阿尔茨海默病的前瞻性记忆损害

目的 探讨阿尔茨海默病（Alzheimer's disease,AD）患者前瞻性记忆(prospective memory，PM)改变的特征，初步了解基于事件的前瞻性记忆(EBPM)和基于时间的前瞻性记忆( TBPM)在早期AD患者中的损害情况。方法 建立前瞻性记忆的神经心理学测验方法，测试20例AD患者（AD组）以及年龄、教育程度相匹配的20例遗忘型轻度认知损害（amnesia mild cognitive impairment，aMCI）患者（aMCI组）及30名健康人（NC组）。结果 与NC组及aMCI组前瞻性记忆(2.23 +0.77、4.83+1.09，1.00+1.03、3.10±1.52)及情景记忆成绩(0.70±0.12、0.66 +0.16，0.45±0.07、0.54±0.10)相比，AD组的成绩(0.20±0.41、2.05±1.43,0.33±0.12、0.32±0.10)差异均有统计学意义，而EBPM的成绩差异更明显（t=-2.792,P＜0.01；t=-10.761，P＜0.01）。结论 早期AD患者的记忆障碍不仅表现为情景记忆的损害，前瞻性记忆损害可能更为突出，且AD的前瞻性记忆损害与aMCI患者呈现了一致性，提示前瞻性记忆的早期测查可能会有利于AD的早期诊断。

Prospective memory disorder in patients with Alzheimer' s disease

Objective To investigate the event-based prospective memory (EBPM) and time-based prospective memory (TBPM) in patients with Alzheimer' s disease (AD). Methods Twenty patients with AD, 20 adults with amnesia mild cognitive impairment (aMCI) and 30 healthy adults with matched age and education level were assessed with a battery of neuropsychological tests including EBPM and TBPM tasks.Results Compared with healthy elders and patients with aMCI on performance of PM (2. 23 + 0. 77,4.83 ±1.09;1.00±1.03,3. 10 ± 1.52) and episodic memory(0. 70 ±0. 12,0.66 +0. 16;0.45 ±0.07,0.54±0. 10), AD patients were all impaired in PM and episodic memory(0.20 +0.41,2.05 ± 1.43;0.33±0. 12,0.32±0. 10), and were impaired in EBPM more significantly (t=-2.792, P＜0.01;t =-10. 761 ,P ＜0. 01 ). Conclusions These results suggest that AD patients show deficits of PM, but their EBPM is impaired more significantly. EBPM impairment may be an early diagnostic of AD.