蒙特利尔认知评估量表在慢性心力衰竭认知评估中的初步应用

目的初步研究蒙特利尔认知评估量表（MoCA）北京版在慢性心力衰竭（CHF）认知评估中的效度。方法对50例CHF患者行MoCA和简易精神状态检查量表（MMSE）认知功能评估。结果MoCA与MMSE的评分分别为（23．8±3．7）分与（27．9±1．8）分,MoCA评分明显低于MMSE评分,两者比较差异有统计学意义（P〈0．05）。MoCA和MMSE评分结果高度相关（r=0．86,P〈0．05）。纽约心脏病学会分级Ⅲ-Ⅳ级中69％患者MoCA评分低于26分,而Ⅰ～Ⅱ级患者中有52％低于26分,与MMSE评分比较差异有统计学意义（P〈0．05）。结论MoCA和MMSE评分有较好的相关性;MoCA用于CHF认知筛查敏感性高于MMSE。     

老年人高血压、抑郁与认知功能减退的相关性研究

目的分析老年人高血压、抑郁患者认知功能状况及其相关性。方法共收集207例患者,分为单纯高血压组、单纯抑郁组、高血压合并抑郁组和正常对照组。采用简易精神状况检查表（MMSE）进行认知功能检查,采用汉密顿抑郁量表（HAMD）进行抑郁程度的评定,并收集相关资料。结果抑郁老人中独居比例较大。与正常对照组比较,单纯高血压组的注意力和计算力明显下降（P〈0．01）,单纯抑郁组的MMSE总分、定向力、注意力和计算力、语言能力明显下降（P〈0．05）;与单纯高血压组比较,高血压合并抑郁组的MMSE总分、定向力、回忆力、语言能力明显降低（P〈0．05）;与单纯抑郁组比较,高血压合并抑郁组的注意力和计算力明显降低（P〈0．05）。抑郁患者的MMSE得分与HAMD得分呈负相关（r=一0．706,P〈0．01）。Logistic回归结果显示抑郁及高血压合并抑郁均为认知功能减退的影响因素（P〈0．01）。结论老年人高血压和抑郁均会引起认知功能的减退,高血压合并抑郁者认知功能减退更为严重,抑郁的严重程度与认知功能减退有关。有效的控制高龄老人的血压和抑郁状态,可能有助于降低其认知功能减退发生的危险。     

急性脑梗塞病人认知功能测定

目的：了解急性脑梗塞病人认知功能和痴呆的发生率及其影响因素。方法：采用简易智力状态检查表（MMSE）对74例急性脑梗塞病人的认知功能进行检查。对有认知受损进一步检查日常生活能力量表（ADL）和Hachinski缺血指数量表（HIS）以确诊血管性痴呆（VD），并对VD组和非痴呆组两组病人临床资料进行统计分析。结果：（1）21例确诊为VD，VD发生率为28．38％，其中≥65岁VD发生率为31．91％。（2）MMSE分值与年龄、化程度有明显相关。年龄大、化程度低MMSE分值低。（3）两组病人相比较，年龄有明显差异，VD组明显高于非痴呆组。结论：对急性脑梗塞病人尤其是老年病人需注意认知功能的减退，以便早期发现VD。     

蒙特利尔认知评估量表在老年轻度认知功能障碍筛查中的应用

目的探讨蒙特利尔认知评估量表（MoCA）在老年轻度认知功能障碍（MCI）患者筛查中的应用。方法选择老年MCI患者56例为MCI组和认知功能正常者50例为对照组,分别给予MoCA、简易精神状态检查量表（MMSE）评估,并分析评估结果。结果 MCI组和对照组MoCA总分明显低于MMSE总分（P〈0.01）。MoCA筛查MCI的敏感性为96.4%、特异性为84%;MMSE筛查MCI的敏感性为35.7%、特异性为100%。MoCA中除定向力项外,总分及其余各亚项的评分在MCI组和对照组间差异均有统计学意义（P〈0.01）。结论 MoCA为高敏感性的MCI筛查工具,能全面评估MCI患者的认知功能,筛查MCI的敏感性优于MMSE。     

