药物联合针刺对轻度认知功能障碍患者认知功能的疗效观察

目的探讨尼莫地平联合电针对轻度认知功能障碍（MCI）患者认知改善情况及安全性的影响。方法采用随机对照试验方法,将80例患者分为观察组和对照组,治疗前、治疗1个疗程、2个疗程后分别进行简易精神状态检查（MMSE）量表检测和图形再认实验。结果治疗2个疗程后两组MMSE总评分均较治疗前高（P〈0.01）,且观察组疗效优于单用药物组（P〈0.01）。认知、记忆、言语亚项评分显示,第1个疗程治疗后两组间差异有高度统计学意义（P〈0.01）;第2个疗程治疗结束后认知、记忆亚组有显著性差异（P〈0.05）,言语亚组组间差异无统计学意义（P〉0.05）。图形再认总评分在治疗后有两组显著性差异（P〈0.05）。结论治疗后两组患者综合认知水平均有明显的改善,且观察组疗效优于药物组。     

轻度认知功能障碍常用筛查量表的比较分析

目的比较分析蒙特利尔认知评估量表（MoCA）与简易精神状态量表（MMSE）在轻度认知功能障碍评估中的差异性,同时揭示其影响因素。方法研究对象为50岁以上患者,以美国Mayo神经病学研究中心提出的MCI诊断标准为评定标准诊断轻度认知功能障碍（MCI）组41例,对照组（NC）34例,进行MoCA、MMSE测试。结果MoCA量表得分与MMSE量表得分高度相关,相关系数为0．654（P〈0．001）,MoCA以26分为分界值,检测MCI的敏感性为100％,明显优于MMSE（以27分为界值）的56．10％。MoCA量表的分项得分上,两组在除数字广度、复述与动物叙述流畅性3个项目以外的其他项目上的得分差异均具有统计学意义。其中连线测试、抽象、延迟回忆、定向力等4项P〈0．01,复制立方体、画钟、命名、听觉辨别、计算等5项P〈0．05;在MMSE量表的分项得分上,两组在时间定向、计算等2项P〈0．01,即刻记忆、延迟回忆等2项P〈0．05,余项目两组得分差异不具有统计学意义;说明MoCA量表更为敏感。多元回归分析结果显示年龄与文化程度对MoCA和MMSE得分均有显著影响。结论MoCA可识别MMSE得分在正常范围内的MCI,MoCA用于筛查MCI时优于MMSE。     

轻度认知功能障碍患者睡眠特征及其与认知功能的相关性分析

目的 通过对轻度认知功能障碍(MCI)患者的睡眠特征进行分析,然后分析MCI与认知功能的关系,为延缓MCI患者的认知功能障碍提供依据。方法 选取2019年2月—2022年2月在我院治疗的MCI患者和同期健康体检者各72例作为观察组和对照组。比较2组睡眠和认知功能,分析睡眠特征与认知功能的相关性。结果 观察组睡眠障碍发生率(44.44%)明显高于对照组(13.89%,P<0.01);观察组爱泼沃斯睡眠量表(ESS)评分、匹兹堡睡眠质量指数(PSQI)总分以及PSQI量表主观睡眠时间、入睡时间、睡眠时间、睡眠效率、睡眠障碍、日间功能障碍等项目评分均明显高于对照组(均P<0.01);观察组浅睡眠期(S1+S2)%占比明显高于对照组(P<0.01),而深睡眠期(S3+S4)、快速动眼期(REM)睡眠时间、REM睡眠占比明显低于对照组(均P<0.01);观察组蒙特利尔认知功能评估量表(Mo-CA)总分及Mo-CA量表中定向、记忆、视空间和执行功能、命名、语言、注意、抽象概括等项目评分均明显低于对照组(均P<0.01);ESS评分、PSQI总分、PSQI量表中的睡眠质...     

睡眠障碍与认知功能损害

近来研究发现睡眠障碍可以引起社会活动、人际交往、职业损害及注意和记忆等认知活动损害。虽然不同的专业对认知活动的定义不完全一致，但睡眠障碍与认知损害的关系已引起了广泛的关注。     

轻度认知损害中医证候与1H-MRS功能改变的关系

目的 基于核磁共振代谢组学分析方法,探讨遗忘型轻度认知损害(amnestic mild cognitive impairment,aMCI)主要证型(肾虚证和痰浊证)的1H-MRS代谢物比值与认知功能的相关特征.方法 采用德国Siemens公司生产的Novus 1.5T磁共振成像系统,对入选的研究对象行相应的常规MRI...     

