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痴呆诊断评估中包含的主观认知主诉有助于在混合记忆门诊队列中进行准确诊断。

Subjective cognitive complaints included in diagnostic evaluation of dementia helps accurate diagnosis in a mixed memory clinic cohort.

作者信息

Salem L C, Vogel A, Ebstrup J, Linneberg A, Waldemar G

机构信息

Memory Disorders Research Group, Danish Dementia Research Centre, Department of Neurology, Copenhagen University Hospital, Rigshospitalet, Denmark.

Research Centre for Prevention and Health, Copenhagen University Hospital Glostrup, Rigshospitalet, Denmark.

出版信息

Int J Geriatr Psychiatry. 2015 Dec;30(12):1177-85. doi: 10.1002/gps.4272. Epub 2015 Apr 17.

Abstract

OBJECTIVE

Our objective was to examine the quantity and profile of subjective cognitive complaints in young patients as compared with elderly patients referred to a memory clinic.

METHODS

Patients were consecutively recruited from the Copenhagen University Hospital Memory Clinic at Rigshospitalet. In total, 307 patients and 149 age-matched healthy controls were included. Patients were classified in 4 diagnostic groups: dementia, mild cognitive impairment, affective disorders and no cognitive impairment. Subjective memory was assessed with subjective memory complaints (SMC) scale. Global cognitive functions were assessed with the Mini-mental state examination (MMSE) and Addenbrooke's cognitive examination (ACE), and symptoms of depression were rated with Major Depression Inventory (MDI). All interviews and the diagnostic conclusion were blinded to the SMC score.

RESULTS

We found that young patients with dementia have a significantly higher level and a different profile of subjective cognitive complaints as compared with elderly patients with dementia. Furthermore, young patients, diagnosed with an affective disorder, had the highest level of subjective cognitive complaints of all patients in a memory clinic. The age of the patients and MDI score (but not MMSE or ACE) had significant impact on the level of subjective cognitive complaints.

CONCLUSIONS

We have established that young patients with dementia have a different profile of subjective cognitive complaints than elderly patients, and further studies are needed to clarify possible relation to specific subtypes of dementia. Altogether, a systematic interview on subjective cognitive complaints may contribute to the diagnostic evaluation of patients referred to a memory clinic.

摘要

目的

我们的目的是研究与转诊至记忆门诊的老年患者相比,年轻患者主观认知主诉的数量和特征。

方法

患者连续从哥本哈根大学医院里格霍斯帕勒特记忆门诊招募。总共纳入了307例患者和149例年龄匹配的健康对照。患者被分为4个诊断组:痴呆、轻度认知障碍、情感障碍和无认知障碍。主观记忆通过主观记忆主诉(SMC)量表进行评估。整体认知功能通过简易精神状态检查表(MMSE)和Addenbrooke认知检查表(ACE)进行评估,抑郁症状用重度抑郁量表(MDI)进行评分。所有访谈和诊断结论均对SMC评分保密。

结果

我们发现,与患有痴呆的老年患者相比,患有痴呆的年轻患者主观认知主诉水平显著更高且特征不同。此外,被诊断为情感障碍的年轻患者在记忆门诊所有患者中主观认知主诉水平最高。患者年龄和MDI评分(而非MMSE或ACE)对主观认知主诉水平有显著影响。

结论

我们已确定,患有痴呆的年轻患者与老年患者主观认知主诉特征不同,需要进一步研究以阐明与特定痴呆亚型的可能关系。总之,对主观认知主诉进行系统访谈可能有助于对转诊至记忆门诊的患者进行诊断评估。

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