3＋1整体康复护理模式对轻中度老年阿尔茨海默病患者认知功能和生活质量的影响

目的探讨3＋1（3个阶段：分期评估＋健康教育＋认知训练＋预防性护理）整体康复护理模式对轻中度老年阿尔茨海默病患者认知功能和生活质量的影响。方法40例轻中度老年痴呆患者,随机均分为干预组和对照组,对照组采用常规护理,干预组实施3＋1整体康复护理。观察2组护理前后简易智能状态检查量表（MMSE）和老年痴呆患者生活质量量表（QOL—AD）评分变化。结果护理前,2组MMSE和QOL—AD评分差异无统计学意义（P〉0．05）;护理后,干预组MMSE和QOL—AD评分分别为（23．88±3．36）和（30．08±3．58）分,明显高于对照组的（21．64±3．70）和（27．68±3．09）分（P〈0．05）。结论3＋1整体康复护理模式能显著改善轻中度老年阿尔茨海默病患者的认知功能,提高其生活质量。     

六省老年人延缓神经退变膳食模式与认知功能的关系研究

目的 探索我国六省老年人延缓神经退变（Mediterranean-DASH diet intervention for neurodegenerative delay,MIND）膳食模式与认知功能的关系，为认知功能障碍及相关疾病的预防控制提供科学依据。方法 采用多阶段分层概率比例抽样方法（PPS）在我国6省12县抽取老年居民进行问卷调查、体格检查，收集调查对象的个人信息、行为生活方式及健康状况，通过食物频率表收集膳食摄入信息，通过简易精神状态评价量表（MMSE）评估认知功能。采用多重线性回归和Logistic回归分析MIND膳食模式与认知功能的相关性。结果 认知功能正常组MIND膳食得分显著高于认知功能受损组得分，分别为6.56（±1.15）分和6.33（±1.07）分。认知功能正常组MMSE总得分显著高于认知功能受损组得分，分别为26.73（±2.74）分和18.53（±5.86）分。MIND膳食得分与MMSE总得分呈正相关，与MIND膳食得分最低组相比，MIND膳食得分最高组老人MMSE总得分显著较高，β值为0.63(95%CI:0.20-1.07)，其中在定向力、注意力和计算力、...     

血压晨峰值与老年隐匿性高血压患者认知功能减退的关系

目的了解老年隐匿性高血压人群血压晨峰值的现状,探讨其血压晨峰值与认知功能之间是否存在相关性。方法入选老年隐匿性高血压患者,共72例。进行动态血压监测（ABPM）检查,计算血压晨峰值,按照血压晨峰值进行分组。血压晨峰值≤30mmHg者分入非血压晨峰组（NMS组）,血压晨峰值〉30mmHg者分入血压晨峰组（MS组）。对入选对象进行认知功能量表测定,包括简短精神状态量表（MMSE）、蒙特利尔认知评估量表（MoCA）。对NMS组及MS组的MMSE、MoCA量表分值进行t检验。对血压晨峰值及MMSE、MoCA量表分值进行相关性分析。结果MS组MMSE评分[（27．69±2．04）分]低于NMS组[（28．87±1．34）分],MS组MoCA评分[（24．85±1．52）分]低于NMS组[（26．54±1．53）分]（P均〈0．01）;血压晨峰值与MMSE评分成负相关（r=-0．308,P〈0．01）;血压晨峰值与MoCA评分成负相关（r=-0．447,P〈0．01）。结论老年隐匿性高血压人群存在血压晨峰现象,血压晨峰值可导致认知功能损害。     

2型糖尿病患者血清胰高血糖素样肽-1水平与认知功能障碍的相关性研究

目的分析2型糖尿病患者血清胰高血糖素样肽-1(GLP-1)水平与认知功能障碍的相关性。方法 选择新疆医科大学第二附属医院2020年2月～2022年2月接诊的148例2型糖尿病患者,根据简易精神状态评价量表（MMSE）评分进行分组,其中认知功能正常组（81例,MMSE评分≥27分）和认知功能障碍组（67例,MMSE评分<27分）。检测两组血清GLP-1水平,同时测定血脂、血糖代谢指标。比较两组一般资料、生化指标及血清GLP-1水平,使用Pearson相关性、多因素logistic回归和受试者工作特征曲线（ROC）分析GLP-1与认知功能障碍的关系。结果 认知功能障碍组体质量指数、胰岛素抵抗数（HOMA-IR）均大于认知功能正常组,空腹血糖（FBG）、空腹胰岛素（FINS）、糖化血红蛋白（HbA1c）水平、MMSE评分均高于认知功能正常组,血清GLP-1水平低于认知功能正常组,差异均有统计学意义（P <0.05）;经Pearson相关性分析,2型糖尿病患者血清GLP-1水平与HbA1c、HOMA-IR呈负相关（r=-0.561、-0.571,P=0.000）,与MMSE评分呈正...     

