血清胆红素和尿酸浓度与轻度认知障碍的相关性研究

目的探讨轻度认知功能障碍(MCI)患者血清胆红素和尿酸水平与认知功能的关系。方法检测71例MCI患者(MCI组)及80名认知正常者(对照组)患者的血尿酸、总胆红素(TB)、直接胆红素(DBIL)、间接胆红素(IBIL)水平。采用MMSE和蒙特利尔认知评估量表(MoCA)对入组者行神经心理学评定。结果与对照组比较,MCI组年龄及吸烟史比率显著升高(均P0.05),受教育年限、MMSE评分、MoCA评分、MoCA子评分中的视空间与执行能力、注意力、抽象思维、延迟回忆及TB、IBIL、尿酸浓度显著降低(P0.05～0.01)。TB与MMSE、MoCA评分呈正相关(r=0.287,P=0.030;r=0.347,P=0.024),与MoCA子项目中的视空间与执行功能、抽象思维、延迟回忆呈正相关(r=0.327,P=0.040;r=0.310,P=0.028;r=0.315,P=0.038)。尿酸与MMSE、MoCA评分呈正相关(r=0.293,P=0.030;r=0.337,P=0.013),与MoCA子项目中的视空间与执行功能、注意力、延迟回忆、抽象思维呈正相关(r=0.300,P=0.021;r=0.318,P=0.013;r=0.302,P=0.020;r=0.296,P=0.025)。多因素Logistic回归分析显示,高龄、低教育程度和吸烟是MCI的独立危险因素(P0.05～0.01),TB及尿酸水平是MCI的保护性因素(均P0.05)。结论高龄、低教育程度和吸烟可促进MCI发生,TB及尿酸水平可防止MCI。     

高同型半胱氨酸血症与糖尿病合并血管性痴呆的相关性分析

目的探讨高同型半胱氨酸血症与糖尿病合并血管性痴呆的相关性。方法选取糖尿病合并血管性痴呆患者、非痴呆性血管性认知功能障碍患者、单纯糖尿病患者各60例,分别设为痴呆组、认知障碍组、对照组,采用简易精神状态量表与蒙特利尔认知评估量表进行评估,比较其认知功能评分。采血测定血浆同型半胱氨酸水平,比较3组同型半胱氨酸水平、高同型半胱氨酸血症发生率。根据高同型半胱氨酸血症发生情况将每组分为A组(高同型半胱氨酸血症)、B组(非高同型半胱氨酸血症),比较其认知功能评分。结果 3组MMSE评分、MoCA评分比较差异均有统计学意义(P0.05)。3组同型半胱氨酸水平、高同型半胱氨酸血症发生率比较差异均有统计学意义(P0.05)。痴呆组、认知障碍组、对照组中,A组MMSE评分、MoCA评分均低于B组(P0.05)。高同型半胱氨酸血症与糖尿病合并血管性痴呆呈正相关(r=0.809,P0.05)。结论高同型半胱氨酸血症与糖尿病合并血管性痴呆密切相关,同型半胱氨酸水平越高,认知功能损害越严重。     

血清胆红素和纤维蛋白原浓度与血管性认知损害非痴呆的相关性

目的探究血管性认知损害非痴呆(vascular cognitive impairment with no dementia,VCIND)患者血清胆红素和血浆纤维蛋白原(fibrinogen,FIB)浓度与认知功能的关系。方法测定82例VCIND组和70例对照组血浆纤维蛋白原和血清胆红素的浓度;采用简易精神状态检查量表(mini-mental state examination,MMSE)、蒙特利尔认知评估量表(Montreal cognitive assessment,MoCA)对入组者行神经心理学评价;比较两组间胆红素和纤维蛋白原浓度及认知功能变化情况;用Logistic回归法分析VCIND的影响因素。结果 VCIND组患者的血清胆红素浓度较对照组降低,而血浆FIB浓度较对照组明显升高;VCIND组MMSE评分(25.40±2.33)和MoCA评分(22.40±2.08)较对照组(28.44±1.11、27.44±1.04)偏低,差别均有统计学意义(t=-8.368,P=0.000;t=-10.644,P=0.000);血清胆红素水平与MMSE评分和MoCA评分总得分(r=0.271,P=0.042;r=0.341,P=0.009)及其子项目中的视空间与执行功能、注意力、延迟回忆等评分均呈正相关(r=0.322,P=0.024;r=0.232,P=0.034;r=0.307,P=0.005),血浆FIB水平与MMSE评分和MoCA总评分(r=-0.538,P=0.001;r=-0.464,P=0.007)及其子项目中的视空间与执行功能、注意力、延迟回忆、抽象思维等评分均呈负相关(r=-0.321,P=0.013;r=-0.305,P=0.016;r=-0.376,P=0.003;r=-0.295,P=0.017);Logistic回归分析显示:在调整多种因素后,高龄和高纤维蛋白原水平与认知功能为负性相关关系(β=0.115,P=0.001;β=2.818,P=0.000),高教育程度和总胆红素水平与与认知功能为正性相关关系(β=-0.281,P=0.000;β=-0.101,P=0.035)。结论 VCIND患者血清胆红素浓度下降,与认知功能呈正相关;血浆FIB升高,与认知功能呈负相关。较高年龄及纤维蛋白原水平是VCIND的危险因素,而较高的受教育程度及总胆红素水平是保护性因素。     

