Barzotti T, Gargiulo A, Marotta M G, Tedeschi G, Zannino G, Guglielmi S, Dell'Armi A, Ettorre E, Marigliano V
Department of Aging Science, Policlinico Umberto I, University La Sapienza, I-00161 Rome, Italy.
Arch Gerontol Geriatr Suppl. 2004(9):57-62. doi: 10.1016/j.archger.2004.04.010.
Patients affected by Alzheimer disease (AD) need an accurate diagnosis, to the extent allowing us to find the best therapy or polytherapy, in order to take under control their cognitive impairment. In our Alzheimer Evaluation Units (from the Italian name abbreviated: UVA), the patients undergo a multidimensional evaluation, which can address us towards a proper diagnosis and of other weakening, or even dementia-related diseases. The patients are also subject to neuropsychometric and neuropsychological evaluations, allowing a more focused analysis on cognitive impairments. Among the tests, we use the Rey auditory-verbal learning test (RAVLT), evaluating the patient's verbal memory. A list of 15 words is read to each patient. N the first part of the test, the clinician repeats 5 times such a list. the patient is hen asked, at the end of every repetition, to tell all words he/she remembers. This part is useful to evaluate the immediate recall (IR) ability. The score, i.e., the total number of recalled words, ranges from 0 to 75. After 15 minutes, the delayed recall (DR) ability is evaluated: the patient is newly asked to repeat as many words as he can recall from the list. The score for this part ranges from 0 to 15 minutes. The score is corrected of rage and education, with a cut-off of 28.5 for IR and 4.7 for DR. We made a survey with the purpose of deciding if there was a correlation between cognitive impairment and verbal memory lack, whose deficiency appears earlier in AD. To this aim, we selected several patients with AD, diagnosed during the period between September 2002 and February 2003. We only considered those patients whose AD was not associated with other weakening diseases, and whose clinical dementia rating scale (CDR) score was between 0.5-2.0. A sample of 35 individuals (11 men and 24 women) could be obtained. A meaningful correlation was observed between CDR and IR (r = -0.725, p < 0.01), as well as between CDR and DR (r = -0.470; p < 0.05). Such a result confirms the importance of evaluating immediate and long-term memories, for the early diagnosis of AD, because it is the only symptom of clinically not yet diagnosed dementia, as proven also by other studies.
阿尔茨海默病(AD)患者需要准确的诊断,以便我们找到最佳治疗方法或联合治疗方案,从而控制他们的认知障碍。在我们的阿尔茨海默病评估单元(源自意大利语缩写:UVA),患者会接受多维度评估,这有助于我们做出正确诊断,并发现其他衰弱甚至与痴呆相关的疾病。患者还需接受神经心理测量和神经心理学评估,以便更有针对性地分析认知障碍。在这些测试中,我们使用雷伊听觉词语学习测验(RAVLT)来评估患者的言语记忆。向每位患者读出一个由15个单词组成的列表。在测试的第一部分,临床医生将该列表重复5次。每次重复结束后,要求患者说出他/她记住的所有单词。这部分用于评估即时回忆(IR)能力。分数即回忆出的单词总数,范围为0至75分。15分钟后,评估延迟回忆(DR)能力:再次要求患者尽可能多地重复他能从列表中回忆出的单词。这部分的分数范围为0至15分。该分数会根据年龄和受教育程度进行校正,IR的临界值为28.5分,DR的临界值为4.7分。我们进行了一项调查,目的是确定认知障碍与言语记忆缺失之间是否存在相关性,而言语记忆缺失在AD中出现得更早。为此,我们选取了2002年9月至2003年2月期间确诊的几名AD患者。我们只考虑那些AD与其他衰弱疾病无关且临床痴呆评定量表(CDR)分数在0.5 - 2.0之间的患者。最终获得了一个由35人组成的样本(11名男性和24名女性)。观察到CDR与IR之间存在显著相关性(r = -0.725,p < 0.01),CDR与DR之间也存在显著相关性(r = -0.470;p < 0.05)。这一结果证实了评估即时和长期记忆对于AD早期诊断的重要性,因为它是临床尚未诊断出的痴呆的唯一症状,其他研究也证明了这一点。