应用Valpar职业评估训练系统治疗脑损伤后认知功能障碍的临床研究

目的研究Valpar职业评估训练系统（VCWS）对脑损伤后认知功能障碍的治疗作用和临床疗效。方法选择232例脑损伤后存认知功能障碍的患者,随机分为治疗组（120例）和对照组（112例）,对照组应用常规康复疗法进行治疗,治疗组增加应用VCWS3-数字化分类训练盒、VCWS6-独立解难技巧训练盒、VCWS 7-多层面分类训练盒进行认知功能训练,应用细微精神状态检查（MMSE）量表分别评定2组患者康复治疗前后认知功能情况,进行比较及统计学分析。结果2组患者治疗后较治疗前MMSE评分均有显著性改善（P〈0．01）;2组患者康复治疗后的认知功能改善情况比较,差异亦有统计学意义（P〈0．05）。结论应用康复治疗可有效地改善脑损伤患者认知功能障碍,增加应用Valpar职业评估训练系统的治疗效果更好。     

社区老年人群认知功能与日常生活功能的关系

[目的]了解贵阳市社区60岁及以上老年人认知功能与日常生活功能和一般人口学因素的关系。[方法]采用多级整群抽样,通过问卷询问和体格检查相结合,对贵阳市城区3229名60岁及以上老人进行现况调查,收集相关资料,用简易智能状态检查量表（MMSE）和日常生活能力量表（ADL）进行认知功能及日常生活功能的检查。[结果]MMSE与ADL得分呈显著负相关（r=-0.313,P﹤0.001）。MMSE与PSMS、IADL得分也呈负相关（r值分别为-0.190,-0.341,P﹤0.001）。按不同年龄、性别、教育程度、婚姻状况以及职业分层后差异仍有统计学意义。对MMSE得分影响显著的因素依次为教育、年龄、ADL得分、婚姻状况及性别（P﹤0.05）。[结论]认知功能与日常生活功能关系密切,对影响日常生活功能下降的因素进行有效干预,有助于预防和减缓认知功能及日常生活功能的衰退。     

江西省赣州市某社区老年人生活方式与认知能力的关系研究

目的了解老年人认知能力及其影响因素,探究不同生活方式对认知能力的影响。方法使用简易精神状态量表(MMSE)及自编生活方式问卷于2012年8月使用方便抽样方法对江西省赣州市章贡区某社区年龄≥60周岁的部分居民进行调查,用方差分析和线性回归分析等方法比较不同生活方式分组间简易精神状态量表(MMSE)测试得分,得出不同生活方式与得分的相关性。结果调查对象MMSE得分为(22.68±5.74)分,老年人部分生活方式与认知能力显著相关。无阅读习惯组MMSE得分(21.07±6.01)明显低于每日阅读0～1 h组得分(24.78±4.30)和1 h以上组得分(25.06±5.04)(P=0.005)。参与集体活动频繁以及较少组得分分别为(26.50±5.04)分和(25.06±4.02)分,明显高于从不参与集体活动组(20.66±5.94)(P=0.000)。有兴趣爱好组(23.13±5.20)显著高于无兴趣爱好组(9.00±4.58)(P=0.000)。此外,年龄、文化程度、婚姻状况等都是影响老年人认知能力的重要因素。看电视时间和睡眠状况对老年人整体认知能力无显著影响,但显著影响回忆能力,记忆力、注意力和计算力等子项目。结论良好的锻炼和读书习惯,丰富精神生活等,有助于预防老年痴呆的发生。     

Reading ability, education, and cognitive status assessment among older adults in Harlem, New York City.