血清脂蛋白相关磷脂酶A2与皮质下缺血性血管病患者认知功能的关系

目的 探讨血清脂蛋白相关磷脂酶A2(Lp-PLA2)与皮质下血管性认知损害的关系,进而探究皮质下血管性认知损害发展的危险因素。方法 选取2019年1月至2020年12月就诊的皮质下缺血性血管病(SIVD)患者70例,按认知损害程度分为血管性痴呆(SVaD)组35例、皮质下血管性轻度认知损害(SVMCI)组35例,另选择34例认知功能正常的老年人作为对照组。测定Lp-PLA2水平,进行简易精神状态检查(MMSE)、蒙特利尔认知评估(MoCA)、连线测验A(TMT-A)、连线测验B(TMT-B)、波士顿命名(BNT)、画钟测验A(CDT-A)、工具性日常生活能力量表(IADL)等神经心理评估,比较各组间Lp-PLA2水平变化,并将MMSE评分与Lp-PLA2和血管危险因素进行多元线性回归分析。结果 SVaD组和SVMCI组的血清Lp-PLA2水平均高于对照组,差异均有统计学意义(均P<0.05);相关性分析显示Lp-PLA2水平与MMSE、MoCA、BNT、CDT-A等量表评分呈负相关(r=-0.432、-0.302、-0.286、-0.297,均P<0.01),Lp-PLA2...     

血清miR-222和miR-206水平与女性阿尔茨海默病患者认知和运动功能的关系及其在诊断中的价值

目的:探讨血清miR-222和miR-206水平与女性阿尔兹海默病(AD)患者认知和运动功能的关系及其在AD诊断中的价值。方法:采用逆转录-聚合酶链反应方法检测66例AD女性患者(AD组)血清miR-222和miR-206相对表达量;应用简易精神状态检查(MMSE)、AD评定量表认知分量表(ADAS-Cog)、日常生活能力量表(ADL)、改良Bruce症状控制心电图平板运动实验评估AD患者的认知功能、生活能力及运动能力;结果与50名健康对照者(对照组)比较;分析血清miR-222和miR-206相对表达量与患者认知及运动功能的关系。结果:AD组血清miR-222相对表达量显著低于、miR-206相对表达量显著高于对照组(P均0.01);AD组血清miR-222水平与MMSE评分、平板运动实验中最大代谢当量(METs)及最大心率呈正相关(r=0.412、0.509、0.423;P均0.05),与ADAS-Cog评分、平板运动实验的心率-血压乘积(RPP)呈负相关(r=-0.531、-0.396;P均0.05);AD组血清miR-206水平与MMSE评分、METs及最大心率呈负相关(r=-0.527、-0.557、-0.471;P均0.05),与ADAS-Cog评分、RPP呈正相关(r=0.630、0.408;P0.05或P0.01);血清miR-222和miR-206诊断AD的ROC曲线下面积分别为0.703、0.784。结论:女性AD患者血清miR-222、miR-206表达异常,并与其认知和运动能力下降相关;血清miR-222、miR-206表达水平对诊断AD具有一定临床价值。     

