Gao Zhong-bao, Wang Wei, Wang Zhen-fu, Guan Wei-ping, Wu Wei-ping
Department of Neurology, Nanlou Division, Chinese PLA General Hospital, Beijing 100853, China.
Zhonghua Yi Xue Za Zhi. 2012 Jan 17;92(3):152-5.
To explore the neuropsychological features of elderly patients with mild cognitive impairment (MCI) susceptible to Alzheimer's disease (AD).
A total of 47 patients with MCI diagnosed from June to October 2008 and 21 controls with normal cognition at the same convalescent camp were selected and followed up for two years. Montreal cognitive assessment (MoCA), mini mental state examination (MMSE) and clock drawing test (CDT) were performed for all subjects at the onset of study and repeated annually.
At Month 12, the visuospatial skill scores of MCI patients decreased significantly versus those of the control (0.6 ± 0.7 vs 0.1 ± 0.6, P = 0.008). No one progressed to AD in neither groups. And at Month 24, both visuospatial skill scores (0.9 ± 0.9 vs 0.4 ± 0.9) and attention scores (1.0 ± 1.0 vs 0.2 ± 0.8) of MCI patients declined significantly versus the control (P = 0.021, 0.001). Among 47 MCI patients, 7 progressed to AD. No obvious difference existed in the score of all items between the AD converters and non-converters at baseline. However, the scores of MMSE (27.6 ± 0.8 vs 28.9 ± 1.0), MoCA (24.3 ± 3.1 vs 27.9 ± 1.6) and such MoCA subitems as visuospatial skill (3.9 ± 0.7 vs 4.5 ± 0.6), language (1.86 ± 0.38 vs 2.65 ± 0.53) and delayed recall (2.1 ± 1.5 vs 3.9 ± 1.0) of the converters were obviously lower than those of the non-converters at Month 12 (P < 0.05). Furthermore, all other scores of the AD converters, except for designation and abstract, were significantly lower than those of the non-converters at Month 24 (P < 0.05).
The visuospatial skill, executive function, delayed recall and language function of MCI patients progressing to AD tend to have early impairment and significant changes. It may be useful to predict AD among the MCI patients.
探讨易患阿尔茨海默病（AD）的轻度认知障碍（MCI）老年患者的神经心理学特征。
选取2008年6月至10月诊断的47例MCI患者和同一疗养院21例认知正常的对照者，进行为期两年的随访。所有受试者在研究开始时进行蒙特利尔认知评估（MoCA）、简易精神状态检查（MMSE）和画钟试验（CDT），并每年重复进行。
在第12个月时，MCI患者的视空间技能得分较对照组显著下降（0.6±0.7对0.1±0.6，P = 0.008）。两组均无进展为AD者。在第24个月时，MCI患者的视空间技能得分（0.9±0.9对0.4±0.9）和注意力得分（1.0±1.0对0.2±0.8）较对照组均显著下降（P = 0.021，0.001）。47例MCI患者中，7例进展为AD。在基线时，进展为AD者和未进展者所有项目的得分无明显差异。然而，在第12个月时，进展为AD者的MMSE得分（27.6±0.8对28.9±1.0）、MoCA得分（24.3±3.1对27.9±1.6）以及MoCA的视空间技能（3.9±0.7对4.5±0.6）、语言（1.86±0.38对2.65±0.53）和延迟回忆（2.1±1.5对3.9±1.0）等子项目得分均明显低于未进展者（P < 0.05）。此外，在第24个月时，除命名和抽象外，进展为AD者的所有其他得分均显著低于未进展者（P < 0.05）。
进展为AD的MCI患者的视空间技能、执行功能、延迟回忆和语言功能往往早期受损且有显著变化。这可能有助于预测MCI患者中的AD。
