Mölsä P K, Paljärvi L, Rinne J O, Rinne U K, Säkö E
J Neurol Neurosurg Psychiatry. 1985 Nov;48(11):1085-90. doi: 10.1136/jnnp.48.11.1085.
With neuropathological diagnosis as the point of reference, the accuracy of clinical diagnosis was studied in a series of 58 demented patients. Alzheimer's disease and multi-infarct dementia were recognised with sensitivities and specificities exceeding 70%, whereas combined dementia as a separate group was relatively unreliably diagnosed. The value of Hachinski's Ischaemic Score in differentiating between Alzheimer's disease and vascular dementias was demonstrated. Its performance was to some extent improved by assigning new weights to the items. In a logistic regression model, fluctuating course, nocturnal confusion, and focal neurological symptoms emerged as features with the best discriminating value, and helped to diagnose correctly 89% of the Alzheimer and 71% of the vascular dementia patients.
以神经病理学诊断为参照标准，对58例痴呆患者进行了临床诊断准确性的研究。阿尔茨海默病和多发梗死性痴呆的诊断敏感性和特异性均超过70%，而混合型痴呆作为一个单独类别，诊断相对不可靠。研究证实了哈金斯基缺血评分在区分阿尔茨海默病和血管性痴呆方面的价值。通过对各项指标赋予新的权重，其性能在一定程度上得到了改善。在逻辑回归模型中，病情波动、夜间意识模糊和局灶性神经症状是最具鉴别价值的特征，有助于正确诊断89%的阿尔茨海默病患者和71%的血管性痴呆患者。
