阿尔茨海默病中的淡漠：对痴呆症进展临床观点的贡献。
Apathy in Alzheimer's disease: Contribution to a clinical view on progression of dementia.
作者信息
Stella Florindo, de Andrade Larissa Pires, Vital Thays Martins, Coelho Flávia Gomes de Melo, Nascimento Carla Manuela Crispim, Hernández Salma Stephany Soleman
机构信息
UNESP, Universidade Estadual Paulista, Biosciences Institute, Campus of Rio Claro, Aging and Physical Activity Laboratory, São Paulo SP, Brazil.
Geriatric Psychiatry Clinic, State University of Campinas, CRUESP Cooperation Program, Campinas SP, Brazil.
出版信息
Dement Neuropsychol. 2010 Jul-Sep;4(3):188-193. doi: 10.1590/S1980-57642010DN40300007.
UNLABELLED
In addition to cognitive impairment, apathy is increasingly recognized as an important neuropsychiatric syndrome in Alzheimer's disease (AD).
AIMS
To identify the relationship between dementia severity and apathy levels, and to discuss the association of this condition with other psychopathological manifestations in AD patients.
METHODS
This study involved 15 AD patients (mean age: 77 years; schooling: 4.9 years), with mild, moderate and severe dementia, living in Rio Claro SP, Brazil. Procedures included evaluation of cognitive status by the Mini-Mental State Examination, Clinical Dementia Rating, and Global Deterioration Scale. Apathy syndrome was assessed by the Apathy Evaluation Scale and Neuropsychiatric Inventory (NPI-apathy domain). Other psychopathological manifestations such as depression were also considered.
RESULTS
Patients with more severe dementia presented higher levels of apathy, reinforcing the hypothesis that apathy severity aggravates as the disease progresses. Using the Spearman coefficient correlation an association was identified between the MMSE and Apathy Evaluation Scale (r=0.63; p=0.01), and also between the MMSE and NPI-apathy domain (r=0.81; p=0.01). Associations were also found between the Global Deterioration Scale and Apathy Evaluation Scale (r=0.58; p=0.02), and between the Global Deterioration Scale and NPI-apathy domain (r=0.81; p=0.01).
CONCLUSIONS
Apathy is a distinct syndrome among patients with AD and increases with global deterioration.
未标注
除认知障碍外，淡漠日益被认为是阿尔茨海默病（AD）中一种重要的神经精神综合征。
目的
确定痴呆严重程度与淡漠水平之间的关系，并探讨这种情况与AD患者其他精神病理表现的关联。
方法
本研究纳入了15名居住在巴西圣保罗州里奥克拉鲁的AD患者（平均年龄：77岁；受教育年限：4.9年），患有轻度、中度和重度痴呆。程序包括通过简易精神状态检查表、临床痴呆评定量表和总体衰退量表评估认知状态。通过淡漠评定量表和神经精神问卷（NPI-淡漠领域）评估淡漠综合征。还考虑了其他精神病理表现，如抑郁。
结果
痴呆程度越严重的患者淡漠水平越高，这强化了淡漠严重程度随疾病进展而加重的假设。使用斯皮尔曼系数相关性分析发现，简易精神状态检查表与淡漠评定量表之间存在关联（r = 0.63；p = 0.01），简易精神状态检查表与NPI-淡漠领域之间也存在关联（r = 0.81；p = 0.01）。在总体衰退量表与淡漠评定量表之间（r = 0.58；p = 0.02）以及总体衰退量表与NPI-淡漠领域之间（r = 0.81；p = 0.01）也发现了关联。
结论
淡漠是AD患者中一种独特的综合征，且随整体病情恶化而增加。
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