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阿尔茨海默病性痴呆和遗忘型轻度认知障碍中的手势模仿

The Gesture Imitation in Alzheimer's Disease Dementia and Amnestic Mild Cognitive Impairment.

作者信息

Li Xudong, Jia Shuhong, Zhou Zhi, Hou Chunlei, Zheng Wenjing, Rong Pei, Jiao Jinsong

机构信息

Department of Neurology, China-Japan Friendship Hospital, Beijing, China.

Department of Senior Official Ward, China-Japan Friendship Hospital, Beijing, China.

出版信息

J Alzheimers Dis. 2016 Jul 14;53(4):1577-84. doi: 10.3233/JAD-160218.

Abstract

BACKGROUND

Alzheimer's disease dementia (ADD) has become an important health problem in the world. Visuospatial deficits are considered to be an early symptom besides memory disorder.

OBJECTIVES

The gesture imitation test was devised to detect ADD and amnestic mild cognitive impairment (aMCI).

METHODS

A total of 117 patients with ADD, 118 with aMCI, and 95 normal controls were included in this study. All participants were administered our gesture imitation test, the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MoCA), the Clock Drawing Test (CDT), and the Clinical Dementia Rating Scale (CDR).

RESULTS

Patients with ADD performed worse than normal controls on global scores and had a lower success rate on every item (p < 0.001). The area under the curve (AUC) for the global scores when comparing the ADD and control groups was 0.869 (p < 0.001). Item 4 was a better discriminator with a sensitivity of 84.62% and a specificity of 67.37%. The AUC for the global scores decreased to 0.621 when applied to the aMCI and control groups (p = 0.002). After controlling for age and education, the gesture imitation test scores were positively correlated with the MMSE (r = 0.637, p < 0.001), the MoCA (r = 0.572, p < 0.001), and the CDT (r = 0.514, p < 0.001) and were negatively correlated with the CDR scores (r = -0.558, p < 0.001).

CONCLUSIONS

The gesture imitation test is an easy, rapid tool for detecting ADD, and is suitable for the patients suspected of mild ADD and aMCI in outpatient clinics.

摘要

背景

阿尔茨海默病性痴呆(ADD)已成为全球一个重要的健康问题。除记忆障碍外,视空间功能缺陷被认为是早期症状。

目的

设计手势模仿测试以检测ADD和遗忘型轻度认知障碍(aMCI)。

方法

本研究共纳入117例ADD患者、118例aMCI患者和95名正常对照者。所有参与者均接受我们的手势模仿测试、简易精神状态检查表(MMSE)、蒙特利尔认知评估量表(MoCA)、画钟试验(CDT)和临床痴呆评定量表(CDR)。

结果

ADD患者在总体得分上比正常对照者差,且每个项目的成功率较低(p<0.001)。比较ADD组和对照组时,总体得分的曲线下面积(AUC)为0.869(p<0.001)。项目4是更好的鉴别指标,敏感性为84.62%,特异性为67.37%。应用于aMCI组和对照组时,总体得分的AUC降至0.621(p=0.002)。在控制年龄和教育因素后,手势模仿测试得分与MMSE(r=0.637,p<0.001)、MoCA(r=0.572,p<0.001)和CDT(r=0.514,p<0.001)呈正相关,与CDR得分呈负相关(r=-0.558,p<0.001)。

结论

手势模仿测试是一种检测ADD的简便、快速工具,适用于门诊疑似轻度ADD和aMCI的患者。

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