Hanyu Haruo, Sato Tomohiko, Akai Tomotaka, Sakai Minoru, Takasaki Rou, Iwamoto Toshihiko
Department of Geriatric Medicine, Tokyo Medical University, Tokyo, Japan.
Nihon Ronen Igakkai Zasshi. 2007 Jul;44(4):463-9. doi: 10.3143/geriatrics.44.463.
We examined the level of awareness of memory deficits in 63 patients with Alzheimer's disease (AD), 17 patients with dementia with Lewy bodies (DLB), 14 patients with vascular dementia (VaD), and 56 patients with amnestic mild cognitive impairment (MCI).
The unawareness of memory impairment was evaluated with a standardized memory questionnaire system based on the Everyday Memory Checklist (EMC). The EMC scores for the patient's own rating, the caregivers' rating and the unawareness score, defined as the discrepancy between these (caregiver rating-patient rating), were analyzed.
Although the EMC self-rating scores were comparable among the four groups, the EMC scores in caregivers were significantly higher in the AD group than in the DLB, VaD, and MCI groups. Therefore, the unawareness scores were significantly higher in the AD groups than in other groups. When an unawareness score of 9 or more was defined as significant, impaired awareness was found in 41 (65%) patients with AD, 1 (6%) patient with DLB, 5 (36%) patients with VaD, and in 19 (34%) patients with MCI.
We found that impaired awareness was found in two-thirds of patients with mild AD and even in one-third of patients with MCI. However, other dementias, in particular DLB, had less severe and less frequent unawareness of memory deficits than AD, suggesting the difference in the pathophysiology between them.
我们研究了63例阿尔茨海默病(AD)患者、17例路易体痴呆(DLB)患者、14例血管性痴呆(VaD)患者和56例遗忘型轻度认知障碍(MCI)患者对记忆缺陷的认知水平。
采用基于日常记忆清单(EMC)的标准化记忆问卷系统评估对记忆损害的无意识情况。分析患者自评、照料者评分的EMC得分以及将二者差异(照料者评分 - 患者评分)定义为的无意识得分。
尽管四组患者的EMC自评得分相当,但AD组照料者的EMC得分显著高于DLB组、VaD组和MCI组。因此,AD组的无意识得分显著高于其他组。当将无意识得分9分及以上定义为显著时,41例(65%)AD患者、1例(6%)DLB患者、5例(36%)VaD患者和19例(34%)MCI患者存在意识受损。
我们发现,三分之二的轻度AD患者甚至三分之一的MCI患者存在意识受损。然而,其他痴呆类型,特别是DLB,与AD相比,记忆缺陷的无意识情况不那么严重且不那么常见,这表明它们之间病理生理学存在差异。