轻中度阿尔茨海默病患者计算能力的研究

目的 研究轻中度阿尔茨海默病(AD)患者计算能力减退的特点.方法 68例正常中老年人、35例轻度AD和19例中度AD被试完成简易精神状态量表、韦氏成人智力测验-计算分测验和EC301数字加工和计算量表中文修订版(EC301-CR).后者包括心算、笔算、估算、珠算、语算(每类型有加、减、乘、除4种运算方式)和相邻数字记忆.结果 正常组、轻度AD组和中度AD组比较,心算(23.1±1.4)分、(18.5±4.4)分、(13.7±7.8)分,F =46.1,P <0.01]、笔算(22.4±2.0)分、(16.7±5.5)分、(9.8±9.6)分,F =51.0 ,(P <0.01]、估算(7.3±1.0)分、(5.1±2.8)分、(2.5±3.0)分,F =45.4 ,P <0.01]、语算(11.5±1.7)分、(7.5±2.4)分、(5.5±2.4)分,F =81.1,P <0.01],3组比较各类型均差异有显著性,但珠算损害相对更早,轻中度AD组之间的珠算表现差异无显著性( P ＞0.05).加、减、乘、除等不同方法的减退除了笔算中的乘法损害更早,其余方式的减退比较均衡,从心算和相邻数字记忆的结果看,数字位数(即难度)与AD计算损害严重度密切相关.结论 AD患者计算能力明显减退, 而决定AD计算能力得分的主要因素是需要计算的数字大小而不是计算类型或方式.

Study of the calculational capacity of mild and moderate patients with Alzheimer disease

Objective To study the characteristics of the declination of calculational capacity of mild and moderate patients with Alzheimer disease(AD) . Methods All the participants including 68 normal aged people,35 patients with mild AD and 19 patients with moderate AD were evaluated by mini mental state examination(MMSE),Wechsler adult intelligence scale-calculation subtest and EC301 number processing and calculation-Chinese revised(EC301-CR). ER301-CR includes mental calculation, written calculation, estimation calculation, abacus calculation and verbal calculation (each category consists of addition, subtraction, multiplication and division) and the adjacent numbers memory. Results There was prominent discrepancy among the normal aged group, mild AD group and moderate AD group in mental calculation (23.1±1.4,18.5±4.4,13.7±7.8,F = 46.1,P <0.01), written calculation (22.4±2.0,16.7±5.5,9.8±9.6,F =51.0,P <0.01), estimation calculation (7.3±1.0,5.1±2.8,2.5±3.0,F =45.4,P <0.01) and verbal calculation (11.5±1.7,7.5±2.4,5.5±2.4,F =81.1,P <0.01) capabilities, and the impairment of abacus calculation presented earlier than the others. However, there was no difference in abacus calculation between the mild AD group and the moderate AD group( P ＞0.05).Among the written calculation, the declination of multiplication occurred earlier than the others, and the declination of the other three were synchronized. According to the findings of mental calculation and the adjacent numbers memory, the digit size was closely related to the impairment of calculational capacity of AD patients.Conclusion There was apparent declination of calculational capabilities in AD patients. And the determinant of calculational capacity in AD patients was the magnitude of the numbers instead of calculational categories or ways.