脑白质高信号、神经精神症状及认知对日常生活活动的影响：阿尔茨海默病与路易体痴呆的差异
Effects of white matter hyperintensities, neuropsychiatric symptoms, and cognition on activities of daily living: Differences between Alzheimer's disease and dementia with Lewy bodies.
作者信息
Mirza Saira Saeed, Saeed Usman, Ramirez Joel, Herrmann Nathan, Stuss Donald T, Black Sandra E, Masellis Mario
机构信息
Division of Neurology, Department of Medicine University of Toronto Toronto Ontario Canada.
Hurvitz Brain Sciences Research Program Sunnybrook Research Institute University of Toronto Toronto Ontario Canada.
出版信息
Alzheimers Dement (Amst). 2022 May 2;14(1):e12306. doi: 10.1002/dad2.12306. eCollection 2022.
INTRODUCTION
Disability is common across Alzheimer's disease (AD) and dementia with Lewy bodies (DLB). White matter hyperintensities (WMHs) are prevalent in both diagnoses and associated with disability; both diagnoses show neuropsychiatric symptoms (NPS) and impaired cognition.
METHODS
In AD and DLB, we examined if WMHs, NPS, and cognition associate with basic and/or instrumental activities of daily living (BADLs and/or IADLs) cross-sectionally, and longitudinally over ≈1.4 years.
RESULTS
Across both diagnoses, NPS were not only associated with greater disability in performing both BADLs and IADLs, but were also associated with a decline in the ability to perform BADLs in the AD group. In the DLB group only, higher WMH volume was associated with greater disability in performing both BADLs and IADLs, and was associated with a decline in the ability to perform BADL over time.
DISCUSSION
Management of NPS and WMHs, particularly in DLB, might help maintain functionality in dementia patients for longer.
引言
残疾在阿尔茨海默病（AD）和路易体痴呆（DLB）中很常见。白质高信号（WMH）在这两种疾病中都很普遍，并且与残疾相关；这两种疾病都表现出神经精神症状（NPS）和认知障碍。
方法
在AD和DLB中，我们横断面地以及在约1.4年的时间里纵向研究了WMH、NPS和认知与基本和/或工具性日常生活活动（BADL和/或IADL）之间的关联。
结果
在这两种疾病中，NPS不仅与BADL和IADL执行能力的更大残疾相关，而且在AD组中还与BADL执行能力的下降相关。仅在DLB组中，更高的WMH体积与BADL和IADL执行能力的更大残疾相关，并且与随着时间推移BADL执行能力的下降相关。
讨论
NPS和WMH的管理，特别是在DLB中，可能有助于痴呆患者更长时间地维持功能。
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