Gallassi Roberto, Bisulli Antonietta, Oppi Federico, Poda Roberto, Di Felice Carla
Centre for the Neurological Study of Cerebral Aging, Department of Neurological Sciences, University of Bologna, Italy.
Int J Geriatr Psychiatry. 2008 Jan;23(1):95-101. doi: 10.1002/gps.1901.
Subjective cognitive complaints (SCC) have been previously investigated to establish whether they are risk factors for dementia, but no clear-cut conclusions have emerged. In this study non-demented patients with SCC were studied and the neuropsychological findings, affective and behavioural aspects and parameters with the highest correct classifications in discriminating patients who had only SCC but no objective clinical and neuropsychological impairment, i.e. no cognitive impairment (NCI) patients and those with objective neuropsychological deficits, namely patients with mild cognitive (MCI) were analyzed.
Consecutive non-demented outpatients with SCC were enrolled of over 9 months and examined using neuropsychological tests and scales for depression, anxiety and behaviour. Clinical criteria and neuropsychological test results were used to classify patients into groups of NCI, MCI and subtypes of MCI.
Ninety-two patients with SCC were included; 49 of them had objective deficits (MCI patients), whereas 43 were without any clinical and cognitive impairment (NCI patients). These patients had lower age, higher education and better general cognitive indices than MCI patients who had higher caregiver distress, depression and irritability. The combination of a battery for mental deterioration and for behavioural memory assessment were the most discriminative in differentiating the two groups.
An objective cognitive impairment, reaching the criteria for a MCI diagnosis, was present in almost half of patients having SCC. MCI patients have more behavioural disturbances than NCI subjects. SCC should not be underestimated and appropriate neuropsychological assessment is required to reassure subjects with normal results and to identify patients with MCI.
既往曾对主观认知主诉（SCC）进行研究，以确定其是否为痴呆的危险因素，但尚未得出明确结论。在本研究中，对患有SCC的非痴呆患者进行了研究，并分析了神经心理学结果、情感和行为方面，以及在区分仅有SCC但无客观临床和神经心理学损害的患者（即无认知损害（NCI）患者）和有客观神经心理学缺陷的患者（即轻度认知障碍（MCI）患者）时具有最高正确分类率的参数。
连续纳入9个多月来患有SCC的非痴呆门诊患者，并使用神经心理学测试以及抑郁、焦虑和行为量表进行检查。根据临床标准和神经心理学测试结果将患者分为NCI组、MCI组和MCI亚型。
纳入了92例患有SCC的患者；其中49例有客观缺陷（MCI患者），而43例无任何临床和认知损害（NCI患者）。这些患者比护理人员困扰、抑郁和易怒程度较高的MCI患者年龄更小、受教育程度更高且一般认知指标更好。用于精神衰退和行为记忆评估的一组测试组合在区分两组患者时最具鉴别力。
几乎一半患有SCC的患者存在达到MCI诊断标准的客观认知损害。MCI患者比NCI受试者有更多行为障碍。不应低估SCC，需要进行适当的神经心理学评估，以使结果正常的受试者放心，并识别出MCI患者。
