社区正常老年人和轻度认知功能损害老年人的随访研究  

Cognitive functioning in community-dwelled aged: a comparison of baseline and 4-year follow-up

作　　者：夏泳[1] 陈斌华[1] 苏雪倩[1] 倪煜青[1] 江长旺[1] 李秀荣[1] 缪英[1] 

机构地区：[1]杭州市第七人民医院老年心理康复中心,310013

出　　处：《中华精神科杂志》2006年第1期29-32,共4页Chinese Journal of Psychiatry

摘　　要：目的了解社区正常和轻度认知功能损害(MCI)老年人的认知功能变化特点和转归。方法分别于2000年5月和2004年6月(时隔4年)对杭州市186名≥60岁老年人采用分层、分段、随机抽取方法进行调查。两次调查的程序和使用工具相同,采用美国精神障碍诊断与统计手册第4版进行诊断,用世界卫生组织老年认知功能评价成套神经心理测验(WHO-BCAI)进行测查。结果(1)在2000年调查时诊断为正常的127例中,4年后有97例(76·4%)正常(NC组),16例(12·6%)为MCI(MCI组),14例(11·0%)为痴呆(痴呆组);而2000年诊断为MCI的18例,4年后全部发展为痴呆。(2)与NC组比较,除性别外,MCI组的年龄大、教育水平低、从事体力劳动和不良婚姻事件多(P<0·05和P<0·01),痴呆组的年龄大和男性比例高(均P<0·05和P<0·01)。(3)WHO-BCAI测验,2004年与2000年比较,三组各项测验的成绩均有所下降(P<0·01或P<0·05),其中以痴呆组为著;而MCI组在听觉词汇学习第4次测验、语言能力测验(小标记测验)、视觉辨认测验(语义联系、视觉推理)、连线测验、注销测验(注销测验2和3)、运动测验和空间结构等项下降明显。结论老年期MCI患者的认知功能损害和功能下降呈进行性加重,主要表现为学习、近记忆能力、记忆再现、语义记忆、抽象思维能力、空间感知及执行功能受损。Objective To investigate the dynamic characteristic and outcome of cognitive functioning in the community-dwelled aged with normal function and mild cognitive impairment （MCI）. Methods In 2000, 186 elderly people with ≥60 years were sampled out in Hangzhou with stratified, clustered randomization, and finished a set of DSM-IV and WHO battery of cognitive assessment for elderly （WHO-BCAI） . In 2004, 163 were followed up in which 145 completed the same assessments. Results In 2004, 97 of the 127 cases with normal cognitive function in 2000 survey still had normal function, and 16 cases developed MCI, 14 cases suffered dementia. All the 18 cases with MCI in 2000 developed to dementia in 2004. In comparison with the cases with normal function, the cases with developed MCI had a lower performances in the tests for measuring auditory vocabulary learning, linguistic ability, visual recognition, attention, motor, spatial structure recognition and reasoning （P 〈 0. 01 or 0. 05 ）. The advanced age, lower education, being engaged in physical work and losing spouse was associated with the occurrence of MCI, and advanced aged, male was associated with the development of dementia. Conclusion The cognitive functioning in the aged with mild cognitive impairments descends progressively and be probably develop into dementia in a few year.

关 键 词：老年人 认知障碍 神经心理学测验 痴呆 

分 类 号：R749[医药卫生—神经病学与精神病学]