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轻度认知障碍和阿尔茨海默病患者的自我报告及他人报告的记忆功能与意识

Self-reported and informant-reported memory functioning and awareness in patients with mild cognitive impairment and Alzheimer´s disease.

作者信息

Silva Martina Rios, Moser Doris, Pflüger Melanie, Pusswald Gisela, Stögmann Elisabeth, Dal-Bianco Peter, Auff Eduard, Lehrner Johann

机构信息

Faculty of Psychology, University of Vienna, Vienna, Austria.

Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1097, Vienna, Austria.

出版信息

Neuropsychiatr. 2016 Jun;30(2):103-12. doi: 10.1007/s40211-016-0185-y. Epub 2016 Jun 13.

Abstract

BACKGROUND

Awareness of subjective memory is an important factor for adequate treatment of patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). This study served to find out whether awareness of subjective memory complies with objective performance, if differences in awareness are observed longitudinally and whether decrease of awareness can serve as a predictor of AD in MCI patients.

METHODS

Thirty-four patients with MCI seeking help in a memory outpatient clinic were included. All participants underwent thorough neuropsychological examination. Awareness of subjective memory was obtained by calculating difference scores between patient and informant ratings on a 16-item questionnaire concerning complaints about loss of memory in every-day life. Retesting was performed after a mean follow-up period of 24 months.

RESULTS

Whole group analyses showed that awareness remained relatively stable across time. Self-reported memory complaints correlated with episodic memory at baseline and with performance on a language task at follow-up. Retests displayed decrease of awareness. At group level differences in awareness between both times of assessment were not significant for MCI and MCI patients converting to mild AD at follow-up. The predictive value of awareness was low.

CONCLUSIONS

Awareness of subjective memory deficit is linked to episodic memory function and decreases with decline of cognitive ability. Further studies evaluating predictive power of awareness of subjective memory should include a larger patient sample.

摘要

背景

主观记忆意识是对轻度认知障碍(MCI)和阿尔茨海默病(AD)患者进行充分治疗的重要因素。本研究旨在探讨主观记忆意识是否与客观表现相符,纵向观察意识差异,以及意识下降是否可作为MCI患者患AD的预测指标。

方法

纳入34名在记忆门诊寻求帮助的MCI患者。所有参与者均接受全面的神经心理学检查。通过计算患者与 informant 在一份关于日常生活中记忆丧失抱怨的16项问卷上的评分差异得分,来获取主观记忆意识。在平均随访24个月后进行重新测试。

结果

全组分析表明,意识随时间保持相对稳定。自我报告的记忆抱怨在基线时与情景记忆相关,在随访时与语言任务表现相关。重新测试显示意识下降。在组水平上,MCI患者以及随访时转化为轻度AD的MCI患者在两次评估之间的意识差异不显著。意识的预测价值较低。

结论

主观记忆缺陷意识与情景记忆功能相关,并随认知能力下降而降低。进一步评估主观记忆意识预测能力的研究应纳入更大的患者样本。

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