Cerman Jiri, Andel Ross, Laczo Jan, Vyhnalek Martin, Nedelska Zuzana, Mokrisova Ivana, Sheardova Katerina, Hort Jakub
Department of Neurology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital, Prague, Czech Republic.
International Clinical Research Center, St. Anne's University Hospital Brno, Bronstred, Czech Republic.
Curr Alzheimer Res. 2018;15(3):219-228. doi: 10.2174/1567205014666171120145349.
Great effort has been put into developing simple and feasible tools capable to detect Alzheimer's disease (AD) in its early clinical stage. Spatial navigation impairment occurs very early in AD and is detectable even in the stage of mild cognitive impairment (MCI).
The aim was to describe the frequency of self-reported spatial navigation complaints in patients with subjective cognitive decline (SCD), amnestic and non-amnestic MCI (aMCI, naMCI) and AD dementia and to assess whether a simple questionnaire based on these complaints may be used to detect early AD.
In total 184 subjects: patients with aMCI (n=61), naMCI (n=27), SCD (n=63), dementia due to AD (n=20) and normal controls (n=13) were recruited. The subjects underwent neuropsychological examination and were administered a questionnaire addressing spatial navigation complaints. Responses to the 15 items questionnaire were scaled into four categories (no, minor, moderate and major complaints).
55% of patients with aMCI, 64% with naMCI, 68% with SCD and 72% with AD complained about their spatial navigation. 38-61% of these complaints were moderate or major. Only 33% normal controls expressed complaints and none was ranked as moderate or major. The SCD, aMCI and AD dementia patients were more likely to express complaints than normal controls (p's<0.050) after adjusting for age, education, sex, depressive symptoms (OR for SCD=4.00, aMCI=3.90, AD dementia=7.02) or anxiety (OR for SCD=3.59, aMCI=3.64, AD dementia=6.41).
Spatial navigation complaints are a frequent symptom not only in AD, but also in SCD and aMCI and can potentially be detected by a simple and inexpensive questionnaire.
人们付出了巨大努力来开发简单可行的工具，以便在阿尔茨海默病（AD）的临床早期阶段进行检测。空间导航障碍在AD早期就会出现，甚至在轻度认知障碍（MCI）阶段就可检测到。
描述主观认知下降（SCD）、遗忘型和非遗忘型MCI（aMCI、naMCI）以及AD痴呆患者自我报告的空间导航问题的频率，并评估基于这些问题的简单问卷是否可用于早期AD的检测。
共招募了184名受试者，包括aMCI患者（n = 61）、naMCI患者（n = 27）、SCD患者（n = 63）、AD所致痴呆患者（n = 20）和正常对照者（n = 13）。受试者接受了神经心理学检查，并填写了一份关于空间导航问题的问卷。对这份包含15个条目的问卷的回答被分为四类（无、轻微、中度和重度问题）。
55%的aMCI患者、64%的naMCI患者、68%的SCD患者和72%的AD患者抱怨其空间导航存在问题。其中38 - 61%的问题为中度或重度。只有33%的正常对照者表示有问题，且无一人被评为中度或重度。在调整年龄、教育程度、性别、抑郁症状（SCD的OR = 4.00，aMCI = 3.90，AD痴呆 = 7.02）或焦虑（SCD的OR = 3.59，aMCI = 3.64，AD痴呆 = 6.41）后，SCD、aMCI和AD痴呆患者比正常对照者更有可能表示有问题（p值<0.050）。
空间导航问题不仅在AD中是常见症状，在SCD和aMCI中也是如此，并且有可能通过一份简单且廉价的问卷进行检测。
