Department of Geriatric Neurology, Shiga Medical Center, Moriyama, Shiga, Japan.
J Neurol Neurosurg Psychiatry. 2015 Nov;86(11):1248-52. doi: 10.1136/jnnp-2014-309436. Epub 2014 Dec 16.
To examine whether imitation of gestures provided useful information to diagnose early dementia in elderly patients.
Imitation of finger and hand gestures was evaluated in patients with mild dementia; 74 patients had dementia with Lewy bodies (DLB), 100 with Alzheimer's disease (AD) and 52 with subcortical vascular dementia (SVaD).
Significantly, more patients with DLB (32.4%) compared with patients with AD (5%) or SVaD (11.5%) had an impaired ability to imitate finger gestures bilaterally. Also, significantly, more patients with DLB (36.5%) compared with patients with AD (5%) or SVaD (15.4%) had lower mean scores of both hands. In contrast, impairment of the imitation of bimanual gestures was comparable among the three patient groups (DLB 50%, AD 42%, SVaD 42.3%).
Our study revealed that imitation of bimanual gestures was impaired non-specifically in about half of the patients with mild dementia, whereas imitation of finger gestures was significantly more impaired in patients with early DLB than in those with AD or SVaD. Although the sensitivity was not high, the imitation tasks may provide additional information for diagnosis of mild dementia, especially for DLB.
研究目的在于探讨模仿手势是否能为诊断老年痴呆患者的早期痴呆提供有用信息。
评估轻度痴呆患者对手指和手势的模仿能力；74 名患者患有路易体痴呆（DLB），100 名患者患有阿尔茨海默病（AD），52 名患者患有皮质下血管性痴呆（SVaD）。
具有显著意义的是，与 AD（5%）或 SVaD（11.5%）患者相比，更多的 DLB 患者（32.4%）双侧手指的模仿能力受损。同样具有显著意义的是，与 AD（5%）或 SVaD（15.4%）患者相比，更多的 DLB 患者（36.5%）双手的平均得分较低。相比之下，三组患者的双手模仿动作障碍相似（DLB 为 50%，AD 为 42%，SVaD 为 42.3%）。
本研究表明，大约一半的轻度痴呆患者双侧手势模仿出现非特异性障碍，而与 AD 或 SVaD 患者相比，早期 DLB 患者手指的模仿能力明显受损。虽然敏感性不高，但模仿任务可能为轻度痴呆的诊断提供额外信息，尤其是对 DLB 患者。
