Yu Yueyi, Wang Jing, Li Dan, Lu Yuanyuan, Lu Lu, Qu Miao
Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China.
Suzhou Vocational Health College, Suzhou, China.
Appl Neuropsychol Adult. 2025 Mar 21:1-10. doi: 10.1080/23279095.2025.2478204.
Dementia with Lewy Bodies (DLB) and Alzheimer's disease (AD) are two types of dementia with a relatively high incidence, and their clinical manifestations are easily confused. However, the cognitive impairment characteristics of the two diseases are different, and the results of cognitive assessment can help the diagnosis of the disease.
To explore the different characteristics of Mini-mental State Examination (MMSE) and Montreal Cognitive Assessment Scale (MoCA) in DLB and AD patients, and to explore potential markers to distinguish AD and DLB.
This study included 66 patients with DLB, 81 with AD, and 58 cognitively normal subjects. All of them completed MMSE, MoCA, and Clinical Dementia Rating (CDR).
Compared with NC, both DLB and AD participants demonstrated statistically lower scores in the total and subitem domains of MMSE and MoCA ( < 0.05). When CDR was less than 2, DLB patients had better performance than AD in two subtests including memory and orientation ( < 0.05), demonstrated worse performance in most subtest including executive function, writing, visuospatial abilities, and attention ( < 0.05). Nonetheless, no notable distinction in scores existed for the DLB and AD groups with a CDR score of 2 ( > 0.05).
We observed distinct cognitive performances in subjects from both the DLB and AD groups across different stages of dementia. Our study confirms the high value of MMSE and MoCA in distinguishing patients with DLB and AD in the early stages of the disease, and they can improve the differential diagnosis of DLB and AD.
路易体痴呆(DLB)和阿尔茨海默病(AD)是两种发病率相对较高的痴呆类型,其临床表现容易混淆。然而,这两种疾病的认知障碍特征不同,认知评估结果有助于疾病的诊断。
探讨简易精神状态检查表(MMSE)和蒙特利尔认知评估量表(MoCA)在DLB和AD患者中的不同特征,并探索区分AD和DLB的潜在标志物。
本研究纳入66例DLB患者、81例AD患者和58例认知正常的受试者。他们均完成了MMSE、MoCA和临床痴呆评定量表(CDR)。
与认知正常组相比,DLB组和AD组在MMSE和MoCA的总分及各分项领域的得分均有统计学意义的降低(P<0.05)。当CDR小于2时,DLB患者在记忆和定向两个子测试中的表现优于AD患者(P<0.05),在包括执行功能、书写、视觉空间能力和注意力在内的大多数子测试中的表现较差(P<0.05)。然而,CDR评分为2的DLB组和AD组在得分上没有显著差异(P>0.05)。
我们观察到DLB组和AD组受试者在痴呆不同阶段有不同的认知表现。我们的研究证实了MMSE和MoCA在疾病早期区分DLB和AD患者方面具有很高的价值,它们可以改善DLB和AD的鉴别诊断。