思维导图训练对轻度认知功能障碍老人认知功能的影响

目的 探讨思维导图训练对轻度认知功能障碍(MCI)老人认知功能的影响.方法 将入选的60名老人按随机数字表法分为训练组30例和对照组30例,对照组不进行训练干预,训练组每天在课题组人员指导下进行思维导图的绘制,每周6d,每天30 min,持续1年.在训练6个月、1年后利用简易精神状态量表(MMSE)、日常生活能力量表(ADL)进行组内及组间对照,评价2组老人认知功能的变化.结果 训练组6个月MMSE得分[(25.55±1.17)分]、1年后MMSE得分[(26.30±1.64)分]均高于干预前(P＜0.05),训练组优于对照组[(24.90±1.97)分],训练组的ADL得分[(14.47±0.64)分]较对照组[(15.33±1.11)分]及干预前[(15.47±1.19)分]有所降低(均为P＜0.05).结论 思维导图训练可以延缓MCI老人认知功能的下降.     

轻度认知功能障碍的临床干预研究

目的探讨老年轻度认知功能损害(MCI)患者的干预治疗。方法治疗组MCI患者33例,给予多奈哌齐5mg/d,共12个月,同期空白对照组27例。分析各组向痴呆转化率以及MMSE、MOCA和ADL变化。结果多奈哌齐组较对照组简易智能状态检测量表(MMSE)评分显著改善(P0.05),蒙特利尔认知量表(MOCA)评分改善更为明显(P0.01),日常生活自理量表(ADL)评分改善不明显。由MCI向AD转化率、服用和未服用多奈哌齐组于12个月时分别为9.1%和14.8%(P0.05)。结论多奈哌齐能有效改善轻度认知功能损害(MCI)患者的认知功能,推迟MCI向AD转化。     

MoCA-B与MMSE对轻度认知功能障碍患者的筛查效果对比

目的 探讨蒙特利尔认知评估基础量表(MoCA-B)和简易精神状态量表(MMSE)对轻度认知障碍(MCI)患者认知功能筛查评估的效果,确定最佳评估阈值,并探讨量表对特定认知功能领域的评估准确度.方法 本研究共纳入南充市社区261名老年人,包括健康老年人(HC)、MCI患者,所有纳入受试者均接受MMSE、MoCA-B及完整...     

老年轻度认知功能损害的研究进展

近年我国人口老龄化进程加快,对痴呆和衰老机制的研究成为热点,其中轻度认知功能损害（Mild Cognitive Impairment,MCI）的概念近些年才逐渐被接受,目前研究中多采用Petersen[1]1999年MCI定义是：1.主观有记忆损害的主诉,客观检查有轻度认知功能损害者确认;2.正常的总体认知功能;3.正常的日常生活行为;4.相对于年龄、教育程度来说记忆有损害;5.未达到痴呆程度.     

中医药对轻度认知功能障碍的研究进展

轻度认知功能障碍(Mild Cognitive Impairment,MIC)是介于正常老化和阿尔兹海默病(Alzheimer disease,AD)的过渡状态,许多研究者都将MCI看作AD的极早期阶端,其转化为痴呆的比率明显高于正常人。中医药在改善轻度认知功能障碍方面具有一定的优势。本文将目前中医药对轻度认知功能障碍的研究进展进行综述。     

以蒙特利尔认知评估量表(MoCA)分析血管源性轻度认知障碍的神经心理学特征

目的利用蒙特利尔认知评估量表(MoCA)探讨血管源性轻度认知障碍(vMCI)的神经心理学特征,为早期发现、早期诊断、早期干预vMCI提供借鉴之处,并对敏感亚项认知域进行分析,以期探讨此类疾病的发生、发展规律。方法将107例vMCI患者的神经心理学检查结果进行各认知领域的亚项分析。结果 vMCI各认知域障碍发生率的不一致、MoCA中的各认知域与总分的相关性分析表明,注意、视空间与执行能力与量表总分密切相关,同时也表明,此次调研患者认知域损害以注意、视空间与执行能力损害为主。结论 MoCA中的相关子域能够很好地筛查出vMCI;MoCA中的延迟记忆及执行能力与总分相关性较强,说明vMCI患者的执行能力与延迟记忆能力密切相关。     

Rapid Eye Movement Sleep Behavior Disorder Symptoms Correlate with Domains of Cognitive Impairment in Parkinson's Disease

Background:

Rapid eye movement (REM) sleep behavior disorder (RBD) may be a risk factor for cognitive impairment in patients with Parkinson''s disease (PD). However, little is known regarding the relation between the severity of RBD and the different domains of cognitive impairment. The aim of this study was: (1) to investigate the domains of cognitive impairment in patients with PD and RBD, and (2) to explore risk factors for PD-mild cognitive impairment (PD-MCI) and the relationship between RBD severity and impairment in different cognitive domains in PD.

