Verhey F R, Ponds R W, Rozendaal N, Jolles J
Department of Psychiatry and Neuropsychology, University of Limburg, Maastricht, The Netherlands.
J Geriatr Psychiatry Neurol. 1995 Jan;8(1):23-7.
Although it is generally believed that depression, retained insight, and preserved personality occur more frequently in vascular dementia than in Alzheimer's disease, there is little empiric evidence for this presumption. Most studies on this subject have been carried out with severely demented inpatients, and confounding factors such as age, sex, and severity of dementia have not been sufficiently taken into account. We compared 48 patients with relatively mild vascular dementia with 48 patients with Alzheimer's disease, matched for age, sex, and stage of dementia, to investigate if depression, lack of insight, and personality changes were related to the cause of dementia. The two groups did not differ regarding the incidence of major depression, the mean depression score, the awareness score, or the sum of scores on the items of the Blessed Dementia Scale concerning personality changes. We conclude that depression, lack of insight, and personality changes do not favor an etiology of vascular dementia over that of Alzheimer's disease. The present findings underscore the notion that the severity of the dementia should be considered in studies on the differences between vascular dementia and Alzheimer's disease.
尽管人们普遍认为，与阿尔茨海默病相比，血管性痴呆患者中抑郁、自知力保留及人格保持更为常见，但这一推测几乎没有实证依据。关于该主题的大多数研究都是针对重度痴呆住院患者开展的，年龄、性别和痴呆严重程度等混杂因素并未得到充分考量。我们将48例相对轻度血管性痴呆患者与48例阿尔茨海默病患者进行了比较，两组在年龄、性别和痴呆阶段相匹配，以调查抑郁、缺乏自知力和人格改变是否与痴呆病因有关。两组在重度抑郁发病率、平均抑郁评分、自知力评分或Blessed痴呆量表中人格改变项目的得分总和方面并无差异。我们得出结论，与阿尔茨海默病相比，抑郁、缺乏自知力和人格改变并不支持血管性痴呆的病因学。目前的研究结果强调了这样一种观念，即在研究血管性痴呆和阿尔茨海默病的差异时应考虑痴呆的严重程度。
