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...     

Rey-Osterriche复杂图形测验在轻度阿尔茨海默病和轻度认知损害患者中的应用研究

目的:研究Rey-Osterrich复杂图形测验(CFT)对轻度阿尔茨海默病(AD)和遗忘型轻度认知损害(MCI)的诊断价值。方法:应用CFT、简明精神状态量表(MMSE)对45例轻度AD患者、73例遗忘型MCI和66名正常老年人进行检测,MMSE总得分分别为(20.2±2.5)分、(26.9±1.8)和(28.2±1.6)分。结果:对照组,CFT结构模仿和延迟回忆得分与教育程度有显著正相关性,与年龄、性别无相关性。MCI组的结构模仿得分为(32.4±6.2)分,轻度AD组为(26.1±10.9)分,对照组为(33.6±3.1)分。AD组与对照组及MCI组比差异有显著意义,延迟记忆对于识别MCI有一定作用,协助AD诊断有较好的敏感性(P<0.01);MCI组的延迟回忆得分与对照组比差异有显著统计学意义(P<0.01),轻度AD组下降更为明显,与MCI组比差异有显著统计学意义(P<0.01)。结论:CFT延迟记忆对于识别MCI有一定作用,协助AD诊断有较好的敏感性。CFT结构模仿不能识别MCI,对轻度AD,其敏感性亦不理想。     

认知功能筛查量表在MCI和轻度AD患者中的应用

目的:探讨认知功能筛查量表在轻度认知功能损害(Mild Cognitive Impairment,MCI)和轻度阿尔茨海默病(Alzhei mer disease,AD)患者中的应用。方法:对61例MCI患者和47例轻度AD患者进行系列神经心理学测验,同时选择41例正常老年人做对照。结果:MCI组和正常老年人比较,MGR、MMSE的短时记忆亚项、FOM、LM、DR、CDT均有统计学差异。轻度AD组和MCI组比较,MMSE的即刻记忆亚项、RVR、DS、ADL、IADL、POD均有统计学差异。CES-D在三组间无统计学差异。结论:MGR量表可用来鉴别正常人和认知功能损害人群,但不宜用来鉴别MCI和轻度AD患者。RVR和DS量表可以用于鉴别MCI和轻度AD患者。ADL量表在轻度AD患者显示损害,提示AD患者存在日常生活行为能力的损害。     

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.     

极简短痴呆筛查测验在识别轻度阿尔茨海默病中的作用

目的探讨2分钟内识别轻度阿尔茨海默病（Alzheimer＇s disease,AD）的测量工具及应用价值。方法使用简明精神状态量表（MMSE）、延长回忆测验、简易数字广度测验、画钟测验、双手连续动作任务、列举超市商品测验和简短命名测验等7种极简短痴呆筛查测验（Very Short Dementia Screening Test,VSDST）检测215例社区正常老人和90例轻度AD患者。结果所有测验指标在社区正常老人和轻度AD患者之间有显著差异。其中延长回忆总分在两组之间的鉴别力最强,简短命名测验、列举超市商品测验、画钟测验、双手连续动作任务和简易数字广度测验的鉴别力依次减弱。这些测验与MMSE项目分的鉴别力相似或略胜,单独采用某种极简短测验辅助诊断轻度AD仍然是不够的。结论极简短测验有助于早期识别轻度AD,但其效力有一定的局限性。     

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。     

轻度认知功能障碍筛查量表研究进展

轻度认知功能障碍(MCI)患者是老年性痴呆(SD)的高危人群。痴呆的发病率随着世界人口老龄化的加剧而迅速攀升,中晚期痴呆的治疗效果欠佳,而对MCI的早期筛查和干预可延缓痴呆病程的进展。文中对国内外MCI筛查量表的研究分析得出,记忆与执行筛查(MES)量表、Dem Tect、中文修订版轻度认知功能障碍测试(CAMCI)和阿尔茨海默病调查问卷(AQ)4种筛查量表可作为MCI筛查的首选筛查量表。     

