Nakatsuka Masahiro, Meguro Kenichi, Nakamura Kei, Akanuma Kyoko, Yamaguchi Satoshi
Department of Geriatric Behavioral Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan.
Dement Geriatr Cogn Disord. 2014;38(1-2):46-54. doi: 10.1159/000357837. Epub 2014 Feb 20.
Although delusion is one of the common symptoms of Alzheimer's disease (AD), the association between cognitive deficits and delusions remains unclear. Considering the heterogeneity of delusion, the correlation may depend upon the type of the delusion.
142 consecutive first-visit AD outpatients of the Tajiri Clinic (Osaki, Miyagi, Japan) were enrolled in the study. Psychological data included the Mini-Mental State Examination (MMSE), the Cognitive Abilities Screening Instrument (CASI) and the Frequency-Weighted Behavioral Pathology in Alzheimer's Disease Rating Scale (BEHAVE-AD-FW). Correlations to cognitive deficits for each category of delusional content were evaluated.
More severe delusion of 'residence is not home' was significantly correlated with a lower total MMSE score and poorer orientation as assessed with the CASI. This type of delusion also correlated to activity disturbances and was weakly associated with affective disturbances.
Our findings suggest that the 'residence is not home' delusion is a particular symptom that has a cognitive background, particularly disorientation, and should be discriminated from other delusional phenomena. We should cope with delusions specifying what types of delusions are present since the content of delusions may critically mark the symptomatology of AD. For this purpose, the BEHAVE-AD-FW may be suitable.
尽管妄想是阿尔茨海默病（AD）的常见症状之一，但认知缺陷与妄想之间的关联仍不明确。考虑到妄想的异质性，这种相关性可能取决于妄想的类型。
选取日本宫城县大崎市田尻诊所连续就诊的142例初诊AD门诊患者纳入研究。心理数据包括简易精神状态检查表（MMSE）、认知能力筛查工具（CASI）以及阿尔茨海默病频率加权行为病理评定量表（BEHAVE-AD-FW）。评估每种妄想内容类别与认知缺陷的相关性。
“住所非家”妄想越严重，MMSE总分越低，且经CASI评估定向力越差，具有显著相关性。这种类型的妄想还与活动障碍相关，与情感障碍的关联较弱。
我们的研究结果表明，“住所非家”妄想是一种具有认知背景，尤其是定向障碍的特殊症状，应与其他妄想现象相区分。由于妄想内容可能是AD症状学的关键标志，我们应针对存在的妄想类型进行处理。为此，BEHAVE-AD-FW可能适用。
