Derouesné Christian, Rapin Jean-Robert, Lacomblez Lucette
Faculté de médecine Pitié-Salpêtrière, Paris.
Psychol Neuropsychiatr Vieil. 2004 Mar;2(1):67-74.
We studied 200 subjects recruited by general practioners and meeting the seminal criteria for the age-associated memory impairment construct (AAMI). These criteria did not allow to select an homogeneous population. Three groups could be distinguished. First, 18 subjects had apparent psychoaffective disturbances, mainly related to anxiety. Second, 41 subjects had lower memory performance than the other subjects and could be classified as severe AAMI or late-life forgetfulness, former constructs similar to the present construct of mild cognitive impairment (MCI). A large majority of subjects (n -/+ 141) had no apparent psychoaffective disturbances and normal memory performance. They could correspond to the proper AAMI construct. Actually, two subgroups could be distinguished in these subjects. Half of them had low cognitive complaints, assessed by the cognitive difficulties scale, compared to those formerly found in a population of 1349 subjects aged over 50, studied by GP, but not specifically recruited on the presence of memory complaints. These subjects could be considered as quite normal subjects. The other half of AAMI subjects had higher scores of memory complaints and more psychoafective disturbances than the subjects of the first group. No relationship was found between subjective complaints and memory performance in the total population as well as in any subgroup. The main correlate of memory complaints was the score on the Zung anxiety scale in the total population, the LLF and the AAMI groups. This study do not support the existence of a specific category of aged subjects intermediate between normal subjects without subjective memory decline and patients with MCI or incipient Alzheimer's disease. Memory complaints appear to be related to psychoaffective disturbances even in subjects with low memory performance.
我们研究了由全科医生招募的200名受试者,这些受试者符合年龄相关性记忆损害(AAMI)的标准。这些标准无法选出同质化的人群。可以区分出三组。第一组,18名受试者有明显的精神情感障碍,主要与焦虑有关。第二组,41名受试者的记忆表现低于其他受试者,可归类为严重AAMI或老年健忘症,这两种情况以前类似于目前的轻度认知障碍(MCI)概念。绝大多数受试者(n = 141)没有明显的精神情感障碍且记忆表现正常。他们可能符合恰当的AAMI概念。实际上,这些受试者可分为两个亚组。其中一半受试者与以前在全科医生研究的1349名50岁以上人群中发现的相比,通过认知困难量表评估,认知主诉较少,这些人群并非专门因记忆主诉而招募。这些受试者可被视为相当正常的受试者。AAMI受试者的另一半与第一组受试者相比,记忆主诉得分更高,精神情感障碍更多。总体人群以及任何亚组中,主观主诉与记忆表现之间均未发现关联。在总体人群、LLF和AAMI组中。记忆主诉的主要相关因素是zung焦虑量表得分。本研究不支持在无主观记忆下降的正常受试者与MCI或早期阿尔茨海默病患者之间存在特定类别的老年受试者。即使在记忆表现较差的受试者中,记忆主诉似乎也与精神情感障碍有关。