Kyoto Kaisei Hospital, Kyoto, Japan.
Kyoto Miniren Asukai Hospital, Kyoto, Japan.
Psychogeriatrics. 2023 Sep;23(5):747-751. doi: 10.1111/psyg.12991. Epub 2023 Jun 14.
Alzheimer's disease dementia (ADD) is the most common cognitive disease, but patients' families may notice some symptoms yet not recognise that they indicate ADD. This study investigated the symptoms that families notice as ADD as the disease progresses.
New outpatients diagnosed with ADD (n = 315) at five memory clinics completed two cognitive assessments, the Revised Hasegawa Dementia Scale (HDS-R) and Mini-Mental State Examination (MMSE). During an interview, family members completed the Functional Assessment Staging Test (FAST), an observational assessment tool that classifies ADD progression into seven stages. We then examined the relationship of the family-assessed FAST score with clinician-assessed HDS-R and MMSE domain scores by comparing between patients with FAST 1-3 and FAST 4-7. Next, we divided the FAST 4-7 group into the FAST 4-5 and FAST 6-7 subgroups and divided the FAST 1-3 group into the FAST 1-2 and FAST 3 subgroups.
Surprisingly, half of the families did not recognise that the symptoms indicated ADD. Scores for orientation of time and place on the HDS-R and MMSE and for visual memory on the HDS-R were significantly related to family-assessed FAST score. Moreover, the orientation of time and place score on both scales and visual memory on the HDS-R were significantly worse in the FAST 4-7 group than in FAST 1-3 group. In the FAST 4-7 group, scores for age on the HDS-R and for reading and drawing on the MMSE were significantly worse in the FAST 6-7 subgroup. In the analysis of the FAST 1-3 group, there was no significant difference among the HDS-R and MMSE domains between the FAST 1-2 and FAST 3 subgroups.
Family members of patients with ADD tend to notice the progression of ADD from the symptoms of disorientation and visual memory.
阿尔茨海默病性痴呆（ADD）是最常见的认知疾病，但患者的家属可能会注意到一些症状，但却没有意识到这些症状表明患有 ADD。本研究调查了随着疾病的进展，家属注意到的 ADD 症状。
在五家记忆诊所新诊断出的 ADD（n=315）患者完成了两项认知评估，即修订后的长谷川痴呆量表（HDS-R）和简易精神状态检查（MMSE）。在访谈过程中，家庭成员完成了功能评估分期测试（FAST），这是一种观察性评估工具，将 ADD 进展分为七个阶段。然后，我们通过比较 FAST 1-3 和 FAST 4-7 患者，比较了家庭成员评估的 FAST 评分与临床医生评估的 HDS-R 和 MMSE 域评分之间的关系。接下来，我们将 FAST 4-7 组分为 FAST 4-5 和 FAST 6-7 亚组，将 FAST 1-3 组分为 FAST 1-2 和 FAST 3 亚组。
令人惊讶的是，一半的家庭没有意识到这些症状表明患有 ADD。HDS-R 和 MMSE 的时间和地点定向以及 HDS-R 的视觉记忆的分数与家庭评估的 FAST 评分显著相关。此外，在 FAST 4-7 组中，HDS-R 的时间和地点定向评分以及 HDS-R 的视觉记忆评分均明显差于 FAST 1-3 组。在 FAST 4-7 组中，HDS-R 的年龄评分以及 MMSE 的阅读和绘画评分在 FAST 6-7 亚组中明显较差。在 FAST 1-3 组的分析中，在 HDS-R 和 MMSE 域之间，FAST 1-2 和 FAST 3 亚组之间没有显著差异。
ADD 患者的家属往往会注意到定向和视觉记忆等症状的 ADD 进展。