轻度认知功能损害、阿尔茨海默病患者和健康对照者的枕区脑干听觉诱发电位的比较

背景轻度认知功能损害（mild cognitive impairment,MCI）患者枕叶异常的证据越来越多,这些患者也存在发展成阿尔茨海默病（Alzheimer s disease,AD）的高危险性。目的比较MCI患者、AD患者以及年龄匹配的健康对照者（normal control,NC）的枕区脑干听觉诱发电位特点。方法使用Nicolet Bravo脑诱发电位仪,用＂Click短声刺激,记录36例MCI、30例AD患者和45名健康对照者的脑干听觉诱发电位。比较脑干听觉诱发电位波III和波V的绝对潜伏期、绝对波幅的差异。结果 AD组的波III绝对潜伏期比MCI组、NC组的长[依次为5.12（0.36）ms、4.60（0.35）ms和4.71（0.35）ms;F=19.47,P〈0.001]。AD组的波III和波V的绝对波幅低于其他两组。MCI组的波V的绝对波幅低于健康对照组。结论枕区脑干听觉诱发电位有助于AD和MCI的诊断与鉴别诊断。     

离退休老人轻度认知功能损害研究

目的：探讨离退休老人轻度认知功能损害(MCI)的发生率及其影响因素。方法：采用哈金斯基缺血指数(HIS)、简易智能状态检查(中文版)(MMSE)、Reisberg总体衰退量表(GDS)、日常生活活动能力(20项版本)(ADL)等，对420名离退休老人MCI的发生情况及其影响因素进行调查，分析相互问关系。结果：离退休老人中MCI的发生率为8．6％，随年龄的增长而有升高趋势，但各年龄组之间差异无显著性。结论：离退休老人中MCI较常见，应对老年人群进行MCI的监测和干预，阻止和延缓MCI发展为痴呆，提高老年人的寿命和生活质量。     

尿液β淀粉样蛋白寡聚体检测在阿尔茨海默病和轻度认知损害中临床意义的初步探索

目的 探索阿尔茨海默病(AD)患者尿液β淀粉样蛋白(Aβ)寡聚体水平及其临床意义.方法 收集60例病例组研究对象:包括轻度认知损害(MCI)组28例、AD组15例、主观认知下降(SCD)组17例;另选择上海市宝山区友谊街道社区认知正常健康者(对照组)19例.收集患者临床信息以及尿液,利用脑脊液Aβ寡聚体检测ELISA试...     

Alzheimer病和轻度认知功能障碍患者认知功能与局部脑血流灌注的相关性研究

目的研究Alzheimer病(AD)和轻度认知功能障碍(MCI)患者的认知功能与脑血流灌注的相关性。方法33例AD、17例MCI患者分别接受临床评估、神经心理学检查[包括简易精神状态检查法(MMSE)及临床记忆量表(CMS)]后进行单光子发射计算机断层(SPECT)检查。应用SPSS 10.0软件对神经心理学指标与脑血流灌注指标进行相关性分析。结果MMSE评分与双侧颞顶叶放射性计数值(RAR)呈正相关,MQ值与左颞叶、左丘脑RAR呈正相关。结论认知功能与脑血流灌注之间有良好相关性,二者结合可更客观地评价脑功能改变,提高判定疾病的准确性。     

The Effect of Cognitive Training in Patients with Mild Cognitive Impairment and Early Alzheimer's Disease: A Preliminary Study

Background and Purpose

The objective of this study was to determine the benefits of cognitive training in patients with amnestic mild cognitive impairment (aMCI) and those with early Alzheimer''s disease (AD).