辛伐他汀改善血管性痴呆患者认知功能障碍效果的初步研究

目的初步探讨辛伐他汀对血管性痴呆患者认知功能障碍的改善效果。方法本实验选取2011-12—2012-02到我院进行治疗的血管性痴呆患者60例为研究对象,按治疗方法分为对照组30例(常规药物治疗)和观察组30例(常规药物联合辛伐他汀治疗),比较2组患者的日常生活能力及认知功能改善情况。结果比较2组患者治疗前ADL评分情况和MMSE评分情况,观察组与对照组均无明显区别,差异无统计学意义(P>0.05);2组患者治疗后语言表述、语言理解、阅读理解、言语表达、时间定向、注意力、画图、短程记忆和计算能力等方面的MMSE评分情况均有不同程度提高,组内比较,2组患者治疗前后MMSE评分情况,差别具有统计学意义(P<0.05);2组患者治疗后较治疗前ADL评分均明显改善,治疗前后比较,差异均有统计学意义(P<0.05);而观察组患者治疗后MMSE评分情况和ADL评分情况则明显优于对照组,差异有统计学意义(P<0.05)。结论血管性痴呆患者在常规治疗基础上加服辛伐他汀可明显提高患者的日常生活能力和认知功能,效果显著,是一种简便有效的治疗方法,值得临床推广和使用。     

天智颗粒治疗血管性痴呆的临床观察

目的观察天智颗粒改善血管性痴呆(VD)认知能力的疗效。方法选择57例血管性痴呆患者,随机分为观察组和对照组,对照组常规治疗,观察组加用天智颗粒冲服。应用韦氏记忆量表(MQ)、简易智能状态量表(MMSE)、长谷川痴呆量表(HDS)、日常生活能力量表(ADL)等评价临床疗效。结果治疗前2组MMSE、MQ、HDS、ADL评分比较差异均无统计学意义(P>0.05),治疗后治疗组MMSE MQ HDSADL评分优于对照组(P<0.05)。结论天智颗粒治疗血管性痴呆可有效改善患者的认知功能,提高日常生活能力。     

盐酸多奈哌齐治疗血管性痴呆的疗效观察

目的观察盐酸多奈哌齐治疗血管性痴呆的效果。方法我院2010-03—2012-03收治血管性痴呆患者70例,随机分为对照组与观察组,对照组常规治疗,观察组在常规治疗基础上口服5mg盐酸多奈哌齐,1次/d,治疗8周后对2组患者进行MMSE评分来判断认知能力,并通过ADL量化法评价生活活动能力。结果经过8周治疗,观察组MMSE和ADL评分与对照组相比差异有统计学意义(P<0.05);同时观察组在血浆黏度改善、血清NO含量与血浆ET-1方面均好于对照组。结论盐酸多奈哌齐治疗血管性老年痴呆有明显疗效,可缓解认知功能障碍,改善痴呆程度,提高生活能力。     

天智颗粒联合尼麦角林治疗血管性痴呆的临床观察

目的研究天智颗粒联合尼麦角林治疗血管性痴呆的有效性和安全性。方法将血管性痴呆病人60例按随机单盲法分为2组,每组30例,对照组给予尼麦角林口服,治疗组在尼麦角林治疗基础上加服天智颗粒,共12周。2组用药前后均进行认知障碍程度检查和痴呆度评分,以日常生活能力量表(ADL)和简易精神状态检查(MMSE)为症状改善的评估指标。结果治疗前2组MMSE评分、ADL评分无显著性差异(P>0.05),对照组用药后MMSE评分明显改善(P<0.05),治疗组MMSE评分显著改善(P<0.01);组间比较治疗组的改善效果明显优于对照组(P<0.01)。对照组ADL用药后评分明显改善(P<0.05),治疗组用药后ADL评分显著改善(P<0.01);治疗组的改善效果亦明显优于对照组(P<0.01)。结论天智颗粒联合尼麦角林能显著改善血管性痴呆患者的认知功能和日常生活能力。     

