嗅觉功能障碍及其与阿尔茨海默病临床症状的关系。

Olfactory Dysfunction and Its Relationship with Clinical Symptoms of Alzheimer Disease.

作者信息

Yu Qiujin, Guo Peng, Li Danning, Zuo Lijun, Lian Tenghong, Yu Shuyang, Hu Yang, Liu Li, Jin Zhao, Wang Ruidan, Piao Yingshan, Li Lixia, Wang Xiaomin, Zhang Wei

机构信息

1Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.

2Department of Geriatrics, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100050, China.

出版信息

Aging Dis. 2018 Dec 4;9(6):1084-1095. doi: 10.14336/AD.2018.0819. eCollection 2018 Dec.

Abstract

Our study aimed to analyse the olfactory dysfunction (OD) evaluations between self-report, the Hyposmia Rating Scale (HRS) and the Sniffin' Sticks test, and the relationship between OD and clinical features of AD. Sixty patients with AD dementia, 37 patients with mild cognitive impairment (MCI) due to AD and 30 healthy controls were consecutively recruited. Olfactory function was evaluated by self-report, HRS and Sniffin' Sticks test. Patients were divided into AD with OD (AD-OD) and AD with no OD (AD-NOD) groups based on the results of the Sniffin' Sticks test. Cognitive symptoms and neuropsychiatric symptoms were assessed by corresponding scales, and activities of daily living (ADL) were assessed by the ADL scale. In the control, MCI due to AD and AD dementia groups, the frequency of OD was 10.0%, 13.5% and 18.3%, respectively, by self-report; 6.7%, 24.3% and 48.3%, respectively, by HRS; and 3.3%, 13.5% and 65.0%, respectively, by the Sniffin' Sticks test. Compared to the results of the Sniffin' Sticks test, the diagnostic coincidence rates of OD by HRS in patients with MCI due to AD and AD dementia were 89.2% and 66.7%, respectively. Compared to the AD-NOD group, the scores of global cognition and memory, visuospatial ability and attention were all decreased (P<0.05), the apathy score was increased (P<0.05), and the ADL score was elevated (P<0.01). The frequency and accuracy of OD by self-report is relatively low. HRS can be used for screening olfaction in patients with MCI due to AD. The Sniffin' Sticks test can be used for validating OD in AD patients. AD-OD patients have severe impairments in global cognition and multiple cognitive domains of memory, visuospatial ability and attention, as well as neuropsychiatric symptoms of apathy, and thus have seriously compromised ADL.

摘要

我们的研究旨在分析自我报告、嗅觉减退评定量表(HRS)和嗅棒测试之间对嗅觉功能障碍(OD)的评估情况,以及OD与阿尔茨海默病(AD)临床特征之间的关系。连续招募了60例AD痴呆患者、37例因AD导致的轻度认知障碍(MCI)患者和30名健康对照者。通过自我报告、HRS和嗅棒测试对嗅觉功能进行评估。根据嗅棒测试结果,将患者分为伴有OD的AD(AD-OD)组和不伴有OD的AD(AD-NOD)组。通过相应量表评估认知症状和神经精神症状,并通过日常生活活动(ADL)量表评估日常生活活动能力。在对照组、因AD导致的MCI组和AD痴呆组中,自我报告显示OD的发生率分别为10.0%、13.5%和18.3%;HRS显示分别为6.7%、24.3%和48.3%;嗅棒测试显示分别为3.3%、13.5%和65.0%。与嗅棒测试结果相比,HRS对因AD导致的MCI患者和AD痴呆患者OD的诊断符合率分别为89.2%和66.7%。与AD-NOD组相比,AD-OD组的整体认知和记忆、视觉空间能力及注意力得分均降低(P<0.05),淡漠得分升高(P<0.05),ADL得分升高(P<0.01)。自我报告对OD的发生率和准确性相对较低。HRS可用于筛查因AD导致的MCI患者的嗅觉。嗅棒测试可用于验证AD患者的OD。AD-OD患者在整体认知以及记忆、视觉空间能力和注意力等多个认知领域存在严重损害,同时伴有淡漠等神经精神症状,因此日常生活活动能力严重受损。

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