Methods

Eleven patients with aMCI and nine with early AD (stage 4 on the Global Deterioration Scale) participated in this study. Six participants with aMCI and six with AD were allocated to the cognitive training group, while five participants with aMCI and three with AD were allocated to a wait-list control group. Multicomponent cognitive training was administered in 18 weekly, individual sessions. Outcome measures were undertaken at baseline, and at 2 weeks and 3 months of follow-up.

Results

In the trained MCI group, there were significant improvements in the delayed-recall scores on the Seoul Verbal Learning Test at both the 2-week and 3-month follow-ups compared with baseline (baseline, 1.6±1.5; 2 weeks, 4.4±1.5, p=0.04; 3 months, 4.6±2.3, p=0.04). The phonemic fluency scores (1.0±0.8 vs. 5.0±1.8, p=0.07) and Korean Mini-Mental State Examination scores (18.8±0.5 vs. 23.8±2.2, p=0.07) also showed a tendency toward improvement at the 2-week follow-up compared to baseline in the trained AD group.

Conclusions

This study provides evidence of the effectiveness of cognitive training in aMCI and early AD. The efficacy of cognitive training programs remains to be verified in studies with larger samples and a randomized design.     

Patterns of Word-List Generation in Mild Cognitive Impairment and Alzheimer's Disease

Patients with amnestic mild cognitive impairment (aMCI) have been described as exhibiting greater impairment on tests of category fluency than letter fluency. This has been offered as evidence that this condition represents pre-clinical Alzheimer's disease (AD). We hypothesized that this pattern of differential impairment is dependent on the specific semantic categories and initial letters selected, and is not specific to AD and aMCI. A total of 40 cognitively normal older adults, 74 MCI patients—25 “amnestic single domain” (aMCI), 27 “amnestic multiple domain”, and 22 non-amnestic—and 29 AD patients were tested with multiple forms of semantic-category and initial-letter fluency tasks. The pattern of deficits within and across groups was highly dependent on the specific categories and letters chosen. Overall, aMCI patients did not demonstrate greater impairment in category than letter fluency. In fact, the level and pattern of their performance resembled that of cognitively normal older adults much more than AD patients. MCI patients with deficits in multiple cognitive domains performed most like AD patients. These findings indicate that verbal fluency performance is highly influenced by the specific tasks used, and impairment on semantic fluency is not characteristic of pure amnestic MCI.     

Memory Phenotypes In Early,De Novo Parkinson's Disease Patients with Mild Cognitive Impairment

Background

Memory deficits in mild cognitive impairment related to Parkinson's disease (PD-MCI) are quite heterogeneous, and there is no general agreement on their genesis.

Objectives

To define memory phenotypes in de novo PD-MCI and their associations with motor and non-motor features and patients’ quality of life.

Methods

From a sample of 183 early de novo patients with PD, cluster analysis was applied to neuropsychological measures of memory function of 82 patients with PD-MCI (44.8%). The remaining patients free of cognitive impairment were considered as a comparison group (n = 101). Cognitive measures and structural magnetic resonance imaging-based neural correlates of memory function were used to substantiate the results.

Results

A three-cluster model produced the best solution. Cluster A (65.85%) included memory unimpaired patients; Cluster B (23.17%) included patients with mild episodic memory disorder related to a “prefrontal executive-dependent phenotype”; Cluster C (10.97%) included patients with severe episodic memory disorder related to a “hybrid phenotype,” where hippocampal-dependent deficits co-occurred with prefrontal executive-dependent memory dysfunctions. Cognitive and brain structural imaging correlates substantiated the findings. The three phenotypes did not differ in terms of motor and non-motor features, but the attention/executive deficits progressively increased from Cluster A, through Cluster B, to Cluster C. This last cluster had worse quality of life compared to others.

Conclusions

Our results demonstrated the memory heterogeneity of de novo PD-MCI, suggesting existence of three distinct memory-related phenotypes. Identification of such phenotypes can be fruitful in understanding the pathophysiological mechanisms underlying PD-MCI and its subtypes and in guiding appropriate treatments. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.