轻度阿尔茨海默病患者年龄对蒙特利尔认知评估量表基本版得分的影响

目的 观察不同年龄段的轻度阿尔茨海默病（Alzheimer's disease，AD）患者在蒙特利尔认知评估量表基本版（the Montreal Cognitive Assessment-Basic，MoCA-B）各亚项的得分有无差异。方法 选取2017年1月至12月首都医科大学附属复兴医院神经内科门诊、住院患者及周边社区居民，诊断为轻度AD者286例，根据受试者年龄，分为3组：51~60岁（57例），61~70岁（112例），71~80岁（117例）。完成简易精神状态量表（Mini-Mental State Examination，MMSE）和MoCA-B。结果 3组轻度AD患者的性别、受教育程度、MMSE得分、MoCA-B总分差异均无统计学意义。MoCA-B各亚项比较上，抽象推理、词语延迟回忆在3组间差异有统计学意义（P<0.05）。词语延迟回忆在3组中呈现60岁以下组得分（0.5±1.0）略高于60岁以上组得分（0.1±0.4），但因平均分均在1分以内，差异虽有统计学意义但无临床指导意义。抽象推理能力在60岁以上组得分明显高于51~60岁组，两两比较的结果，51~60岁组与61~70岁组比较，及51~60岁组与71~80岁组比较，差异均有统计学意义（P<0.05）。结论 临床上在动态观察轻度AD的MoCA-B总分变化时，还应注意一些认知域亚项的结果可能与年龄相关，特别是抽象推理能力部分。

Differences of cognitive impairment pattern in the montreal cognitive assessment-basic in different age patients with mild Alzheimer's disease

Objective To investigate the difference of the Montreal Cognitive Assessment-Basic (MoCA-B) subitem score among different ages in patients with mild Alzheimer's disease(AD).Methods Totally 286 AD patients were recruited from outpatients and inpatients department of Neurology and Community Settings of Fuxing Hospital, from January 2017 to December 2017. Patients were divided into three groups according to their age:51-60(n=57), 61-70(n=112), 71-80(n=117). All the patients were administered with Mini-Mental State Examination(MMSE)and MoCA-B.Results There were no significant difference between three groups in gender, education, MMSE and MoCA-B. Comparing every item of MoCA-B in three groups, the abstraction and similarity task and delayed recall have significant difference(P<0.05). The patients less than 60 get a little higher score in delayed recall than the patients older than 60 (0.5±1.0 vs 0.1±0.4). But the difference of the score in less than one score, so there was not much clinical meaning in memory. For the abstract reasoning task, the patients less than 60 get higher score than the older patients(1.2±1.1 vs 0.7±1.1, 1.3±1.1 vs 0.7±1.1, respectively). The differences of the three groups were significant(P<0.05).Conclusion To interpret the score of every item of MoCA-B, we should pay attention to the possible influences of age, especially for the abstract reasoning task.