Methods:

The participants were grouped as follows: PD without RBD (PD-RBD; n = 42), PD with RBD (PD + RBD; n = 32), idiopathic RBD (iRBD; n = 15), and healthy controls (HCs; n = 36). All participants completed a battery of neuropsychological assessment of attention and working memory, executive function, language, memory, and visuospatial function. The information of basic demographics, diseases and medication history, and motor and nonmotor manifestations was obtained and compared between PD-RBD and PD + RBD groups. Particular attention was paid to the severity of RBD assessed by the RBD Questionnaire-Hong Kong (RBDQ-HK) and the RBD Screening Questionnaire (RBDSQ), then we further examined associations between the severity of RBD symptoms and cognitive levels via correlation analysis.

Results:

Compared to PD-RBD subjects, PD + RBD patients were more likely to have olfactory dysfunction and their Epworth Sleepiness Scale scores were higher (P < 0.05). During neuropsychological testing, PD + RBD patients performed worse than PD-RBD patients, including delayed memory function, especially. The MCI rates were 33%, 63%, 33%, and 8% for PD-RBD, PD + RBD, iRBD, and HC groups, respectively. RBD was an important factor for the PD-MCI variance (odds ratio = 5.204, P = 0.018). During correlation analysis, higher RBDSQ and RBDQ-HK scores were significantly associated with poorer performance on the Trail Making Test-B (errors) and Auditory Verbal Learning Test (delayed recall) and higher RBD-HK scores were also associated with Rey–Osterrieth complex figure (copy) results.

Conclusions:

When PD-RBD and PD + RBD patients have equivalent motor symptoms, PD + RBD patients still have more olfactory dysfunction and worse daytime somnolence. RBD is an important risk factor for MCI, including delayed memory. Deficits in executive function, verbal delayed memory, and visuospatial function were consistently associated with more severe RBD symptoms.     

血管源性轻度认知障碍中医核心术语在不同人群中应答情况研究

目的就不同人群临床应答情况验证、优化血管源性轻度认知障碍中医核心术语。方法通过对945例有认知障碍主诉或家属代诉患者的调查,现场收集信息,采用卡方分析、信度分析的方法验证、优化血管源性轻度认知障碍中医核心术语。结果验证并优化出“转盼遗忘”“多忘善误”“神思不聚”“持筹握算差”“言语懒、重复、言善误”“言辞颠倒、贫乏”“忧愁思虑”“庶事皆废”“居暗避人”“思维反应迟钝”“懒动嗜卧”“日间静则瞌睡、夜间躁扰不宁”12项核心术语,“多疑寡断”需进行进一步论证及临床再验证。结论12项核心术语能较好的体现血管源性轻度认知障碍患者的状态,所有术语与痴呆术语及西医术语有较好的区分,可用于其症状描述。     

MCI患者胰岛素抵抗与认知及海马⁃内嗅皮层体积的关系

目的：探讨轻度认知功能障碍（mild cognitive impairment,MCI）患者的胰岛素抵抗（insulin resistance,IR）程度与认知水平、海马?内嗅皮层体积变化的关系。方法：417例研究对象根据Petersen的MCI诊断标准分别纳入MCI组或正常认知组,MCI患者再据胰岛素敏感指数（insulin sensitivity index,ISI）纳入相对胰岛素抵抗组（MCI?rIR组）或相对无抵抗组（MCI?rnIR组）,简易智力状态检查表（mini?mental state examination,MMSE）、临床记忆量表（clinical memory scale,CMS）进行认知评分,MRI测量海马?内嗅皮层体积,分析MCI患者IR程度与认知评分、海马?内嗅皮层体积的关系。结果：同正常认知组比较,MCI患者胰岛素抵抗程度更重,并存在病理性海马?内嗅皮层体积萎缩,萎缩同认知功能相关;MCI患者中,MCI?rIR组较MCI?rnIR组的海马?内嗅皮层体积萎缩更严重,总认知评分及多项认知功能更差,除外糖尿病患者后亦然;多元回归分析显示,MCI患者海马?内嗅皮层体积同胰岛素抵抗程度呈正相关,同年龄、空腹血糖、收缩压呈负相关。结论：MCI患者存在病理性海马、内嗅皮层萎缩,该萎缩能同相应的认知损伤相印证,且二者与胰岛素抵抗有关联。     

