Hall James R, Harvey Michelle B
University of North Texas Health Science Center, TX, USA.
Int J Geriatr Psychiatry. 2008 Mar;23(3):314-8. doi: 10.1002/gps.1881.
Executive dysfunction is a hallmark of both Dementia of the Alzheimer's Type (AD) and Vascular Dementia (VaD). A complete neuropsychological battery contains measures of executive function, but the focus tends to be on cognitive processes with verbal or written output. The Behavioral Dyscontrol Scale (BDS) is purported to be a measure of executive function that addresses control over voluntary motor behavior. Previous factor analyses revealed three-factor solutions using a variety of patient populations. Our goals were to examine the factor structure in a sample of geriatric outpatients and to apply that factor structure to detect possible differences between AD, VaD, amnestic Mild Cognitive Impairment (MCI), non-amnestic MCI, and normal controls.
An exploratory factor analysis was performed on 260 outpatient evaluations from 2002-2006. Only the seven items requiring motor responses were included.
A two-factor solution emerged. We named the factors Motor Problem-Solving and Simple Motor Repetitive Behaviors. For the first factor, the AD and VaD groups differed from the MCI groups and normal controls, but did not differ from each other. There were no differences between the control, amnestic MCI, and non-amnestic MCI groups. There were no differences between the groups for the second factor.
It was concluded that voluntary control of behavior that requires problem-solving for complex tasks may help differentiate dementia from mild cognitive impairment and normal aging.
执行功能障碍是阿尔茨海默病型痴呆（AD）和血管性痴呆（VaD）的一个标志性特征。一套完整的神经心理测试包含执行功能的测量指标，但重点往往放在有言语或书面输出的认知过程上。行为失控量表（BDS）据称是一种执行功能的测量工具，用于评估对自主运动行为的控制。先前的因素分析使用了各种患者群体，得出了三因素解决方案。我们的目标是在老年门诊患者样本中检验因素结构，并应用该因素结构来检测AD、VaD、遗忘型轻度认知障碍（MCI）、非遗忘型MCI和正常对照组之间可能存在的差异。
对2002年至2006年的260例门诊评估进行探索性因素分析。仅纳入需要运动反应的七个项目。
出现了一个两因素解决方案。我们将这些因素命名为运动问题解决和简单运动重复行为。对于第一个因素，AD组和VaD组与MCI组和正常对照组不同，但彼此之间没有差异。对照组、遗忘型MCI组和非遗忘型MCI组之间没有差异。对于第二个因素，各组之间没有差异。
得出的结论是，对需要解决复杂任务问题的行为进行自主控制，可能有助于区分痴呆与轻度认知障碍以及正常衰老。
