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动词流畅性在阿尔茨海默病早期认知障碍检测中的作用。

The Role of Verb Fluency in the Detection of Early Cognitive Impairment in Alzheimer's Disease.

机构信息

Memory Clinic and Research Center of Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain.

Mental Health Research Group, IMIM (Hospital del Mar Research Institute), CIBERSAM (Centro de Investigación Biomédica en Red de Salud Mental), Barcelona, Spain.

出版信息

J Alzheimers Dis. 2018;62(2):611-619. doi: 10.3233/JAD-170826.

Abstract

BACKGROUND

Verb fluency (VF) is the less commonly used fluency test, despite several studies suggesting its potential as a neuropsychological assessment tool.

OBJECTIVE

To investigate the presence of VF deficits in mild cognitive impairment (MCI) and mild Alzheimer's disease (AD) dementia; to assess the usefulness of VF in the detection of cognitively healthy (CH) people who will convert to MCI, and from MCI to dementia; and to establish the VF cut-offs useful in the cognitive assessment of Spanish population.

METHODS

568 CH, 885 MCI, and 367 mild AD dementia individuals were administered the VF test and a complete neuropsychological battery. Longitudinal analyses were performed in 231 CH and 667 MCI subjects to search for VF predictors of diagnosis conversion.

RESULTS

A worsening on VF performance from CH, MCI to AD dementia groups was found. Lower performances on VF were significantly related to conversion from CH to MCI/MCI to dementia. When the effect of time to conversion was analyzed, a significant effect of VF was found on the faster conversion from CH to MCI, but not from MCI to dementia. Moreover, VF cut-off scores and sensitivity/specificity values were calculated for 6 conditions (3 age ranges by 2 educational levels).

CONCLUSION

The VF test may be a useful tool for the differential diagnosis of cognitive failure in the elderly. Since VF deficits seem to take place in early stages of the disease, it is a suitable neuropsychological tool for the detection not only of CH people who will convert to MCI, but also from MCI to dementia.

摘要

背景

动词流畅性(VF)是一种较少使用的流畅性测试,尽管有几项研究表明它具有作为神经心理评估工具的潜力。

目的

研究轻度认知障碍(MCI)和轻度阿尔茨海默病(AD)痴呆患者中是否存在 VF 缺陷;评估 VF 在检测认知健康(CH)人群向 MCI 转化、从 MCI 向痴呆转化中的有用性;并确定 VF 截止值在西班牙人群认知评估中的有用性。

方法

对 568 名 CH、885 名 MCI 和 367 名轻度 AD 痴呆患者进行了 VF 测试和完整的神经心理学测试。对 231 名 CH 和 667 名 MCI 患者进行了纵向分析,以寻找 VF 预测诊断转换的指标。

结果

发现从 CH、MCI 到 AD 痴呆组,VF 表现逐渐恶化。VF 表现较差与从 CH 向 MCI/MCI 向痴呆的转换显著相关。当分析转换时间的影响时,发现 VF 对从 CH 向 MCI 的更快转换有显著影响,但对从 MCI 向痴呆的转换没有影响。此外,还计算了 6 种情况下(3 个年龄范围和 2 个教育水平)的 VF 截断值分数和灵敏度/特异性值。

结论

VF 测试可能是老年认知功能障碍鉴别诊断的有用工具。由于 VF 缺陷似乎发生在疾病的早期阶段,因此它是一种适合的神经心理学工具,不仅可以检测到将转化为 MCI 的 CH 人群,还可以检测到从 MCI 向痴呆的转化。

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