轻度认知障碍和阿尔茨海默病中的疾病失认症与疾病感缺失症
Anosognosia and anosodiaphoria in mild cognitive impairment and Alzheimer's disease.
作者信息
Lindau Maria, Bjork Randall
机构信息
Department of Psychology, Stockholm University, Stockholm, Sweden.
Colorado Springs Neurological Associates, Colorado Springs, Colo., USA.
出版信息
Dement Geriatr Cogn Dis Extra. 2014 Dec 3;4(3):465-80. doi: 10.1159/000369132. eCollection 2014 Sep-Dec.
AIMS
To evaluate the occurrence of anosognosia (lack of awareness) and anosodiaphoria (insouciance) in mild cognitive impairment (MCI) and Alzheimer's disease (AD) and to evaluate the influence of a worsening of dementia on these phenomena.
METHODS
A self-evaluation scale was used assessing degrees of anosognosia and anosodiaphoria; furthermore, a neuropsychological assessment and statistical analyses with nonparametric tests which could cope with data on an ordinal scale level and small samples were employed.
RESULTS
Cognitive ability was lower in AD (n = 9) than in MCI patients (n = 12), but AD patients self-rated lower cognitive disabilities, which is interpreted as one relative sign of anosognosia in AD. Awareness of the reasons for cognitive problems was also lower in AD, which is considered as another sign of anosognosia. The main pattern in MCI found that the higher the awareness, the lower the cognitive ability. In AD low awareness paralleled low cognitive functioning. Anosodiaphoria was present in AD but not in MCI.
CONCLUSION
According to the literature anosognosia and anosodiaphoria seem to increase with progression of dementia from MCI as a result of right hemispheric alterations.
目的
评估轻度认知障碍（MCI）和阿尔茨海默病（AD）中失认症（缺乏意识）和疾病失认症（漠不关心）的发生情况，并评估痴呆症恶化对这些现象的影响。
方法
使用自我评估量表评估失认症和疾病失认症的程度；此外，采用神经心理学评估以及可处理有序量表水平数据和小样本的非参数检验进行统计分析。
结果
AD患者（n = 9）的认知能力低于MCI患者（n = 12），但AD患者自我评定的认知障碍程度较低，这被解释为AD中失认症的一个相关迹象。AD患者对认知问题原因的认知也较低，这被视为失认症的另一个迹象。MCI的主要模式是意识越高，认知能力越低。在AD中，低意识与低认知功能并行。疾病失认症存在于AD中，而不存在于MCI中。
结论
根据文献，由于右半球改变，失认症和疾病失认症似乎随着痴呆症从MCI的进展而增加。
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