Cognitive Training in Older Adults with Mild Cognitive Impairment

ObjectiveWe investigated the feasibility and efficacy of cognitive training for older adults in rural settings and with low education levels, who have mild cognitive impairment (MCI).
MethodsForty-five older adults (ages >65 years) with MCI were assigned to treatment or control groups, at a 2:1 ratio. Cognitivetraining occurred in the treatment group for 2 months. The cognitive abilities of the participants were assessed at pre-training, metaphase, and post-training time points, using the Mini-Mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Loewenstein Occupational Therapy Cognitive Assessment (LOTCA), and Hamilton Depression Scale (HAM-D).
ResultsFollowing training, cognitive abilities improved in the treatment group, based on the total scores of all 4 measures, as well as specifically on the MoCA and LOTCA. There were differences in the main effects of group and time point on some subscales, but these differences had little, if any, effect on the overall analyses.
ConclusionThe present study demonstrated that cognitive training has beneficial effects on attention, language, orientation, visual perception, organization of visual movement, and logical questioning in patients with MCI. Furthermore, the observed effects are long-term changes.     

益气补肾活血方对轻度认知功能损伤患者的影响

目的观察益气补肾活血方对轻度认知功能损伤（MCI）患者的临床疗效。方法60例MCI患者随机分为治疗组和对照组,每组30例。两组治疗期间停服一切中西医和其他促智药物,以及停服对大脑功能代谢有影响的药物直至疗程结束。对照组只给予治疗既往存在疾病的药物,治疗组给予治疗既往存在疾病的药物,并给予益气补肾活血方,12W为1个疗程,1个疗程后观察临床疗效。结果治疗组治疗后临床疗效与对照组比较有显著性差异（P〈0.01）;治疗组治疗前后简短精神状态量表（MMSE）评分及无意义图形再认积分比较有显著性差异（P〈0.01）。结论益气补肾活血方对MCI患者的临床疗效较理想,有较好的临床推广价值。     

Night Sleep Duration and Risk of Cognitive Impairment in a Chinese Population: A Cross-sectional Study

Objective Although sleep is one of the most important health-related behavioral factors,the association between night sleep duration and cognitive impairment has not been fully understood.A cross-sectional study was conducted with a random sample of 2,514 participants(≥40 years of age;46.6% women) in China to examine the association between night sleep duration and cognitive impairment.Methods Night sleep duration was categorized as ≤ 5,6,7,8,or ≥9 h per night.Cognitive function was measured using the Mini-Mental State Examination.A multivariate regression analysis was used to analyze the association of night sleep duration with cognitive impairment.A total of 122 participants were diagnosed with cognitive impairment.Results A U-shaped association between night sleep duration and cognitive impairment was found.The odds ratios(95% confidence intervals) of cognitive impairment(with 7 h of daily sleep being considered as the reference) for individuals reporting ≤ 5,6,8,and ≥9 h were 2.14(1.20-3.83),1.13(0.67-1.89),1.51(0.82-2.79),and 5.37(1.62-17.80),respectively(P≤0.01).Conclusion Short or long night sleep duration was an important sleep-related factor independently associated with cognitive impairment and may be a useful marker for increased risk of cognitive impairment.     

社区老年人夜间睡眠时间与认知功能障碍的关联研究

背景 随着我国人口快速老龄化,老年人认知功能障碍正日益成为突出的公共卫生问题。目的 探讨社区老年人夜间睡眠时间与认知功能障碍的关联。方法 本研究数据来源于2018年7—9月建立的阜阳市老年人健康与环境可控性队列,最终纳入认知功能数据和睡眠时间数据完整的4 837例老年人为本研究对象。提取其中的一般人口学特征（性别、年龄、地区、文化程度、职业、婚姻状况等）、生活方式、慢性病患病情况、睡眠时间和认知功能数据。采用二元Logistic回归模型分析夜间睡眠时间与认知功能障碍的关联。采用限制性立方样条模型绘制睡眠时间与认知功能障碍的剂量-反应曲线。结果 4 837例老年人中,平均睡眠时间为（6.95±1.75）h,其中1 773例（36.65%）每天睡眠时间≤6 h,2 088例（43.17%）每天睡眠时间为>6～8 h,976例（20.18%）每天睡眠时间>8 h;认知功能障碍检出率为37.44%(1 811/4 837)。调整性别、年龄、地区、文化程度等混杂因素后,总人群睡眠时间≤6 h和>8 h的老年人认知功能障碍检出率分别是睡眠时间>6～8 h者的1.26倍[95...