Zhang Meiyan, Wang Huali, Li Tao, Yu Xin
Dementia Care and Research Center, Peking University Institute of Mental Health, and Key Laboratory for Mental Health, Ministry of Health, Beijing, China.
Dement Geriatr Cogn Dis Extra. 2012 Jan;2(1):200-8. doi: 10.1159/000338410. Epub 2012 Apr 27.
The study aimed to compare the frequency of neuropsychiatric symptoms (NPS) across the declining memory continuum, from normal aging, subjective cognitive impairment (SCI), and mild cognitive impairment (MCI) to Alzheimer's disease (AD), and to explore the clinical correlates of NPS.
In a memory clinic, 157 subjects (46 mild AD patients, 38 MCI individuals, 24 SCI subjects, and 49 normal controls) completed the neurobehavioral assessments with the Neuropsychiatric Inventory (NPI). The clinical significance of each NPI domain was defined as an item score ≥4.
Clinically significant depression was more common in the SCI than in the normal control group (p < 0.05). The frequency of NPS was significantly greater in the mild AD group compared to other groups. Clinically significant apathy and aberrant motor behavior were more common among the AD group than the MCI group (p < 0.05). The MMSE score (OR 4.84, 95% CI 1.92-12.16, p = 0.001) and apathy (OR 12.73, 95% CI 1.48-109.68, p = 0.021) significantly determined the diagnostic status as MCI or mild AD.
Across the declining memory continuum, the frequency of NPS was highest among mild AD patients. Depression, apathy, and aberrant motor behavior deserve more attention. Presence of apathy might be an independent determinant for mild AD.
本研究旨在比较从正常衰老、主观认知障碍(SCI)、轻度认知障碍(MCI)到阿尔茨海默病(AD)整个记忆功能逐渐衰退过程中神经精神症状(NPS)的发生频率,并探讨NPS的临床相关因素。
在一家记忆门诊中,157名受试者(46名轻度AD患者、38名MCI个体、24名SCI受试者和49名正常对照)使用神经精神科问卷(NPI)完成了神经行为评估。每个NPI领域的临床意义定义为项目得分≥4。
临床上显著的抑郁在SCI组中比正常对照组更常见(p<0.05)。与其他组相比,轻度AD组中NPS的发生频率显著更高。临床上显著的冷漠和异常运动行为在AD组中比MCI组更常见(p<0.05)。简易精神状态检查表(MMSE)评分(比值比4.84,95%置信区间1.92 - 12.16,p = 0.001)和冷漠(比值比12.73,95%置信区间1.48 - 109.68,p = 0.021)显著决定了诊断为MCI或轻度AD的状态。
在整个记忆功能逐渐衰退过程中,轻度AD患者中NPS的发生频率最高。抑郁、冷漠和异常运动行为值得更多关注。冷漠的存在可能是轻度AD的一个独立决定因素。