de Siqueira Alaise Silva Santos, Yokomizo Juliana Emy, Jacob-Filho Wilson, Yassuda Mônica Sanches, Aprahamian Ivan
Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, Brazil.
Dement Geriatr Cogn Disord. 2017;43(1-2):81-88. doi: 10.1159/000455120. Epub 2017 Jan 18.
Changes in decision-making (DM) have recently been investigated in patients with Alzheimer disease (AD) or mild cognitive impairment (MCI). DM is highly relevant to everyday functioning and autonomy. It relies on several cognitive abilities, such as semantic and episodic memory, as well as aspects of executive functioning. We conducted a systematic review of DM in older adults with MCI and AD.
Only 5 studies whose main objective was to evaluate the DM performance were selected. The results extracted indicated that DM in ambiguity and in at-risk situations are both impaired in probable AD patients. MCI patients have difficulty making advantageous decisions under ambiguity and at risk, similar to patients with probable AD but they are less impaired. Key Messages: DM deficits may be a predictor of cognitive impairment and conversion to dementia and its potential clinical value should be further explored in longitudinal studies involving direct comparison between MCI and AD patients.
近期,针对阿尔茨海默病(AD)或轻度认知障碍(MCI)患者的决策制定(DM)变化展开了研究。决策制定与日常功能及自主性高度相关。它依赖于多种认知能力,如语义和情景记忆,以及执行功能的各个方面。我们对患有MCI和AD的老年人的决策制定进行了系统综述。
仅选取了5项主要目的为评估决策制定表现的研究。提取的结果表明,在可能患有AD的患者中,在模糊情境和风险情境下的决策制定均受到损害。MCI患者在模糊和有风险的情况下做出有利决策存在困难,这与可能患有AD的患者类似,但受损程度较轻。关键信息:决策制定缺陷可能是认知障碍和向痴呆症转化的预测指标,其潜在临床价值应在涉及MCI和AD患者直接比较的纵向研究中进一步探索。