Fuh J-L, Wang S-J, Cummings J L
Neurological Institute, Taipei Veterans General Hospital, Taiwan, Republic of China.
J Neurol Neurosurg Psychiatry. 2005 Oct;76(10):1337-41. doi: 10.1136/jnnp.2004.056408.
To explore the neuropsychiatric manifestations in patients with Alzheimer's disease (AD) and cortical and subcortical vascular dementia (VaD).
We investigated consecutive patients with dementia. All the participants received brain computed tomography. The diagnosis of dementia was confirmed by clinical criteria and the imaging findings. Only patients with probable AD, and subcortical and cortical VaD were included. The Mini Mental State Examination (MMSE) was used to evaluate global cognitive function, and the Neuropsychiatric Inventory (NPI) was used to assess neuropsychiatric symptoms.
Of the 536 participants with dementia, 320 (59.7%) had AD, 161 (30%) had subcortical VaD, 35 (6.4%) had cortical VaD, and 16 (2.9%) had mixed cortical and subcortical VaD. Cortical VaD patients had the highest mean composite NPI scores in all domains and AD patients had the lowest composite scores in most domains. The mean composite scores of the apathy and sleep disturbance domains in patients with cortical VaD were significantly higher than those in the patients with AD after controlling for years of education and MMSE score (p < 0.01).
There were few differences among the patients with AD, subcortical VaD and cortical VaD. The most consistent differences were the high sleep disturbance scores in those with cortical VaD.
探讨阿尔茨海默病(AD)、皮质性和皮质下血管性痴呆(VaD)患者的神经精神症状。
我们对连续性痴呆患者进行了调查。所有参与者均接受了脑部计算机断层扫描。痴呆的诊断通过临床标准和影像学检查结果得以证实。仅纳入可能患有AD、皮质下VaD和皮质VaD的患者。采用简易精神状态检查表(MMSE)评估整体认知功能,采用神经精神症状量表(NPI)评估神经精神症状。
在536例痴呆患者中,320例(59.7%)患有AD,161例(30%)患有皮质下VaD,35例(6.4%)患有皮质VaD,16例(2.9%)患有皮质和皮质下混合性VaD。皮质VaD患者在所有领域的平均NPI综合得分最高,而AD患者在大多数领域的综合得分最低。在控制受教育年限和MMSE得分后,皮质VaD患者的情感淡漠和睡眠障碍领域的平均综合得分显著高于AD患者(p < 0.01)。
AD、皮质下VaD和皮质VaD患者之间差异不大。最一致的差异是皮质VaD患者的睡眠障碍得分较高。