老年精神分裂症和Alzheimer氏病患者认知功能的对照研究

目的：探讨老年精神分裂症和Alzheimer氏病在额叶执行功能和记忆方面的神经心理功能障碍及其特征；了解老年精神分裂症和Alzheimer氏病人认知功能与社会生活功能的关系。方法：采用简易智力状态检查（MMSE）、韦氏记忆量表（WMS）、威斯康星卡片分类测验（WCST）、日常生活能力量表（Alzheimer氏病），对34例45岁（含45岁）以前起病反复发作或持续到老年的精神分裂症、28例Alzheimer氏病及31例正常对照组进行对照研究。结果：老年精神分裂症和Alzheimer氏病都有记忆障碍和额叶执行功能障碍。老年精神分型症语义记忆受损严重程度与Alzhe-imer氏病无明显差异，而对新信息在延迟期的快速遗忘损害要轻；老年精神分裂症的额叶执行功能障碍对记忆损有选择性，两者密切相关，Alzheimer氏病的记忆损害与额叶执行功能障碍的相关不明显。老年精神分裂症的社会日常生活功能优于Alzheimer氏病，与正常老年人无明显差异。结论：老年精神分裂症认知功能损害不同于Alzhe-imer氏病，有一定的特征性。提示老年精神分裂症和Alzheimer氏病认知功能障碍的差别在于各自神经生物学病理机制的不同。

A Comparative Study on Cognitive Function between Geriatric Schizophrenic and Alzheimer's Patients

Objective:The purpose was to examine neu ropsychological difference between schizophrenia and Alzheimer patients in respe ct of frontal executive function and memo ry functions.as well as their relationship with social functional activity.Methods:A total of 93 subject s participated in this study:31 normal control subjects,34 geriatric schizophren ic patients with disease onset before the age of 45 years,and 28 AD patients. A ll subjects were administered a battery of neuropsychological tests,which includ ed Wec hsler Memory Scale (WMS),Wisconsin Card-sorting Test(WCST),Mini-Mental State Exa mination(MMSE),and Activity of Daily Living Scale(ADL) Results:Differences in neuropsycholog ical defficits between schizophrenic and AD patie nts were show on WMS and WCST. schizophrenia patients were less impaired with de layed recall but similar on semantic memory when compared with AD patients. Sign ifica nt correlation was found between memory deficits and frontal executive function among schizophrenic patients.When compared to AD patients,social level compatibl e with normal controls.Conclusion:The pattern of neuropaychological d efictits in schizophrenia was different from that in progressive cortical dement ia.The study suggests major differences in neurobiological mechanisms underlying schizophrenia and Alzheimer's disease.