阿尔茨海默病各种临床记忆检测方法的评价

目的评价各种临床记忆检测方法对阿尔茨海默病(Alzheimer’s disease,AD)诊断的临床效度,从而组合出最适宜AD患者的一套记忆力检测量表。方法以北京市十五攻关项目中研究的患者为背景,对正常老年人1 584例(常模组),AD患者351例(AD组),应用各种记忆力检测量表进行临床分析。结果各种记忆力检测量表对AD的记忆力检测均有较好的临床效度。结合记忆力检测量表的敏感性、特异性、临床可行性及不同的记忆模式,以常模组记忆总得分的第5百分位为分界值,联合各量表的记忆检测,轻度AD患者敏感性为82.57%,特异性为93.29%;检测中度AD患者的敏感性为85.46%,特异性为91.63%。结论联合各量表的记忆检查对AD患者的记忆力检测,敏感性及特异性高,对AD的轻、中度分界有辅助作用。

Evaluation of various memory tests for diagnosis of Alzheimer's disease

Objective To assess the validity of various kinds of memory test for diagnosis of Alzheimer's disease(AD) in order to draw up a set of the most suitable measurable tests that can be applied to examine the memory of patients with AD.Methods Based on the individuals who were enrolled in the 10th-five-year-plan's study on the standard of various kinds of clinical measurable tests for early diagnosis of dementia in Beijing City,the clinical validity of these measurable tests that were used to examine the memory of 351 demented patients and 1584 normal old adults was evaluated.Results All kinds of measurable tests for memory in dementia had good clinical validity.By comparing the sensitivity,specificity and practicability of various tests for different memory types,the newly established tests were efficient in diagnosis of dementia.By taking the 5th percentile of total memory score in control group as the borderline,the sensitivity was 82.57% and the specificity was 93.29% by using these newly-composed tests to detect mild dementia.The sensitivity was 85.46% and specificity was 91.63% for moderate dementia.Conclusions The sensitivity and specificity of these newly composed tests are high in determining memory of AD patients.Also,these tests can distinguish mild dementia from moderate dementia.