OBJECTIVES: This study examined reported level of education and current reading ability as predictors of cognitive status among older African Americans in central Harlem, New York City. METHODS: A probability sample of 164 noninstitutionalized older African Americans was assessed. Mini-Mental State Examination (MMSE) scores were regressed on education and reading ability measures. RESULTS: Reading ability and educational attainment were significant, independent predictors of MMSE performance. Within any level of education, subjects whose grade-equivalent reading ability exceeded reported level of education scored significantly higher on the MMSE. CONCLUSIONS: Reading ability may be useful in interpreting the results of cognitive screening among low-educated and minority groups.     

Trajectories of cognitive decline over 10 years in a Brazilian elderly population: the Bambuí Cohort Study of Aging

Few population-based studies have examined long term cognitive trajectory, and these studies were conducted in high income countries. We investigated the association of age, gender and education with 10-year cognitive trajectory in a well-defined population of elderly using data from the Bambuí Cohort Study of Aging, in Brazil. Cognition was measured using the Mini- Mental State Examination (MMSE). Cohort members underwent annual follow-ups. This analysis was based on 12,206 MMSE measurements from 1,461 (91%) baseline participants. We used mixed effects models to study MMSE as outcome. The key findings from this analysis are that women and people with a higher schooling level at baseline had high scores of MMSE, while older participants started off lower. Regarding cognitive decline, women, older people and those with a higher schooling level declined faster.     

社区老年人认知功能及相关因素调查

目的了解社区老年人认知功能及相关影响因素,为促进老年保健提供依据。方法对上海市卢湾区某社区601名60岁及以上老年人,采用简易智能状态量表（mini—mental status examination,MMSE）评定认知功能,采用日常生活能力量表（activities of daily living scale,ADL）调查认知功能相关因素。结果年龄与MMSE评分呈负相关,与ADL评分呈正相关;MMSE评分与ADL评分呈负相关。单因素统计分析结果显示,性别、年龄、文化程度、职业、婚姻状况影响老年人认知功能。多元线性回归分析显示,文化程度、年龄、心脏疾病影响MMSE评分。结论增龄、文化程度低、女性、无业或工人、心脏病可能对老年人认知功能产生不良影响。对其中的可干预因素进行干预,有利于提高老年人的认知功能和生活质量。     

Heat-processed ginseng enhances the cognitive function in patients with moderately severe Alzheimer's disease

Abstract

Objectives

Ginseng has been reported to improve cognitive function in animals and in healthy and cognitively impaired individuals. In this study, we investigated the efficacy of a heat-processed form of ginseng that contains more potent ginsenosides than raw ginseng in the treatment of cognitive impairment in patients with moderately severe Alzheimer's disease (AD).

Methods

Forty patients with AD were randomized into one of three different dose groups or the control group as follows: 1.5 g/day (n = 10), 3 g/day (n = 10), and 4.5 g/day (n = 10) groups, or control (n = 10). The Alzheimer's Disease Assessment Scale (ADAS) and Mini-Mental State Examination (MMSE) were used to assess cognitive function for 24 weeks.

Results

The treatment groups showed significant improvement on the MMSE and ADAS. Patients with higher dose group (4.5 g/day) showed improvements in ADAS cognitive, ADAS non-cognitive, and MMSE score as early as at 12 weeks, which sustained for 24-week follow-up.

Discussion

These results demonstrate the potential efficacy of a heat-processed form of ginseng on cognitive function and behavioral symptoms in patients with moderately severe AD.     

Total homocysteine and cognitive decline in a community-based sample of elderly subjects: the Rotterdam Study.

Homocysteine has been associated with an increased risk of cardiovascular disease. Cardiovascular diseases have been related to cognitive decline. The authors investigated the association of homocysteine with concurrent cognitive impairment and subsequent cognitive decline in a random sample of 702 community-dwelling respondents aged 55 years or over to the prospective Rotterdam Study in 1990-1994. Multiple logistic regression was used to calculate odds ratios and 95 percent confidence intervals for the association between total homocysteine levels and cognitive impairment (Mini-Mental State Examination (MMSE) score <26) and cognitive decline (drop in MMSE score of >1 point/year). Mean duration of follow-up was 2.7 years. After adjustment for age, sex, and education, there was no relation between total homocysteine and cognitive impairment (highest vs. lowest tertile: odds ratio (OR) = 1.30, 95% confidence interval (CI): 0.50, 3.38) or cognitive decline (middle vs. lowest tertile: OR = 1.14, 95% CI: 0.67, 1.93; highest vs. lowest tertile: OR = 0.91, 95% CI: 0.52, 1.58). Subjects who were lost to follow-up due to death or nonresponse had slightly higher age-adjusted homocysteine levels and lower MMSE scores at baseline. Sensitivity analyses showed that selective loss to follow-up was not a likely explanation for the absence of an association in the participants. Although a relation between homocysteine and reduced cognitive function is biologically plausible, this study suggests no such association in a community-based sample of the elderly.     

