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神经精神症状作为记忆诊断的区分因素。

Neuropsychiatric symptoms as a distinguishing factor between memory diagnoses.

机构信息

School of Aging Studies, University of South Florida, Tampa, Florida, USA.

Wien Center for Alzheimer's Disease and Memory Disorders, Mount Sinai Medical Center, University of Miami, Miami, Florida, USA.

出版信息

Int J Geriatr Psychiatry. 2020 Oct;35(10):1115-1122. doi: 10.1002/gps.5333. Epub 2020 Jun 9.

Abstract

OBJECTIVES

To determine whether neuropsychiatric symptoms (NPS) are able to differentiate those with mild cognitive impairment (MCI) and dementia from persons who are cognitively healthy.

METHODS

Multinomial and binary logistic regressions were used to assess secondary data of a sample (n = 613) of older adults with NPS. Analyses evaluated the ability to differentiate between diagnoses, as well as the influence of these symptoms for individuals with amnestic MCI (MCI-A), non-amnestic MCI (MCI-NA), and dementia compared with those who are cognitively healthy.

RESULTS

Persons with MCI were more likely to have anxiety, apathy, and appetite changes compared with cognitively healthy individuals. Persons with dementia were more likely to have aberrant motor behaviors, anxiety, apathy, appetite changes, and delusions compared with those who were cognitively healthy. Individuals with any type of cognitive impairment were more likely to have anxiety, apathy, appetite changes, and delusions. Specifically, anxiety, apathy, appetite changes, and disinhibition were predictors of MCI-A; agitation and apathy were predictors of MCI-NA; and aberrant motor behaviors, anxiety, apathy, appetite changes, and delusions were predictors of dementia. Finally, nighttime behavior disorders were less likely in individuals with dementia.

CONCLUSIONS

The present study's results demonstrate that specific NPS are differentially represented among types of cognitive impairment and establish the predictive value for one of these cognitive impairment diagnoses.

摘要

目的

确定神经精神症状(NPS)是否能够区分轻度认知障碍(MCI)和痴呆患者与认知健康者。

方法

使用多项和二项逻辑回归评估了有 NPS 的老年人样本(n=613)的二级数据。分析评估了区分诊断的能力,以及这些症状对遗忘型 MCI(MCI-A)、非遗忘型 MCI(MCI-NA)和痴呆患者与认知健康者的影响。

结果

与认知健康者相比,MCI 患者更有可能出现焦虑、冷漠和食欲改变。与认知健康者相比,痴呆患者更有可能出现异常运动行为、焦虑、冷漠、食欲改变和妄想。任何类型认知障碍的个体更有可能出现焦虑、冷漠、食欲改变和妄想。具体而言,焦虑、冷漠、食欲改变和抑制障碍是 MCI-A 的预测因子;激越和冷漠是 MCI-NA 的预测因子;异常运动行为、焦虑、冷漠、食欲改变和妄想是痴呆的预测因子。最后,痴呆患者夜间行为障碍较少。

结论

本研究结果表明,特定的 NPS 在不同类型的认知障碍中存在差异,并确定了这些认知障碍诊断中的一种的预测价值。

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