Motta M, Ferlito L, Magnolfi S U, Petruzzi E, Pinzani P, Malentacchi F, Petruzzi I, Bennati E, Malaguarnera M
Department of Senescence Sciences, University of Catania, Cannizzaro Hospital, Via Messina 829, I-95126 Catania, Italy.
Arch Gerontol Geriatr. 2008 Mar-Apr;46(2):245-52. doi: 10.1016/j.archger.2007.04.004. Epub 2007 Jun 21.
Usually, the effects of cognitive decline are not noted before the age of 70 years, which involve the intellectual capacities, the attention, the processes of elaboration and the memory. The studies on the cognitive disturbances of the elderly are numerous, and document the progressive increase of cerebral deterioration with advancing age. However, only a few studies refer to the significance of the cognitive disturbances in the clinical conditions and autonomy of the long living subjects. For this reason, we studied the cerebral deterioration of an adequate number of centenarians in correlation with their clinical conditions and autonomy. Our centenarian sample derived from the Italian multi-center study on centenarians (IMUSCE), which was an epidemiological study which identified 1173 centenarians (202 males, 971 females) in the age range of 100-109 years. From this sample, we analyzed 346 subjects as far as the cognitive functions and the degree of autonomy by using the psychometric tests of the mini-mental state examination (MMSE) and the instrumental activities of daily living (IADL) for the functional evaluations. In addition, we evaluated the clinical conditions of the subjects dividing them in three groups: Group A (those in good clinical conditions), Group B (those in discrete clinical conditions), and Group C (those in deteriorated clinical conditions). These analyses revealed that 187 (54.1%) of the 346 examined centenarians have shown an MMSE score in the normal range (score ratio from 1.0 to 0.63). The cognitive disorders are present in the centenarians in a clearly higher frequency (13.1%), than found in the common elderly (5.1%). The severe cognitive disorders do not allow a total autonomy or even a slight dependency. Only six subjects (1.7%) of the total sample were totally independent. These subjects had no cognitive disorders, and were in good clinical conditions. The results show that having an MMSE score in the normal range, and being in good clinical conditions are necessary but not sufficient prerequisites for a total autonomy in the IADL scores.
通常，认知衰退的影响在70岁之前并不明显，其涉及智力、注意力、思维加工过程和记忆力。关于老年人认知障碍的研究众多，这些研究记录了随着年龄增长大脑退化的逐渐加剧。然而，只有少数研究提及认知障碍在长寿者临床状况和生活自理能力方面的意义。因此，我们研究了相当数量的百岁老人的大脑退化情况，并将其与他们的临床状况和生活自理能力相关联。我们的百岁老人样本来自意大利多中心百岁老人研究（IMUSCE），这是一项流行病学研究，在100 - 109岁年龄范围内确定了1173名百岁老人（202名男性，971名女性）。从这个样本中，我们通过使用简易精神状态检查表（MMSE）的心理测量测试以及用于功能评估的日常生活活动能力（IADL），对346名受试者的认知功能和自理程度进行了分析。此外，我们将受试者的临床状况分为三组进行评估：A组（临床状况良好者）、B组（临床状况一般者）和C组（临床状况较差者）。这些分析表明，在接受检查的346名百岁老人中，有187名（54.1%）的MMSE评分在正常范围内（评分比例为1.0至0.63）。百岁老人中认知障碍的出现频率（13.1%）明显高于普通老年人（5.1%）。严重的认知障碍不允许完全自理，甚至连轻微依赖都做不到。在整个样本中，只有6名受试者（1.7%）完全独立。这些受试者没有认知障碍，且临床状况良好。结果表明，MMSE评分在正常范围内且临床状况良好是IADL评分实现完全自理的必要但不充分的前提条件。
