Rivera-Fernández Claudia, Custodio Nilton, Soto-Añari Marcio
Universidad Nacional de San Agustín de Arequipa ‒ Arequipa, Perú.
Instituto Peruano de Neurociencias ‒ Lima, Perú.
Dement Neuropsychol. 2021 Apr-Jun;15(2):192-199. doi: 10.1590/1980-57642021dn15-020006.
The preclinical stages of dementia include subtle neurocognitive changes that are not easily detected in standard clinical evaluations. Neuropsychological evaluation is important for the classification and prediction of deterioration in all the phases of dementia.
Compare the neuropsychological performance in healthy older adults with subjective cognitive decline (SCD) and with mild cognitive impairment (MCI) using principal components analysis.
We evaluated 94 older adults with a clinical protocol which included general measures of mental, emotional and functional state. The neuropsychological protocol included tasks of memory, executive function, attention, verbal fluency and visuoconstructional abilities. We used principal component analysis (PCA) to reduce variables´ dimensionality on neuropsychological evaluation.
33(35%) participants had a normal cognitive function, 35(37%) had subjective cognitive decline and 26(28%) had a mild cognitive impairment. The PCA showed seven factors: processing speed, memory, visuoconstruction, verbal fluency and executive components of cognitive flexibility, inhibitory control and working memory. ANOVA had shown significant differences between the groups in the memory (F=4.383, p=0.016, η2p=0.087) and visuoconstructional components (F=5.395, p=0.006, η2p=0.105). Post hoc analysis revealed lower memory scores in MCI than SCD participants and in visuospatial abilities between MCI and SCD and MCI and Normal participants.
We observed differentiated cognitive profiles among the participants in memory and visuoconstruction components. The use of PCA in the neuropsychological evaluation could help to make a differentiation of cognitive abilities in preclinical stages of dementia.
痴呆的临床前期包括在标准临床评估中不易检测到的细微神经认知变化。神经心理学评估对于痴呆各阶段的分类和病情恶化预测很重要。
使用主成分分析比较健康老年人、主观认知下降(SCD)者和轻度认知障碍(MCI)者的神经心理学表现。
我们采用临床方案评估了94名老年人,该方案包括心理、情绪和功能状态的一般测量。神经心理学方案包括记忆、执行功能、注意力、语言流畅性和视觉构建能力的任务。我们使用主成分分析(PCA)来降低神经心理学评估中变量的维度。
33名(35%)参与者认知功能正常,35名(37%)有主观认知下降,26名(28%)有轻度认知障碍。主成分分析显示有七个因素:处理速度、记忆、视觉构建、语言流畅性以及认知灵活性、抑制控制和工作记忆的执行成分。方差分析显示,各组在记忆(F = 4.383,p = 0.016,η2p = 0.087)和视觉构建成分(F = 5.395,p = 0.006,η2p = 0.105)方面存在显著差异。事后分析显示,MCI参与者的记忆得分低于SCD参与者,MCI与SCD以及MCI与正常参与者在视觉空间能力方面存在差异。
我们观察到参与者在记忆和视觉构建成分方面存在不同的认知特征。在神经心理学评估中使用主成分分析有助于区分痴呆临床前期的认知能力。