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与阿尔茨海默病或脑小血管病相关的认知功能障碍:有何不同。

The cognitive dysfunction related to Alzheimer disease or cerebral small vessel disease: What's the differences.

机构信息

School of Medicine, Taizhou University, Zhejiang Province, Taizhou 318000, China.

School of Nursing, The second Military Medical Universtiy, Shanghaihai 2000433, China.

出版信息

Medicine (Baltimore). 2021 Aug 27;100(34):e26967. doi: 10.1097/MD.0000000000026967.

Abstract

Alzheimer disease (AD) and sporadic cerebral small vessel disease (CSVD) are common cognitive disorders. Both AD and CSVD have mental symptoms including chronic progressive cognitive impairment, dysfunction, and behavioral abnormalities. However, the differences on the cognitive dysfunction of AD and CSVD remain unclear. It is necessary to elucidate the cognitive dysfunction differences of AD and CSVD, and to identify the potential risk factors.AD or sporadic CSVD patients treated in our hospital from December 1, 2018 to May 31, 2019 were included. And we selected healthy participants as controls. The mini-mental state examination and Montreal Cognitive Assessment Scale were used for neuropsychological assessment, and related medical information were collected and compared.A total of 190 patients were included. The total mini-mental state examination scores in AD, CSVD group were significantly less than that of control group, there were significant differences in the domains of directional ability, attention and computing ability, delayed recall, and visual perception (all P < .05); the total Montreal Cognitive Assessment Scale scores in AD, CSVD group were significantly less than that of control group. There were significant differences in the domains of visual space and execution, immediate remember, attention and computing ability, language, delayed recall, and directional ability (all P < .05); diabetes was a risk factor both for AD (hazard ratio = 1.63, 95% confidence interval: 1.35-1.97) and CSVD (hazard ratio = 1.15, 95% confidence interval: 1.08-1.27).The cognitive dysfunctions of AD are difference to that of CSVD patients, and diabetes is the risk factor both for AD and CSVD, future studies are needed to further identify the prevention and treatment of AD and CSVD.

摘要

阿尔茨海默病(AD)和散发性脑小血管病(CSVD)是常见的认知障碍。AD 和 CSVD 均有精神症状,包括慢性进行性认知障碍、功能障碍和行为异常。然而,AD 和 CSVD 的认知功能障碍差异尚不清楚。有必要阐明 AD 和 CSVD 的认知功能障碍差异,并确定潜在的危险因素。

纳入 2018 年 12 月 1 日至 2019 年 5 月 31 日在我院治疗的 AD 或散发性 CSVD 患者,并选择健康参与者作为对照。采用简易精神状态检查和蒙特利尔认知评估量表进行神经心理学评估,并收集和比较相关的医疗信息。

共纳入 190 例患者。AD、CSVD 组的简易精神状态检查总分明显低于对照组,定向力、注意力和计算能力、延迟回忆和视觉感知等领域差异均有统计学意义(均 P < 0.05);AD、CSVD 组的蒙特利尔认知评估量表总分明显低于对照组,视觉空间和执行、即刻记忆、注意力和计算能力、语言、延迟回忆和定向力等领域差异均有统计学意义(均 P < 0.05);糖尿病是 AD(危险比=1.63,95%置信区间:1.35-1.97)和 CSVD(危险比=1.15,95%置信区间:1.08-1.27)的危险因素。

AD 的认知功能障碍与 CSVD 患者不同,糖尿病是 AD 和 CSVD 的危险因素,需要进一步研究以确定 AD 和 CSVD 的预防和治疗方法。

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