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[轻度认知障碍与阿尔茨海默病:CERAD-NP测试组合的研究]

[Mild cognitive impairment and Alzheimer's disease: an investigation of the CERAD-NP test battery].

作者信息

Barth S, Schönknecht P, Pantel J, Schröder J

机构信息

Sektion Gerontopsychiatrie der Psychiatrischen Klinik der Universität Heidelberg.

出版信息

Fortschr Neurol Psychiatr. 2005 Oct;73(10):568-76. doi: 10.1055/s-2004-830249.

Abstract

To investigate the psychometric properties of the German version of the CERAD-NP, neuropsychological deficits were compared between 49 patients with mild cognitive impairment (MCI), 80 patients with Alzheimer's disease (AD), 36 with major depression (MD), and 26 elderly controls. All participants were outpatients of the memory clinic of the Section of Geriatric Psychiatry, Heidelberg University. Diagnoses were established based on clinical examination, laboratory testing, neuroimaging, and routine neuropsychological testing according to the criteria of aging-associated cognitive decline (AACD) for MCI, NINCDS-ADRDA for AD, and DSM-IV for MD, respectively. All CERAD-NP subtests discriminated between controls and AD patients with the latter showing significantly (p< or = 0.05) lower test scores. The subtests verbal fluency and constructive apraxia differed significantly between mildly and moderately AD, while the subtests assessing declarative (epsisodic) memory performance showed only minor, non-significant differences between the respective groups. The LKB patients took an intermediate position between controls and AD patients with significantly lower scores in verbal fluency and declarative memory performance than the controls. When compared with the AD patients, MCI patients were significantly impaired in all subtests except constructive apraxia. Relative to the controls, the patients with MD showed a decreased episodic memory performance but no evidence suggesting an impairment in other neuropsychological domains. Our results indicate that the CERAD-NP is a psychometric instrument which allows a sensitive discrimination between mild and moderate AD, MCI, MD and healthy controls. However, sensitivity of discrimination between different stages of dementia varies with respect to the different subtest. While the subtest for episodic memory showed floor effects already for mild dementia, subtests for verbal fluency and constructive apraxia were able to discriminate even between more advanced stages of the disease.

摘要

为研究德语版CERAD-NP的心理测量特性,对49例轻度认知障碍(MCI)患者、80例阿尔茨海默病(AD)患者、36例重度抑郁症(MD)患者和26例老年对照者的神经心理学缺陷进行了比较。所有参与者均为海德堡大学老年精神病学系记忆门诊的门诊患者。分别根据MCI的衰老相关认知衰退(AACD)标准、AD的NINCDS-ADRDA标准和MD的DSM-IV标准,通过临床检查、实验室检测、神经影像学检查和常规神经心理学测试进行诊断。所有CERAD-NP子测验均能区分对照组和AD患者,后者的测验分数显著更低(p≤0.05)。轻度和中度AD患者在言语流畅性和结构性失用症子测验上存在显著差异,而评估陈述性(情景性)记忆表现的子测验在各相应组之间仅显示出微小的、不显著的差异。LKB患者处于对照组和AD患者之间的中间位置,其言语流畅性和陈述性记忆表现得分显著低于对照组。与AD患者相比,MCI患者在除结构性失用症外的所有子测验中均有显著受损。相对于对照组,MD患者的情景性记忆表现有所下降,但没有证据表明在其他神经心理学领域存在损害。我们的结果表明,CERAD-NP是一种心理测量工具,能够敏感地区分轻度和中度AD、MCI、MD和健康对照者。然而,痴呆不同阶段之间的区分敏感性因不同子测验而异。虽然情景性记忆子测验在轻度痴呆时就已出现地板效应,但言语流畅性和结构性失用症子测验甚至能够区分疾病的更晚期阶段。

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