Small B J, Viitanen M, Winblad B, Bäckman L
Stockholm Gerontology Research Center and Department of Clinical Neuroscience and Family Medicine, Karolinska Institute, Sweden.
J Clin Exp Neuropsychol. 1997 Apr;19(2):245-60. doi: 10.1080/01688639708403855.
Longitudinal changes in global cognitive functioning, indexed by the Mini-Mental State Examination (MMSE), in subjects with dementia (Alzheimer's disease and vascular dementia) were examined. The roles of several demographic, psychometric, and biological indices in predicting cognitive deterioration were also examined. The sample consisted of 36 very old (M age at entry = 83.0 years, range = 75-95) adults with dementia from a community-based study. Subjects were tested on two occasions separated by approximately 2.5 years. Results indicated significant longitudinal decline in MMSE scores over the retest interval; the average decline was estimated as 2.43 (SD = 1.81) points per year. Several factors were associated with cognitive deterioration. Higher initial MMSE scores were associated with greater deterioration, whereas superior forward digit span and Block Design at entry were associated with attenuated decline, once differences in baseline severity were accounted for. By contrast, a variety of other putatively important variables exhibited no relationship to decline, including age, gender, education, onset age, dementia type, backward digit span, as well as a number of biological parameters (e.g., vitamin B12, folic acid). The results suggest that although the magnitude of cognitive deterioration in dementia is highly variable, several indicators may be useful predictors of future changes in cognitive functioning.
研究了以简易精神状态检查表（MMSE）为指标的痴呆症（阿尔茨海默病和血管性痴呆）患者的整体认知功能的纵向变化。还研究了一些人口统计学、心理测量学和生物学指标在预测认知衰退中的作用。样本包括来自一项基于社区研究的36名高龄（入组时平均年龄 = 83.0岁，范围 = 75 - 95岁）痴呆症成年人。对受试者进行了两次测试，间隔约2.5年。结果表明，在重新测试期间MMSE分数出现了显著的纵向下降；估计平均每年下降2.43（标准差 = 1.81）分。几个因素与认知衰退有关。初始MMSE分数较高与衰退程度较大有关，而在考虑基线严重程度差异后，入组时较好的顺背数字广度和积木设计与衰退减弱有关。相比之下，各种其他假定重要的变量与衰退无关，包括年龄、性别、教育程度、发病年龄、痴呆类型、倒背数字广度以及一些生物学参数（如维生素B12、叶酸）。结果表明，尽管痴呆症患者认知衰退的程度差异很大，但一些指标可能是未来认知功能变化的有用预测指标。
