Departments of Psychology & Section of Brain Maturation, Institute of Psychiatry, King's College London, London, England.
J Int Neuropsychol Soc. 2010 Jan;16(1):77-83. doi: 10.1017/S1355617709990981. Epub 2009 Oct 19.
Recent evidence suggests that patients with Alzheimer's disease (AD) and vascular comorbidities (VC) perform worse across measures of verbal reasoning and abstraction when compared to patients with AD alone. We performed a qualitative error analysis of Wechsler Adult Intelligence Scale-III Similarities zero-point responses in 45 AD patients with varying numbers of VC, including diabetes, hypertension, and hypercholesterolemia. Errors were scored in set if the answer was vaguely related to how the word pair was alike (e.g., dog-lion: "they can be trained") and out of set if the response was unrelated ("a lion can eat a dog"). AD patients with 2-3 VC did not differ on Similarities total score or qualitative errors from AD patients with 0-1 VC. When analyzing the group as a whole, we found that increasing numbers of VC were significantly associated with increasing out of set errors and decreasing in set errors in AD. Of the vascular diseases investigated, it was only the severity of diastolic blood pressure that significantly correlated with out of set responses. Understanding the contribution of VC to patterns of impairment in AD may provide support for directed patient and caregiver education concerning the presentation of a more severe pattern of cognitive impairment in affected individuals.
最近的证据表明，与单纯患有阿尔茨海默病（AD）的患者相比，患有 AD 合并血管性共病（VC）的患者在言语推理和抽象能力等方面的各项测量指标上表现更差。我们对 45 名 AD 患者的韦氏成人智力量表-III 相似零分反应进行了定性错误分析，这些患者的 VC 数量不同，包括糖尿病、高血压和高胆固醇血症。如果答案与单词对的相似之处有模糊的关联（例如，狗-狮子：“它们可以被训练”），则计为错误，如果答案与单词对没有关联（例如，狮子可以吃狗）则不计为错误。有 2-3 种 VC 的 AD 患者在相似性总分或定性错误上与有 0-1 种 VC 的 AD 患者没有差异。当分析整个组时，我们发现，VC 数量的增加与 AD 患者的离题错误增加和切题错误减少显著相关。在所调查的血管疾病中，只有舒张期血压的严重程度与离题反应显著相关。了解 VC 对 AD 损害模式的影响可能为针对受影响个体认知障碍更严重模式的患者和护理人员提供有针对性的教育提供支持。