高龄老人血浆超氧化物歧化酶和丙二醛与认知功能的关系

目的:分析高龄老人血浆超氧化物歧化酶(SOD)、丙二醛(MDA)与认知功能的关系。方法:通过问卷调查基本信息、生活方式及认知功能等,测定血浆相关生化指标及SOD和MDA水平。logistic回归分析和多元线性回归模型研究认知功能与SOD、MDA水平的关系。结果:与最低水平组比较,最高水平组SOD下认知受损发生的OR(95%CI)为3.96(1.66-9.45)。SOD水平与认知功能评分之间显著相关(P<0.05),MDA与认知功能评分之间无显著相关性(P>0.05)。结论:高龄老人中血浆SOD活性与认知功能呈负向关系,未发现血浆MDA与认知功能有显著关系。     

高龄急性缺血性脑卒中患者认知功能障碍影响因素的Logistic回归分析

目的 了解高龄急性缺血性脑卒中患者（acute ischemic stroke,AIS）认知功能障碍的发生率及影响因素。方法 选取2013年1月~2016年9月海口市第三人民医院收治的AIS患者725例,最终纳入患者426例。根据患者病情稳定即将出院时采用简易精神状态量表（mini mental state examination,MMSE）评估其是否存在认知功能障碍,分为认知功能障碍组201例和认知功能正常组225例。应用单因素及多元Logistic回归分析急性缺血性脑卒中患者认知功能障碍的影响因素,并绘制受试者工作特征曲线来评估Logistic回归模型的效果。结果 单因素及多元Logistic回归分析显示,高血压史、高脂血症、高同型半胱氨酸血症、体育锻炼、交流频率、日常生活能力是脑卒中患者发生认知功能障碍的独立影响因素（均有P<0.05）。受试者工作特征曲线评价Logistic回归模型效果的曲线下面积为0.853（95%CI:0.781~0.926）。>3个独立危险因素组MMSE评分低于≤ 3个独立危险因素组MMSE评分（t=4.183,P=0.016）。结论 高龄急性缺血性脑卒中患者认知功能障碍的发生率较高,影响认知功能障碍的危险因素较多,需采取预防措施,以减少或延缓认知障碍的发生。     

Measuring cognitive change in a cohort of patients with Alzheimer's disease

Annualized rates of cognitive change in Alzheimer's disease (AD), an important index of disease progression, show marked variability. To determine factors leading to such variability, we computed rates of change in a cohort of patients with AD tested annually with the Mini Mental State Examination (MMSE) and the more detailed Dementia Rating Scale (DRS). Estimates of rates of change (slopes) and intercepts were calculated using least squares and best linear unbiased predictors (BLUPs). Potential predictors of rates of change were examined using multivariate linear regression analysis. We found that the MMSE had more noise than the DRS. For the MMSE, slopes showed a moderate floor effect and a slight ceiling, depending on initial MMSE scores. These effects were less prominent for the DRS, for which slopes increased as intercepts decreased. In analyses of predictors of change, the MMSE was less useful than the DRS. In multiple linear regression models using DRS data, predictors showed statistically stronger effects and explained a greater extent of variation of slopes than did similar models using MMSE data. For example, among patients who died and underwent brain examination at autopsy, neuropathology of Lewy bodies plus AD (Lewy Body variant; LBV) was associated with significantly faster rates of cognitive decline compared to pure AD in analyses that used the DRS, but only trends were identified with the MMSE. The metric properties and longitudinal characteristics of cognitive tests and the statistical methods used to calculate change are key factors in obtaining reliable estimates of change in studying cohorts of patients with AD.