Estévez-González Armando, Kulisevsky Jaime, Boltes Anunciación, Otermín Pilar, García-Sánchez Carmen
Department of Psychiatry and Clinical Psychobiology-University of Barcelona, Spain.
Int J Geriatr Psychiatry. 2003 Nov;18(11):1021-8. doi: 10.1002/gps.1010.
To confirm that performance in verbal learning and memory test (Rey's Auditory Verbal Learning Test-RAVLT) is a helpful early neuropsychological marker of dementia of Alzheimer's type (DAT).
RAVLT was administered as part of a more extensive neuropsychological battery at baseline evaluation in 116 unselected patients referred by subjective memory complaints (SMC). Patients were followed longitudinally for 2 years (average interval of 27.7+/-4 months). Seventy patients were included in the study: 27 developed probable DAT; 17 were diagnosed as cognitively normal persons and 26 were diagnosed with Mild Cognitive Impairment (MCI). Remaining patients abandoned or they did not meet the criteria for DAT, MCI or control. Performance on RAVLT at the baseline evaluation was compared between groups.
Patients diagnosed two years later with probable DAT showed lower results, more frequently performed a score of zero at the delayed recall test (Trial 6) and had a percentage of forgetting (difference between Trials 5 and 6) higher than 75%. Score at delayed recall test and percentage of forgetting correlated with functional scales such as MMSE, Geriatric Depression Screening, Informant Questionnaire and Blessed's Dementia Rating.
RAVLT could help to identify those patients with SMC who would progress to DAT over a few years, and also to differentiate between the preclinical phase of Alzheimer's disease, mild cognitive impairment and normal aging. A score of zero at the delayed recall test or a percentage of forgetting > or =75% in patients with SMC is suggestive of probable DAT in the future.
确认言语学习与记忆测试(雷伊听觉词语学习测验,RAVLT)的表现是阿尔茨海默病型痴呆(DAT)的一项有用的早期神经心理学指标。
在对116名因主观记忆主诉(SMC)前来就诊的未筛选患者进行基线评估时,RAVLT作为更广泛的神经心理学成套测试的一部分进行施测。对患者进行了为期2年的纵向随访(平均间隔27.7±4个月)。70名患者纳入研究:27名发展为可能的DAT;17名被诊断为认知正常者,26名被诊断为轻度认知障碍(MCI)。其余患者放弃或不符合DAT、MCI或对照的标准。比较了各组在基线评估时RAVLT的表现。
两年后被诊断为可能DAT的患者得分较低,在延迟回忆测试(第6次试验)中更频繁地得零分,遗忘百分比(第5次和第6次试验之间的差异)高于75%。延迟回忆测试得分和遗忘百分比与功能量表相关,如简易精神状态检查表(MMSE)、老年抑郁筛查、知情者问卷和布氏痴呆评定量表。
RAVLT有助于识别那些有主观记忆主诉且几年后会发展为DAT的患者,也有助于区分阿尔茨海默病的临床前期、轻度认知障碍和正常衰老。主观记忆主诉患者在延迟回忆测试中得零分或遗忘百分比≥75%提示未来可能患有DAT。