脑出血患者血清脑源性神经营养因子与痴呆的相关性分析

目的探讨脑出血患者血清脑源性神经营养因子(BDNF)与痴呆的相关性。方法选取180例脑出血患者,出院后6个月根据认知功能评分分为血管性认知功能障碍组(VCI)60例,其中血管性痴呆组(VD)22例,非痴呆型血管性认知功能障碍组(VCIND)38例;对照组为无认知障碍者120例。入院后及出院后6个月采用酶联免疫吸附法(ELISA)检测血清BDNF水平,分析其与认知功能障碍的相关性。采用ROC曲线分析BDNF对VCI发生的预测价值。结果VCI组年龄、NIHSS评分、出血量、出血部位、Hcy水平及BDNF水平与对照组比较差异有统计学意义(P<0.05)。多因素分析示高龄、NIHSS评分高、大量出血、脑叶出血、Hcy水平升高及BDNF水平降低是脑出血患者发生VCI的危险因素(P<0.05)。出院时6个月VCIND组与对照组MMSE评分、BDNF水平均高于入院时(P<0.05)。出院后6个月VD组BDNF水平高于入院时(P<0.05)。出院后6个月3组MMSE评分比较差异有统计学意义(P<0.05),两两比较,VD组与VCIND组MMSE评分低于对照组(P<0.05),VD组MMSE评分低于VCIND组(P<0.05)。入院时及出院后6个月3组BDNF水平比较差异有统计学意义(P<0.05),两两比较,入院时及出院后6个月VD组与VCIND组BDNF水平均低于对照组(P<0.05),VD组BDNF水平低于VCIND组(P<0.05)。出院后6个月BDNF水平与MMSE评分呈正相关(P<0.05)。BDNF预测VD及预测VCIND的AUC面积分别为0.749、0.704,均>0.7,灵敏度分别为84.2%、85.9%,特异度分别为80.9%、80.6%。结论脑出血患者血清BDNF水平与出血后VCI的发生相关,随着BDNF水平的降低,VCI严重程度随之增加,且入院后血清BDNF水平可以预测VCI的发生,特别是VD发生的标记物之一,临床上血清BDNF水平低的患者需引起重视。     

Clock drawing test in mild and moderate dementia of the Alzheimer's type: a comparative and correlation study

OBJECTIVES: (a) To compare two different clock drawing tests (CDTs) in mild and moderate dementia of the Alzheimer's type (DAT); (b) To examine presumed correlation between these CDTs and some demographic, cognitive and activities of daily living (ADL) variables in mild and moderate DAT. METHODS: Cross-sectional study. Psychogeriatric outpatient clinic. 49 DAT patients, total; 26-mild, 23-moderate, mean age 77.8 and 80.6, respectively.Evaluations included the Mini-Mental State Examination (MMSE), the Cambridge Cognitive Examination (CAMCOG), the Instrumental Activities of Daily Living Scale (IADL), and a Basic Activities of Daily Living (BADL)-dressing subscale. Severity of dementia was determined with the Clinical Dementia Rating (CDR). Each clock was blindly scored by the same investigator, according to Shulman's and Freedman's methods. RESULTS: Mild and moderate DAT groups were similar in age, gender and education. Performance on Shulman's clock was similar between groups while moderate DAT subjects performed significantly worse on Freedman's clock compared to mild DAT patients. Both clocks correlated highly in mild and moderate DAT. CDT scores correlated significantly with age and education only in mild DAT. Neither clock correlated with ADLs in either stage of dementia severity. CDTs correlated with the MMSE score, and the CAMCOG score in mild DAT, and only with the CAMCOG score in moderate DAT. These correlations were still significant after controlling for age and education. CONCLUSIONS: Different aspects of cognition and dementia severity are reflected depending on how a clock drawing is scored. Some scoring systems may have greater sensitivity than others in monitoring progression of cognitive deterioration. Correlation between different CDTs and the variables studied (demographic, cognitive, ADLs), when present, is not ubiqitous and changes with the dementia severity.     

血清S100B蛋白抗脑抗体海马体积变化与阿尔茨海默病患者认知功能变化的关系

目的探讨血清S100B蛋白、抗脑抗体(ABAb)、海马体积大小变化与阿尔茨海默病(AD)患者认知功能变化的关系。方法选取濮阳市油田总医院确诊的88例阿尔茨海默病患者(AD组),选取正常体检者90例为对照组,检测并对比2组血清S100B蛋白、ABAb、海马体积,采用线性相关、多元线性回归分析各项研究指标与简易精神状态量表(MMSE)的相关性。结果AD组血清S100B蛋白、ABAb测定值均高于对照组(P<0.05);AD组海马体积、MMSE评分均低于对照组(P<0.05);AD组血清S100B蛋白、ABAb测定值与MMSE评分呈负相关性(P<0.05);AD组海马体积与MMSE评分呈正相关性(P<0.05);多元线性回归模型显示,血清S100B蛋白、ABAb增高与AD患者MMSE评分呈负相关(P<0.05),海马体积、受教育年限与MMSE评分呈正相关(P<0.05)。结论AD患者的血清S100B蛋白、ABAb增高,海马体积较健康人群降低,且与患者认知功能受损程度有关。     

