阿尔茨海默病（AD）和皮质下缺血性血管性痴呆（SIVD）的进展是否不同？
Do Alzheimer's disease (AD) and subcortical ischemic vascular dementia (SIVD) progress differently?
机构信息
Department of Neurology, Yong-In Hyoja Geriatric Hospital, 33 Sangha-dong, Giheung-gu, Yongin 446-769, Republic of Korea.
Department of Neurology, Konyang University College of Medicine, 685 Gawuwon-dong, Seo-gu, Daejeon 302-718, Republic of Korea.
出版信息
Arch Gerontol Geriatr. 2014 May-Jun;58(3):415-9. doi: 10.1016/j.archger.2013.11.005. Epub 2013 Nov 22.
Our study aimed to compare cognitive status and declines in AD with/without small vessel disease (SVD) and SIVD at baseline and 1-year follow-up. Patients with Alzheimer's disease without small vessel disease (AD(-)SVD) (n=148), Alzheimer's disease with small vessel disease (AD(+)SVD) (n=94) and SIVD (n=60) were recruited from database of multiple centers in Korea. Basic demographics and detailed neuropsychological results were compared. AD, regardless of SVD, showed worse memory and better executive function than SIVD at baseline. Mini-Mental State Examination scores and visual memory function declined more in AD than those in SIVD whereas Barthel Activities of Daily Living (B-ADL) scores declined more in SIVD. AD showed different patterns of cognitive impairment compared with SIVD. After 1 year, AD showed more rapid cognitive decline in some domains. Further investigations with longer follow-up duration may be needed to confirm the cumulative effects of SVD in AD and different patterns of decline between AD and SIVD.
我们的研究旨在比较基线和 1 年随访时伴有/不伴有小血管疾病 (SVD) 和脑淀粉样血管病 (SIVD) 的 AD 患者的认知状态和认知下降情况。从韩国多个中心的数据库中招募了无小血管疾病的阿尔茨海默病患者 (AD(-)SVD) (n=148)、伴有小血管疾病的阿尔茨海默病患者 (AD(+)SVD) (n=94) 和 SIVD 患者 (n=60)。比较了基本人口统计学和详细的神经心理学结果。AD 无论是否存在 SVD，在基线时的记忆功能均比 SIVD 差，执行功能比 SIVD 好。与 SIVD 相比，AD 的简易精神状态检查评分和视觉记忆功能下降更多，而 SIVD 的日常生活活动能力（Barthel 日常生活活动能力评分，B-ADL）下降更多。AD 与 SIVD 的认知障碍模式不同。1 年后，AD 在某些领域的认知下降更为迅速。需要进行更长时间的随访研究，以确认 SVD 在 AD 中的累积效应以及 AD 和 SIVD 之间的不同下降模式。
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