老年性痴呆和轻度认知障碍患者时间地点定向力受损情况探讨(1)
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中图分类号：R749.16 文献标 识码：A 文章编号：1009_816X(2010)02_0095_02
Temporal and Spatial Disorientation in Patients with Alzheimer's Dise ase and Mild Cognitive Impairment.JIN Yu, NI Jiao_na, WU Jiong. Department of neurology, Zhejiang Hospital, Zheji ang 310013, China
[Abstract] Objective To explore spatial and temporal disorient ation in patients with Alzheimer's disease(AD) and mild cognitive impairment( MCI). Methods51 AD patients, 9 MCI patients and 26 healthy elders (controls) were given the M MSE test. MMSE total score and 10 subset of MMSE items including temporal orient ation and spatial orientation were analysed.ResultsThere was no significant differen ce between MCI and controls in temporal, spatial orientation and MMSE total scor e. There was no significant difference between MCI and mild AD in spatial orient ation. There was significant difference in item of year, month, week, street andfloor between mild and moderate AD. There was significant difference in item ofseason, province, strict, street and place between moderate and severe AD.ConclusionsWith the cognitive impairment going on, orientation in AD and MCI patient s declined gradually. The decline of temporal orientation is more markedly in ea rly stage, while in later stage impairment of spatial orientation became more an d more evident. No special items were found to be more sensitive than others.
[Key words] Alzheimer's disease; Mild cognitive impairment; Te mporal orientation; Spatial orientation
痴呆是一种后天获得性的、持续进行性的全面性智能减退。患者无意识障碍，但在记忆、认 知、语言、视空间技能、情感或人格等5项心理活动中，至少3项功能缺损，常影响职业 、社会活动和生活能力。定向力是认知能力的一种，也是认知下降的敏感指标，时间地点定 向力测定是多个常用痴呆筛查量表的重要分项，如MMSE、7分钟痴呆筛查量表等[1] 。本文对正常认知老人、轻度认知障碍(mild cognitive impairment，MCI)患者和老年 痴呆(Alzheimer's disease,AD)患者MMSE总分和时间地点定向10个分项的测定，探讨AD和MC I患者的时间和地点定向力受损情况。
1 资料与方法
1.1 一般资料：自2007年9月至2009年3月收集AD患者51名，其中男31名，女20名，年龄 60～96(平均80.7±9.2)岁；MCI患者9名，其中男6名，女3名，年龄73～86(平均79. 6±4.4)岁；正常对照26名，其中男17名，女9名，年龄66～90(平均77.2±6.7)岁 。AD诊断根据《中国精神疾病分类方案与诊断标准》第三版(CCMD_3，2001)。根据总体衰 退量表(Global Deteriorate Scale,GDS)总分，将患者分为轻度(GDS:4级)14例、 中度(GDS:5级)11例、重度(GDS:6～7级)26例。MCI的诊断根据文献报道[2,3] 。排除血管性痴呆、路易体痴呆、抑郁症引起的假性痴呆和其他原因引起的认知障碍患者。
1.2 方法：专人对所有患者进行MMSE检查，记录各例患者的MMSE总分、时间定向分(最高 5分)及地点定向分(最高5分)。时间和地点定向力分的10个分项指标，包括年份、季度、 月份、日期、星期、省市、区、街道、楼层、所在地，每题正确得1分。
1.3 统计方法：采用SPSS 10.0 For Windows统计软件作统计分析 ......
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