血清硫氧还蛋白、褪黑激素水平与阿尔茨海默病患者病情严重程度的关系

目的 探讨血清硫氧还蛋白、褪黑激素与阿尔茨海默病(Alzheimer's disease,AD)患者病情严重程度的关系.方法 选取2018年1月-2019年12月于本院随诊的AD患者94例作为AD组,另选取同时期于本院体检的健康人80例作为对照组(CON组);比较2组不同AD病情程度下血清硫氧还蛋白、褪黑激素水平及相关...     

丁苯酞辅助治疗对老年痴呆症患者的疗效

目的 探讨丁苯酞辅助治疗对老年痴呆症患者的疗效及其可能的机制.方法 本研究对象为2018年1月～2019年8月我院收治的88例老年痴呆症患者,按照数字表法随机均分为两组,每组44人,对照组给予常规治疗,观察组在此基础上联合丁苯酞治疗.比较两组患者治疗前后病理行为评分表(BEHA VE-AD)、生活能力量表(ADL)、简...     

癫痫小儿认知功能与血清蛋白激酶C表达水平的相关性分析

目的观察癫痫小儿认知功能改变及与血清蛋白激酶C(PKC)表达变化的相关性。方法选取2018-01—2019-10就诊于开封市儿童医院的10~15岁癫痫患儿79例纳入癫痫组,同时征询正常发育同龄儿童40例为对照组。应用MMSE量表评估2组儿童的认知功能,利用酶联免疫吸附实验(ELISA)检测2组血清PKC的表达水平,并将结果与MMSE评分进行Pearson相关性分析。结果MMSE评分显示,2组定向力、注意力和计算力及语言能力比较差异无统计学意义(P>0.05),癫痫组记忆能力、回忆能力及总评分均明显降低,差异有统计学意义(P<0.01)。ELISA检测结果显示,与对照组相比,癫痫组癫痫患儿血清PKC水平明显降低,差异有统计学意义(P<0.01)。Pearson相关性分析显示,定向力评分与PKC水平略呈负相关,但无统计学相关性;记忆力评分、回忆能力及MMSE总评分与PKC水平呈正相关(P<0.0001);注意力和计算能力评分与PKC水平呈正相关(P=0.0044);语言能力与PKC水平呈正相关,但相关性不显著。结论癫痫造成患儿认知能力下降,特别是学习记忆能力,同时癫痫患儿血清PKC水平表达降低,且与认知能力改变整体呈正相关。     

Utility of TICS-M for the assessment of cognitive function in older adults

BACKGROUND: Routine screening of high-risk elderly people for early cognitive impairment is constrained by the limitations of currently available cognitive function tests. The Telephone Interview of Cognitive Status is a novel instrument for assessment of cognitive function that can be administered in person or by telephone. OBJECTIVE: To evaluate the determinants and utility of TICS-M (13-item modified version) for assessment of cognitive function in healthy elderly people. METHODS: The utility of TICS-M was compared with more widely used MMSE and CAMCOG in a cross-sectional survey of 120 older (62 to 89 years) UK adults. RESULTS: The TICS-M cognitive test scores (27.97, SD 4.15) were normally distributed in contrast with those for MMSE and CAMCOG that had a negatively skewed distribution. TICS-M scores were inversely correlated with age (r = -0.21) and with the NART fullscale IQ (r = -0.35), but were independent of years of education in this cohort. TICS-M was highly correlated with MMSE (r = 0.57) and with CAMCOG (r = 0.62) scores. The time required to complete the test is comparable to MMSE and substantially less than CAMCOG. CONCLUSIONS: The normal distribution of TICS-M test scores suggest that this test is less constrained by the ceiling effect which limits the utility of MMSE and CAMCOG test scores in detecting early cognitive impairment. TICS-M is an appropriate instrument to assess cognitive function in both research and in clinical practice.     

