Cahn D A, Salmon D P, Bondi M W, Butters N, Johnson S A, Wiederholt W C, Barrett-Connor E
Department of Psychiatry, University of California, San Diego, La Jolla, USA.
J Int Neuropsychol Soc. 1997 Jul;3(4):387-93.
Qualitative features of the neuropsychological test performance of individuals with dementia of the Alzheimer type (DAT) were examined in a population-based study. Qualitative error scores were derived from measures of verbal and figural memory, verbal fluency and confrontation naming for 38 patients with clinically diagnosed DAT, 236 normal elderly (NE) individuals, and 72 others who were questionably demented and at risk (AR) for DAT. Persons with DAT made a greater proportion of intrusion and perseverative errors, and more lexical and semantic naming errors, than the NE participants. These measures provided fair specificity but poor sensitivity for the diagnosis of DAT, and a logistic model based on these measures correctly classified 98% of the NE participants, but only 29% of the DAT participants. The AR participants demonstrated a pattern of errors that was highly similar to that of the DAT patients, and when their scores were subjected to the logistic model, 90% were classified as NE and 10% as DAT. These results indicate that specific error types that have been associated with DAT in self-referred or clinic-based samples also occur in the general population to a greater degree in individuals with DAT or questionable dementia than in NE individuals. Furthermore, these qualitative features may have some diagnostic usefulness in that their presence provides reasonable specificity for DAT or questionable dementia.
在一项基于人群的研究中，对阿尔茨海默型痴呆（DAT）患者神经心理测试表现的定性特征进行了检查。定性错误分数来自对38例临床诊断为DAT的患者、236名正常老年人（NE）以及72名有DAT可疑痴呆风险（AR）的其他患者的言语和图形记忆、言语流畅性及对质命名的测量。与NE参与者相比，DAT患者出现的侵入性和持续性错误比例更高，词汇和语义命名错误更多。这些测量对DAT诊断的特异性尚可但敏感性较差，基于这些测量的逻辑模型正确分类了98%的NE参与者，但仅29%的DAT参与者。AR参与者表现出与DAT患者高度相似的错误模式，当他们的分数应用于逻辑模型时，90%被分类为NE，10%被分类为DAT。这些结果表明，在自我推荐或基于诊所的样本中与DAT相关的特定错误类型在普通人群中也有出现，在DAT或可疑痴呆个体中比在NE个体中出现的程度更高。此外，这些定性特征可能具有一定的诊断价值，因为它们的存在为DAT或可疑痴呆提供了合理的特异性。
