不同程度脑白质疏松轻度认知障碍患者的MoCA评估分析

目的 通过蒙特利尔认知评估(MoCA)量表初步分析脑白质疏松(LA)轻度认知障碍特点.方法 选择78例LA轻度认知障碍患者,进行MoCA量表测评,初步分析LA轻度认知障碍特点,比较LA不同分级患者认知功能障碍损伤程度.结果 78例患者MoCA总分平均(21.8±2.9)分.视空间与执行功能平均(3.4±1.1)分,83.3%的患者受损;命名平均(2.8±0.6)分,17.9%的患者受损;注意与计算力平均(5.3±1.0)分,46.2%的患者受损;语言平均(1.6±0.8)分,88.5%的患者受损;抽象思维平均(0.9±0.7)分,76.9%的患者受损;延迟记忆平均(1.8±1.3)分,98.7%的患者受损;定向力平均(5.9±0.4)分,9.0%的患者受损.MoCA总分、命名、注意与计算力评分LA 3级低于LA 1级(P<0.05),语言评分LA 3级低于LA 1级和LA 2级(P<0.05),其余各亚项评分组间比较差异无统计学意义.结论 LA轻度认知障碍患者表现多个认知领域的损害,其中延迟记忆受损最常见,其次为语言、视空间与执行功能、抽象思维、注意与计算力.LA不同分级与认知功能损害程度存在相关性.

Montreal Cognitive Assessment for patients with leukoaraiosis mild cognitive impairment in different degrees

Objective To analyze initially the characteristics of leukoaraiosis mild cognitive impairment(LACI) by using the Montreal Cognitive Assessment(MoCA).Methods The patients with LACI(n=78) were selected and detected by using MoCA.The characteristics of LACI were analyzed initially and the degrees of cognitive impairment were compared in patients with different grades LA.Results The average total score of MoCA was(21.8±2.9) in 78 patients.The average score of visuospatial and executive function was(3.4±1.1) and 83.3% patients had visuospatial agnosia and executive function loss,that of denomination,(2.8±0.6) and 17.9% had anomia,that of attention and calculation,(5.3±1.0) and 46.2% had attention deficit and dyscalculia,that of linguistic competence,(1.6±0.8) and 88.5% had aphasia,that of abstract thinking,(0.9±0.7) and 76.9% had impaired abstract thinking,that of delayed memory,(1.8±1.3) and 98.7% patients had impairment of delayed memory,and that of orientation,(5.9±0.4) and 9.0% had unorientation.The total score of MoCA and scores of denomination,attention and calculation were lower in patients with grade 3 LA than those in patients with grade 1 LA(P<0.05),and the score of linguistic competence was lower in patients with grade 3 LA than that in patients with grade 1 LA and grade 2 LA(P<0.05).The scores of other indexes had no statistical differences compared among all groups.Conclusion The patients with LACI have the manifestations of impairment in multiple cognitive fields,among which the most common one is impairment of delayed memory,and others include aphasia,visuospatial agnosia,executive function loss,impaired abstract thinking,attention deficit and dyscalculia.There is a correlation between grades of LA and degree of cognitive impairment.