Clinical usefulness of cognitive evoked potentials to assess cognitive deficits in cerebrovascular diseases

Background: The aim of the present study is to evaluate the clinical applicability and usefulness of cognitive evoked potentials (CEP) to identify a cognitive deficit in patients with cerebrovascular diseases (CVD). Methods: The P3 latencies, amplitudes and latency to amplitude ratios (LAR) of CEP were measured in 25 healthy control subjects and 35 inpatients with CVD. The association of CEP with variables including age, sex, mini‐mental state examination (MMSE) score, CVD types, loci of hemiplegic limbs, duration, education, brief psychiatric rating scale (BPRS), instrumental activities of daily living (IADL) and daily living function assessment (DLFA) was also analyzed. Results: (i) The P3 latencies (447.87 ± 113.06 msec) and LAR (65.83 ± 43.25) were prolonged in CVD (P < 0.05), while the amplitudes (8.18 ± 2.51 µV ) were not changed; (ii) the P3 latencies (537.31 ± 101.14msec) and LAR (94.89 ± 46.44 in CVD with a MMSE score <24 were prolonged, and the amplitudes (6.45 ± 1.98 µV ) were reduced (P < 0.05, respectively); (iii) the BPRS, IADL and DLFA in CVD with a MMSE score <24 were different from MMSE ≥24 (P < 0.05); (iv) there was no difference in CEP between CVD caused by infaction and hemorrhage; (v) the P3 latencies were correlated positively with age, BPRS and IADL, while negatively with MMSE and DLFA. The amplitudes were correlated positively with MMSE and DLFA, while negatively with age, BPRS and IADL. The LAR were correlated positively with age, BPRS and IADL, while negatively with MMSE and DLFA; and (vi) on analyzing association of CEP with variables in CVD with MMSE <24, the P3 latencies were correlated positively with BPRS and DLFA, while negatively with MMSE and DLFA. The amplitudes were positively correlated with age. The LAR were positively correlated with IADL. Conclusions: The P3 latencies and LAR of CEP seemed to be useful clinical measures to assess cognitive disorders in CVD as well as in vascular dementia.     

血管性痴呆患者血清CGRP、NPY水平的变化及意义

目的探讨血管性痴呆(VD)患者血清中降钙素基因相关肽(CGRP)及神经肽Y(NPY)水平的变化及其意义。方法测定VD组、脑梗死非痴呆组(CI组)、健康对照组(NC组)血清CGRP及神经肽NPY水平变化,分析与蒙特利尔认知评估量表(MoCA)评分的关系。结果 VD组MoCA评分、CGRP水平低于NC组和CI组,NPY水平高于NC组和CI组,差异均有统计学意义(P<0.05)。VD组的MoCA评分与血清CGRP水平呈正相关(r=0.439,P<0.01),与血清NPY水平呈负相关(r=-0.278,P<0.05)。结论脑的长期慢性低灌注是VD发生发展的主要危险因素。脑血管舒缩功能平衡失调既可能是脑缺血缺氧的结果,又可能是进一步导致脑细胞损伤的重要原因。     

Are the care levels of people with dementia correctly assessed for eligibility of the Japanese long‐term care insurance?

BACKGROUND: A new long-term care insurance system was launched in Japan in April 2000. OBJECTIVES: We performed the first national survey on special units of psychiatric hospitals for dementia patients to examine whether their disabilities were well reflected in the eligibility assessment. METHODS: Of all 248 dementia special units of psychiatric hospitals in Japan, 180 units (72.6%) participated in the survey. Five patients were randomly selected in each unit, and we used data of 802 (89.1%) of 900 patients whose care levels were obtained by the primary computer assessment. These patients were assessed using the Mini-Mental State Examination (MMSE), dementia rating scale by Gottfries et al. (1982) (GBS), and Activities of Daily Living (ADL). The mean score (SD) of the MMSE was 9.3 (6.9). RESULTS: Multiple regression analysis revealed that the scores of motor function in GBS, ADL, MMSE, and the degree of bedridden explained 73% of the variation of care level. The higher care levels were inversely related to lower MMSE scores. In the group of people who were not bedridden, the MMSE score sharply decreased even though their physical functions were maintained. There were no significant differences in the MMSE scores among the care level 1 and 5 groups except between care level 1 and 3 after controlling for the motor function scores in GBS. CONCLUSIONS: Our results suggest that care level and cognitive impairment are generally correlated in the primary assessment, but some adjustment measure for cognitive impairment is needed in mildly or moderately physically disabled patients.