摘要
目的了解阿尔茨海默病（Alzheimer disease，AD）患者执行功能损害状况及对于生活能力的影响，探讨执行功能障碍与记忆等AD常见认知功能损害的相关性。方法运用神经心理学测验的方法对40例AD患者及30例轻度认知功能损害（mild cognitive impairment，MCI）患者进行执行功能、记忆及其他认知功能检查，同时进行生活能力评定。另外选择40名健康老人作对照。结果AD组的执行功能测验成绩均显著低于健康对照组（P〈0．01），其中额叶功能评定量表（FAB）（5．29±2．47）分，执行性画钟作业（CLOX1）（4．63±3．56）分，Stroop测验错误次数（Stroop1）（14．17±8．99）分，词语流畅性测验（RVR）（17．56±10．51）分。除Stroop测验反应时间（Stroor2）外，MCI组的其他执行功能测验成绩显著低于健康对照组（P〈0．05），其中FAB为（7．67±2．44）分，CLOX1为（7．86±3．78）分，Stroop1为（7．21±8．07）分，RVR为（30．86±8．38）分。用多元逐步回归方法分析不同认知功能对生活能力的影响，结果为反映执行功能的FAB测验成绩处于第一位，独立与操作性日常生活能力（IADL）相关（β=-0．778，t=-7．079，P〈0．01）。各项执行功能测验与年龄相关性不明显（r=0．026～0．250，P〉0．05），与简易精神状态量表（MMSE）、记忆测验成绩相关性好（r=0．438～0．786，P〈0．01）。结论AD患者具有明显的执行功能障碍；在尚未到达痴呆水平的MCI阶段也可发现执行功能损害。执行功能和整体认知功能及记忆等认知域功能具有良好的相关性。AD患者的执行功能障碍是导致生活能力下降的重要因素。
Objective To investigate the executive function in patients with Alzheimer＇s disease （AD）, the relations between executive dysfunction and performances in other neuropsychological domains and the effects of executive dysfunction on patients＇ daily functioning. Methods Forty patients with AD, 30 patients with mild cognitive impairment （MCI） and 40 healthy elderly subjects were tested with a wide neuropsychological battery of tests including those of executive function, memory and other cognition domain tests. Executive function was evaluated by using the Stroop test, frontal assessment battery （FAB）, executive clock drawing test （CLOX） and rapid verbal retrieve （RVR） test. Results The results showed the presence of significant executive function impairment in AD patients as compared with the healthy controls （P 〈 0.01）. The scores of executive function tests in AD patients were 5.29±2.47 （FAB）, 4.63±3.56 （CLOX1）, 14.17±8.99 （Stroop1）, and 17.56±10.51 （RVR） respectively. The performance of MCI patients on executive function tests was shown worse significantly （P 〈 0.05） as compared with the controls except from Stroop2 test. The scores of executive function tests in MCI patients were 7.67±2.44 （FAB）, 7.86±3.78 （CLOX1）, 7.21±8.07 （Stroop1）, and 30.86±8.38 （RVR） respectively. In the stepwise linear regression analysis, FAB test made a significant independent contribution to instrumental activity of daily living （IADL） and loaded it first （β = -0.778, t = -7.079, P 〈 0.01）. Executive function was not related to age （P 〉 0.05） and only FAB test had a wake relation with education （r = 0.264, P = 0.028）. All executive function tests were correlated very significantly with mini-mental state examination （MMSE） and memory （r = 0.438～0.786, P 〈 0.01）. Conclusion Executive dysfunction is commonly seen in patients with AD, even occurring in MCI stage which does not reach the dementia level. Executive function is closely
出处
《中华神经科杂志》
CAS
CSCD
北大核心
2006年第2期84-88,共5页
Chinese Journal of Neurology
关键词
阿尔茨海默病
行为障碍
认知障碍
神经心理学测验
Alzheimer disease
Conduct disorder
Cognition disorders
Neuropsychological tests
