早发和晚发遗忘型轻度认知损害与阿尔茨海默病的神经心理学比较研究

目的:比较早发性与晚发性阿尔茨海默病(AD)、早发性和晚发性遗忘型轻度认知损害(aMCI)的神经心理学表现。方法:记忆障碍门诊患者根据首诊年龄分组,70岁为晚发组。接受简明精神状态量表(MMSE)、听觉词语学习测验(AVMT)、逻辑记忆测验(LM)、斯特鲁普(Stroop)色词测验(CWT)、Rey-Osterrich复杂图形测验(CFT)、言语流畅性测验(VFT)、连线测验(TMT)、画钟测验(CDT)等。结果:共257例患者,分为4组,分别为早发AD34例,晚发AD78例,早发aMCI58例,晚发aMCI87例;早发、晚发AD间大部分神经心理学表现相似;早发aMCI患者在大部分测验上的表现优于晚发患者,听觉词语延迟回忆、言语流畅性、TMTB耗时等项目的差异最为显著(P<0.01)。晚发aMCI患者逻辑记忆即刻、延迟回忆更佳。结论:早发与晚发AD认知损害较为相似,晚发aMCI患者的认知损害较早发aMCI患者更为弥漫。

Neuropsychological differences of Alzheimer's disease and amnestic mild cognitive impairment:early-onset vs late-onset

Objective To compare the differences of neuropsychological performance between early-onset and late-onset of Alzheimer's disease (AD) and amnestic mild cognitive impairment (aMCI). Methods Patients admitted into a single memory clinic were undergone a battery of neuropsychological tests, including mini-mental state examination(MMSE), auditory verbal memory test (AVMT), logic memory test (LM), Stroop color word test (CWT), Rey-Osterrich complex figure test (CFT), verbal fluency test (VFT), trail marking test (TMT), and clock drawing test (CDT). Results A total of 257 patients were divided into 4 groups accoring to the age of disease onset: early-onset AD(n=34); late-onset AD(n=78); early-onset-aMCI(n=58), and late-onset-aMCI(n=87). The neuropsychological patterns of early-onset AD and late-onset AD patients were similiar. In contrast, early-onset-aMCI patients demonstrated a better performance in AVMT, VFT, CWT and TMT, while late-onset-aMCI patients had better LM ability. Conclusions Early-onset AD and late-onset AD patients have similar cognitive impairment. Late-onset-aMCI patients have worse cognitive impairment than early-onset-aMCI patients.