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[记忆主诉与痴呆的诊断]

[Memory complaints and the diagnosis of dementia].

作者信息

Almeida O P

机构信息

Departamento de Saúde Mental da Santa Casa de São Paulo.

出版信息

Arq Neuropsiquiatr. 1998 Sep;56(3A):412-8. doi: 10.1590/s0004-282x1998000300010.

Abstract

Ageing is often associated with the decline of some cognitive abilities, although in most cases these losses do not progress to full blown dementia. The current study aimed to evaluate the association between subjective memory complaint and the diagnosis of dementia among the elderly assessed at the Old Age Unit of the Department of Mental Health of Santa Casa de São Paulo-Brazil between February and December 1997. Subjects were assessed with the SRQ-20 and MMSE. Further clinical information was also collected to allow for the diagnosis of mental disorders according to ICD-10 diagnostic guidelines. Fifty-nine percent of the 220 patients included in the study complained of memory difficulties. Seventy-one percent of the complainers were women, although there was no clear statistical association between sex, education, marital status and living conditions with the memory complaint. There was a trend for memory complainers to present with higher scores on the SRQ-20(p = 0.122). The complaint of memory difficulties had a sensitivity of 76.2%, specificity of 47.8%, positive predictive value of 36.9%, and negative predictive value of 83.3% for the diagnosis of dementia. Memory complaints are frequent among the elderly, particularly among those with more severe depressive and anxiety symptoms. The subjective experience of memory difficulties has a low predictive value for the diagnosis of dementia. The identification of "at risk" cases should, instead, be based on new neuroimaging and genetic methods.

摘要

衰老往往与某些认知能力的下降有关,尽管在大多数情况下,这些能力丧失不会发展为全面的痴呆症。本研究旨在评估1997年2月至12月在巴西圣保罗圣卡塔琳娜医院心理健康部老年科接受评估的老年人中,主观记忆抱怨与痴呆症诊断之间的关联。对受试者进行了SRQ - 20和MMSE评估。还收集了进一步的临床信息,以便根据ICD - 10诊断指南诊断精神障碍。纳入研究的220名患者中,59%抱怨有记忆困难。抱怨者中71%为女性,尽管性别、教育程度、婚姻状况和生活条件与记忆抱怨之间没有明显的统计学关联。记忆抱怨者在SRQ - 20上的得分有升高趋势(p = 0.122)。记忆困难抱怨对痴呆症诊断的敏感性为76.2%,特异性为47.8%,阳性预测值为36.9%,阴性预测值为83.3%。记忆抱怨在老年人中很常见,尤其是在那些有更严重抑郁和焦虑症状的人群中。记忆困难的主观体验对痴呆症诊断的预测价值较低。相反,“高危”病例的识别应基于新的神经影像学和基因方法。

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