standard deviation from independent delayed recall to multiple-choice recognition, and this was mediated by perceptual organization skills but not by injury parameters. It is concluded that performance on the RCF after traumatic brain injury is affected relatively more by perceptual organization skills than by injury severity characteristics.     

Sources of Age Differences on the Rey-Osterrieth Complex Figure Test

The contributions of visuo-spatial abilities, organization, and memory to adult age differences on the Rey-Osterrieth Complex Figure Test were evaluated by means of the Boston Qualitative Scoring System (BQSS), the standard 36-point system, and an extension of the standard system. Age deficits in copying were due to minor inaccuracies of drawing, but not to poor organization. In the recall condition, robust declines were primarily the result of omission of elements rather than visuo-spatial distortions or poor organization. Comparisons of results based on the BQSS and the extended 36-point scoring system provide evidence for advantages and disadvantages of each.     

Comparability of the Rey and Mack Forms of the Complex Figure Test

Equivalent versions of the Complex Figure Test (CFT) are useful for assessing change over time in constructional skills, planning, spatial organization, and visual-spatial memory while minimizing practice effects. To address the need for an equivalent version of the CFT to the Rey, the present study compared copy and 45min-delayed recall accuracy scores of the Rey and Mack CFTs obtained from 245 adults involved in a study of the neuropsychological correlates of sleep apnea and its treatment. Accuracy scores did not significantly differ between individuals with and without sleep apnea. Also, there was no significant difference between copy or recall accuracy scores obtained on the Rey and Mack CFTs. Similar correlations were found between relevant demographic factors, estimated IQ, and accuracy scores for both CFTs. These data suggest that the Mack figure may be a useful alternative to the Rey CFT.     

A comparison of qualitative scoring systems for the Rey-Osterrieth Complex Figure Test

Abstract

Qualitative scoring systems for evaluating strategy and organization on the Rey-Osterrieth Complex Figure (CF) Test were compared. Eighty-five healthy older adults copied and then reproduced the CF from memory. Copy trials were scored according to 10 qualitative scoring systems. Scores obtained from each system were evaluated for shape of distribution, relation to memory scores, relation to executive ability (convergent validity), relation to general cognitive ability (discriminant validity), and interrater reliability. Two scoring systems — those proposed by Bennett-Levy (1984) and Bylsina, Bobholz, Schretlen, and Correa (1995) — fared particularly well according to these criteria. Both systems had a wide range of possible scores, assessed multiple aspects of qualitative performance, and applied higher weights to performance on the structural framework of the CF.     

阿尔茨海默病与血管性危险因素

阿尔茨海默病(Alzheimer disease,AD)是一种多因素致病疾病,涉及遗传、环境和社会心理等诸多方面以及不同因素之间复杂的相互作用。研究结果显示,血管性危险因素不仅与认知损害和血管性痴呆(vascular dementia,VD)有关,     

Use of Informants to Identify Mild Cognitive Impairment in Older Adults

Extensive research supports the use of informant ratings in diagnosing dementia. In comparison, far fewer studies have examined the use of informant ratings in identifying mild cognitive impairment (MCI), a state that occurs as healthy older adults make the gradual transition to dementia. A review of available studies that have examined discrepancies between MCI patient and informant reports has for the most part demonstrated that informant ratings reveal greater loss of everyday functional ability and cognitive competency. Additionally, current findings support a significantly greater association of informant ratings with objective measures of patient cognitive performance and characteristics of underlying dementing processes. Structured measures used to examine the diagnostic efficacy of informant ratings in identifying cases of MCI are reviewed. Two recently developed instruments seem especially promising, but further validation efforts will be required before they can be considered to meet standards for clinical use.     

血小板活化在Alzheimer病中的意义

目的探讨血小板活化在Alzheimer病中的意义。方法应用流式细胞术检测了24例AD和13例对照组人群的血小板膜糖蛋白(GMP)CD4l、CD62p和CD63的阳性表达率。结果AD患者血小板3种GMP的表达率均显著高于对照组(P＜0.05)，其差异具有统计学意义。结论血小板活化可能与AD患者血浆中淀粉样前体蛋白(APP)和β-淀粉样肽(βA4)浓度增高有关，故血小板活化与AD的发病机制有关。