离退休体检人群认知功能检查的意义探讨

目的了解≥50岁离退休职工常规体检人群的认知功能状态，探讨常规体检中增加认知功能检查的意义。方法对2005年8月，10月在我院参与常规体检的秦皇岛港务局≥50岁的离退休职工进行面对面调查。调查分为筛查、复查诊断两个阶段。筛查用简易智能精神状态量表（MMSE）、Hachinski缺血评分、焦虑自评量表、抑郁自评量表；复查诊断用临床痴呆评定量表（CDR）、扩充痴呆量表（ESD）及记忆检查记录。轻度认知功能障碍（MCI）使用Perterson诊断标准、老年性痴呆（Alzheimer’s disease，以下简称AD）诊断标准使用美国国立神经和语言障碍和卒中——老年性痴呆及相关疾病学会（NINCDS-ADRDA）痴呆诊断标准。结果2269例体检者中，MMSE正常高分组1970人，占86．8％；正常低分126人。占5．6％。MCI70人，检出率3.1％；AD50人，均为轻度痴呆，检出率2．2％。血管性轻度认知功能障碍（VCI）36人。占1．6％。血管性痴呆（VaD）15人。占0．7％。混合性痴呆（MD）2人。占0．1％。各种异常项目检出率随年龄增加而增加。随文化程度的提高而减低。结论≥50岁常规体检人群可检出认知功能障碍，主要表现为MMSE正常低分、MCI和轻度AD。常规体检工作中增加认知功能检查有助于早期发现重点人群，既有利于早预防、早治疗．又便于管理，意义重大。

SURVEY OF COGNITIVE FUNCTION STATE IN ROUTINE PHYSICAL EXAMINATION FOR RETIRED PEOPLE IN QINHUANGDAO HARBOUR

objective To study the cognitive function state in retired people aged 50 years or over. methods From august to October 2005, a total of 2269 retired people aged 50 years and over were investigated with two-stage survey. In screening survey, each participant was interviewed face to face with the Mini-Mental State Examination (MMSE), Hachinski Iskemic Scale(HIS), SAS and SDS. In diagnosing stage, those who had cognitive impairment were reassessed with Clinical Dementia Rating(CDR), ESD. The clinical diagnoses of Mild Cognitive Impairment(MCI) and Alzheimer Disease(AD) were made respectively according to the Perterson's criteria and the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer Disease and Related Disorders Association (NINCDS-ADRDA) criteria. results Among 2269 retired people, 2096 of normal MMSE scores (92.4%), 70 of MCI(3.1%), 50 of AD(2.2%), 36 of VCI(1.6%), 15 of VaD(0.2%), 2 of MD(0.1%) were screened out. conclusions The cognitive impairment was common in retired people aged 50 years and over.The prevalence of every abnormal state increases with aging and decreases with education.