Herlitz A, Hill R D, Fratiglioni L, Bäckman L
Stockholm Gerontology Research Center, Karolinska Institute, Sweden.
J Gerontol A Biol Sci Med Sci. 1995 Mar;50(2):M107-13. doi: 10.1093/gerona/50a.2.m107.
This study examined the efficacy of a cognitive test battery in detecting and staging dementia in a community-based sample of very old adults.
The sample consisted of 398 nondemented and 108 demented adults taken from all the inhabitants in the Kungsholmen parish of Stockholm, Sweden (2,368 individuals), aged 75 years and older, who were part of a large-scale epidemiological study on aging and dementia. Participants received a cognitive test battery that consisted of specialized episodic memory tasks, as well as standardized psychometric measures of visuospatial ability and primary memory.
A discriminant analysis revealed that highly supported episodic memory tasks (recognition, cued recall) were primarily responsible for correctly classifying normal old adults (94.5%) from those with the diagnosis of dementia (66.7%). Using the Mini-Mental State Exam (MMSE) as the criterion of dementia severity, a correct classification of 88.9% was achieved for mildly demented subjects and 77.8% for moderately demented subjects. Visuospatial tasks made the greatest contribution in distinguishing those at different levels of dementia severity.
The results of this investigation indicate that cognitively supported measures assessing episodic memory may be particularly useful in the detection of dementia, whereas visuospatial measures are more effective in staging the disease. Consistent with biological models of the progression of dementia, this suggests that visuospatial abilities may deteriorate later and/or at a slower rate than episodic memory skills in the early stages of dementia. It is noteworthy that these conclusions are based on samples of very old adults taken from the general population.
本研究考察了一套认知测试组合在检测和划分社区高龄成年人样本中痴呆症方面的功效。
样本包括从瑞典斯德哥尔摩孔斯霍尔门教区的所有居民（2368人）中选取的398名非痴呆成年人和108名痴呆成年人，年龄在75岁及以上，他们是一项关于衰老和痴呆症的大规模流行病学研究的一部分。参与者接受了一套认知测试组合，该组合包括专门的情景记忆任务，以及视觉空间能力和初级记忆的标准化心理测量指标。
判别分析显示，得到高度支持的情景记忆任务（识别、线索回忆）主要负责正确区分正常老年人（94.5%）和被诊断为痴呆症的人（66.7%）。以简易精神状态检查表（MMSE）作为痴呆严重程度的标准，轻度痴呆受试者的正确分类率为88.9%，中度痴呆受试者的正确分类率为77.8%。视觉空间任务在区分不同痴呆严重程度的人群方面贡献最大。
本调查结果表明，评估情景记忆的认知支持措施在痴呆症检测中可能特别有用，而视觉空间措施在疾病分期方面更有效。与痴呆症进展的生物学模型一致，这表明在痴呆症早期，视觉空间能力可能比情景记忆技能恶化得更晚和/或以更慢的速度恶化。值得注意的是，这些结论基于从普通人群中选取的高龄成年人样本。
