Ricci Monica, Guidoni Silvia Vittoria, Sepe-Monti Micaela, Bomboi Giuseppe, Antonini Giovanni, Blundo Carlo, Giubilei Franco
Regina Apostolorum Hospital, Albano Laziale, Italy.
Department of Neurological Science, II Faculty of Medicine, "Sapienza" University of Rome, Via di Grottarossa 1035, I-00189, Rome, Italy.
Arch Gerontol Geriatr. 2009 Sep-Oct;49(2):e101-e104. doi: 10.1016/j.archger.2008.10.001. Epub 2008 Dec 11.
Few studies have compared neuropsychiatric disorders and functional abilities in the early stage of DLB and AD and their influence on caregiver distress. The aim of this study is to assess neuropsychiatric disorders, functional abilities and caregiver distress in DLB and in AD subjects. Sixteen subjects affected by probable DLB and 12 subjects affected by probable AD were enrolled. All subjects underwent a wide neuropsychological examination. Caregiver's distress was also assessed. Subjects affected by DLB performed better in long-term memory tests, whereas AD subjects performed better in attentive and executive function tests. The Neuropsychiatric Inventory (NPI) total score was significantly higher in DLB subjects than in AD subjects. Furthermore, DLB subjects scored worse than AD subjects in both Activities of Daily Living scale (ADL) and Instrumental Activities of Daily Living scale (IADL) scales. Overall caregiver distress was higher in DLB than in AD subjects. High distress was observed in DLB caregivers alone and was caused by delusion, hallucinations, anxiety and apathy. DLB subjects have a different neuropsychological profile, more psychiatric symptoms and more serious functional deficits than AD subjects in the early cognitive decline, furthermore DLB caregivers are more stressed than AD caregivers.
很少有研究比较过路易体痴呆（DLB）和阿尔茨海默病（AD）早期的神经精神障碍及功能能力，以及它们对照料者痛苦的影响。本研究旨在评估DLB患者和AD患者的神经精神障碍、功能能力及照料者痛苦。招募了16名可能患有DLB的受试者和12名可能患有AD的受试者。所有受试者均接受了全面的神经心理学检查。还评估了照料者的痛苦程度。DLB患者在长期记忆测试中表现较好，而AD患者在注意力和执行功能测试中表现较好。DLB患者的神经精神科问卷（NPI）总分显著高于AD患者。此外，DLB患者在日常生活活动量表（ADL）和工具性日常生活活动量表（IADL）上的得分均低于AD患者。总体而言，DLB患者照料者的痛苦程度高于AD患者照料者。仅在DLB患者的照料者中观察到高度痛苦，其原因是妄想、幻觉、焦虑和冷漠。在早期认知衰退阶段，DLB患者与AD患者相比具有不同的神经心理学特征、更多的精神症状和更严重的功能缺陷，此外，DLB患者的照料者比AD患者的照料者压力更大。
