考虑阿尔茨海默病和路易体痴呆中的功能丧失：超越认知。
Accounting for functional loss in Alzheimer's disease and dementia with Lewy bodies: beyond cognition.
作者信息
Hamilton Joanne M, Salmon David P, Raman Rema, Hansen Lawrence A, Masliah Eliezer, Peavy Guerry M, Galasko Douglas
机构信息
Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA.
Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA.
出版信息
Alzheimers Dement. 2014 Mar;10(2):171-8. doi: 10.1016/j.jalz.2013.04.003. Epub 2013 Jul 11.
BACKGROUND
The relative contributions of cognitive, motor, and behavioral deficits to the impairment of physical or instrumental activities of daily living (ADLs) may differ in patients with dementia with Lewy bodies (DLB) and Alzheimer's disease (AD).
METHODS
Multiple linear regression analyses were used to identify the amount of variability in physical self-maintenance and instrumental ADL ratings predicted by cognitive, motor, and behavioral indices separately for patients with autopsy-diagnosed DLB (n = 39) or AD (n = 39).
RESULTS
Motor dysfunction accounted for significant variance in physical ADLs in DLB (R(2) change = 0.17), whereas behavioral (R(2) change = 0.23) and motor dysfunction (R(2) change = 0.13) accounted for significant variance in AD. Motor (R(2) change = 0.32) and cognitive (R(2) change = 0.10) dysfunction accounted for significant variance in instrumental ADLs in DLB, whereas cognitive (R(2) change = 0.36) and behavioral (R(2) change = 0.12) dysfunction accounted for significant variance in AD.
CONCLUSIONS
Cognitive, motor, and behavioral deficits contribute differently to ADL changes in DLB and AD. Thus, treatments designed to ameliorate a certain aspect of AD or DLB (e.g., cognitive dysfunction) may have a larger impact on everyday functioning in one disorder than the other.
背景
在路易体痴呆（DLB）和阿尔茨海默病（AD）患者中，认知、运动和行为缺陷对日常生活自理或工具性活动（ADL）受损的相对贡献可能有所不同。
方法
采用多元线性回归分析，分别针对尸检诊断为DLB（n = 39）或AD（n = 39）的患者，确定由认知、运动和行为指标预测的身体自我维持和工具性ADL评分的变异量。
结果
运动功能障碍在DLB的身体ADL中占显著变异（R²变化 = 0.17），而在AD中行为（R²变化 = 0.23）和运动功能障碍（R²变化 = 0.13）占显著变异。运动（R²变化 = 0.32）和认知（R²变化 = 0.10）功能障碍在DLB的工具性ADL中占显著变异，而在AD中认知（R²变化 = 0.36）和行为（R²变化 = 0.12）功能障碍占显著变异。
结论
认知、运动和行为缺陷对DLB和AD的ADL变化的贡献不同。因此，旨在改善AD或DLB某一方面（如认知功能障碍）的治疗，对一种疾病日常功能的影响可能比对另一种疾病的影响更大。
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