Faculty of Health Sciences, Department of Physiatry and Nursing, University of Zaragoza, Zaragoza, Spain.
Institute of Health Research of Aragón (IIS Aragón), Zaragoza, Spain.
PLoS One. 2021 Dec 20;16(12):e0261313. doi: 10.1371/journal.pone.0261313. eCollection 2021.
Late-life cognitive decline ranges from the mildest cases of normal, age-related change to mild cognitive impairment to severe cases of dementia. Dementia is the largest global burden for the 21st century welfare and healthcare systems. The aim of this study was to analyze the neuropsychological constructs (temporal orientation (TO), spatial orientation (SO), fixation memory (FM), attention (A), calculation (C), short-term memory (STM), language (L), and praxis (P)), semantic fluency, level of functionality, and mood that reveal the greatest deficit in the different stages ranging from normal cognition (NC) to cognitive impairment in older adults in a primary healthcare setting. The study included 337 participants (102 men, 235 women), having a mean age of 74 ± 6 years. According to their scores on the Spanish version of the Mini-Mental State Examination (MEC-35), subjects were divided into 4 groups: no deterioration (ND) (score 32-35), subtle cognitive impairment (SCI) (score 28-31), level deterioration (LD) (score 24-27) and moderate deterioration (MD) (score 20-23). The ND group revealed significant differences in TO, STM, C, A, L, P, and S-T as compared to the other groups. The MD group (in all the neuropsychological constructs) and the ND and SCI groups showed significant differences on the Yesavage geriatric depression scale (GDS-15). All except the FM neuropsychological construct were part of the MEC-35 prediction model and all of the regression coefficients were significant for these variables in the model. Furthermore, the highest average percentage of relative deterioration occurs between LD and MD and the greatest deterioration is observed in the STM for all groups, including A and TO for the LD and MD groups. Based on our findings, community programs have been implemented that use cognitive stimulation to prevent cognitive decline and to maintain the neuropsychological constructs.
从最轻微的正常、与年龄相关的认知变化到轻度认知障碍再到严重痴呆，老年人认知能力下降的范围很广。痴呆症是 21 世纪福利和医疗保健系统面临的最大全球性负担。本研究旨在分析神经心理学结构（时间定向（TO）、空间定向（SO）、固定记忆（FM）、注意力（A）、计算（C）、短期记忆（STM）、语言（L）和实践（P））、语义流畅性、功能水平和情绪，这些因素揭示了在初级保健环境中从正常认知（NC）到老年人认知障碍的不同阶段中最大的缺陷。该研究包括 337 名参与者（102 名男性，235 名女性），平均年龄为 74 ± 6 岁。根据他们在西班牙版简易精神状态检查表（MEC-35）上的得分，将受试者分为 4 组：无恶化（ND）（得分 32-35）、轻度认知障碍（SCI）（得分 28-31）、水平恶化（LD）（得分 24-27）和中度恶化（MD）（得分 20-23）。与其他组相比，ND 组在 TO、STM、C、A、L、P 和 S-T 方面存在显著差异。MD 组（在所有神经心理学结构中）和 ND 和 SCI 组在耶萨维格老年抑郁量表（GDS-15）上存在显著差异。除 FM 神经心理学结构外，所有结构均为 MEC-35 预测模型的一部分，并且模型中所有变量的回归系数均显著。此外，LD 和 MD 之间的相对恶化平均百分比最高，所有组的 STM 恶化最大，包括 LD 和 MD 组的 A 和 TO。基于我们的发现，已经实施了社区计划，使用认知刺激来预防认知能力下降并维持神经心理学结构。
