成功老龄化机制的系列研究:基线部分  

A preliminary study of the mechanism of successful aging: analysis of baseline data

作　　者：吴文源[1] 张明园[2] 李春波[1] 肖世富[2] 张旭[1] 江三多[2] 何燕玲[2] 申远[1] 方芳[1] 李晨虎[1] 

机构地区：[1]同济大学附属同济医院精神医学科,上海200065 [2]上海市精神卫生中心

出　　处：《中华精神科杂志》2006年第1期24-28,共5页Chinese Journal of Psychiatry

基　　金：国家自然科学基金资助项目(30170327);上海联合利华研究与发展基金资助项目(145)

摘　　要：目的探索成功老龄（SA）化的可能机制。方法通过心理社会问卷、神经心理学测验、分子遗传学及功能磁共振成像等方法，比较230名SA与137名常态老龄（UA）及58例轻度认知功能损害（MCI）患者的差异。结果（1）SA组老年人的自我效能水平高于UA组及MCI组，评分分别为[（18．99±1．84）分，（19．46±1.72）分，（20.11±2．14）分]，差异均有统计学意义（P=0．01）；神经质和宿命感倾向的评分从高至低依次为MCI组（均为0，19）、UA组（均为0．04分）和SA组（均为-0．14分），差异均有统计学意义（P分别=0．02和0．00）。（2）除UA组在信息处理及加工速度、即刻及延迟回忆的评分低于SA组外，多数认知测验评分与SA组的差异无统计学意义。MCI组与SA组、UA组在绝大多数认知测验分项目上的差异均有统计学意义，其中以SA组与UA组71—75岁老年人在神经心理学测验中有差异的项目最多。（3）分子遗传学指标：SA组血管紧张素转换酶1／1基因型频率（23．67％）分布高于UA组（11．21％）及MCI组（1．72％），外周血单核粒细胞端粒酶活性亦高于UA组及MCI组，差异均具有统计学意义（P均=0 .00）。（4）功能磁共振成像：在听觉词汇流畅性任务刺激下，SA组前额叶尤其是背外侧皮质激活比UA组及MCI组明显，偏侧化指数为0．46，差异均有统计学意义。结论SA在多个维度具有一定特点，UA的认知功能有可塑性，71—75岁是认知老化的敏感阶段。Objective To explore the possible mechanism of successful aging. Methods The subjects included 230 elderly with successful aging （SA）, 137 with usual aging （UA） and 58 with mild cognitive impairment （MCI）. The psychosocial and neuropsyehologieal functions were assessed with the serfefficacy scale, personality indicators and the Ncuropsychological Test Battery for Elderly （NTBE）. The polymorphisms of ApoE and ACE genes were determined with the polymerase chain reaction （PCR）-based technique. Blood oxygenation level dependent functional magnetic resonance imaing （fMRI） using auditory verbal fluency task （VFT） as paradigm was performed. Results The SA group had lower score （ 18. 99 ± 1.84） in serf-efficacy level than the UA （ 19.46 ± 1.72） and MCI （20. 11 ± 2.14） group, and so was the standardized score in neurosis and fatalism subscale （ MCI ： 0. 19 ; UA ： 0. 04 ; SA ： - 0. 14）. The SA had better cognitive function as measured with the neuropsychological tests compared with other two groups. Comparing the NTBE score between SA and UA group according to the age groups （65--70 years, 71--75 years, 976 years）, the difference at most was seen in the 71--75 years group. The frequency of ACE 1/1genotype and activity of telomerase in SA were significantly higher than the other groups. In fMRI scanning, SA showed special brain activation in prefrontal cortex especially dorsal lateral prefrontal cortex （DLPFC） and laterality index than that in UA and MCI elderly. Conclusion Successful aging has some characteristics concerning the social-psycho-biological dimensions. Usual aging still possesses potential plasticity on learning and memory. The 71--75 years elderly should be targeted as giving intervention for successful aging.

关 键 词：老年人 脑 认知 遗传学 生物化学 磁共振成像 神经心理学测验 

分 类 号：C913.6[经济管理]