摘要
目的 了解老年期轻微认知功能损害 (MCI)和痴呆患者的结局、认知功能和生活功能的变化。方法 于 1997年 6月至 1998年 4月用两阶段法对成都市 10个区市县中年龄≥ 5 5周岁的老年人 (共 5 385人 )进行老年期痴呆患病率调查。采用美国精神障碍诊断和统计手册第 3版、Hachinski缺血指数量表、美国神经病语言障碍和中风研究所及阿尔茨海默病与相关障碍协会的阿尔茨海默病的诊断标准和痴呆严重程度临床评定量表进行诊断和评定痴呆的严重程度。查出MCI 6 5例 (MCI组 )、痴呆 137例 (痴呆组 ) ,共 2 0 2例。 1998年 12月至 1999年 2月用简易精神状态检查中文版(CMMSE)、Pfeffer功能活动调查表 (POD)和神经心理测验工具对 2 0 2例患者进行随访 ;用CMMSE随访15 1名正常老年人 (对照组 )。结果 MCI组和痴呆组的病死率分别为 13 8%和 2 7 0 % ,认知功能损害越重的患者病死率越高。随访时两组CMMSE评分较首次评分分别下降 (2 1± 3 9)分和 (2 3± 4 7)分(P均 <0 0 1) ,较对照组下降 [(0 6± 2 5 )分 ]为著 (P <0 0 1) ;而两组的POD评分较首次评分却有升高 [差值分别为 (- 3 6± 4 0 )分 ,和 (- 1 3± 4 1)分 ,P均 <0 0 1]。结论 老年期MCI和痴呆患者的认知功能损害和功能下降呈进行性加重 ,其病死率随认?
Objective To study the outcome of mild cognitive impairment(MCI)and senile dementia in the urban and rural aged population. Methods 65 subjects with MCI and 137 patients with dementia were screened out from 5 385 participants aged 55 and over in the urban and rural population in Chengdu, China with two stage interview. All the subjects were met with the criteria of the clinical staging of dementia rating for MCI or the DSM Ⅲ R criteria for dementia. After1 year, the subjects with MCI or dementia were followed up with Chinese Mini Mental State Examination (CMMSE), Pfeffer′s Outpatient Disability Questionnaire (POD) and a battery of neuropsychological tests. 151 normal elderlies were followed up with CMMSE as control. Results During the following up study, 13 8% of the subjects with MCI and 27 0% of those with senile dementia were dead, far more than in the control group. And the mortality increased with cognitive impairment advancing. The decreased CMMSE scores of the subjects with MCI and with senile dementia were 2 1±3 9 (P<0 01) and 2 3±4 7 (P< 0 01) respectively, all significantly more than that of the control group (0 6±2 5, P<0 01). The POD score of the subjects with MCI and with senile dementia increased 3 6±4 0 (P<0 01) and 1 3±4 1 (P<0 01) respectively in 1 year. The scores of Block Design of the patients with mild dementia were significant decreased (1 3±3 8, P<0 05) . Their scores of Rapid Verbal Retrieve, Fuld Objective memory Examination were not changed significantly. Conclussions The mortality of subjects with MCI and senile dementia increases with cognitive impairment advancing and the cognitive function decreases progressively. The scores of CMMSE and POD were sensitive to cognitive impairment.
出处
《中华精神科杂志》
CAS
CSCD
2000年第4期218-221,共4页
Chinese Journal of Psychiatry
关键词
老年精神病学
痴呆
认知障碍
日常生活活动
随访研究
Geriatric psychiatry
Dementia
Cognitive disorders
Activities of daily living
Follow-up studies
