阿尔茨海默病和额颞叶痴呆徘徊行为的比较  

The Differences in level and rhythm of locomotor activity between patients with Alzheimer disease and those with frontotemporal dementia.

作　　者：廖晓艳[1] 牧本清子[2] 山川みやえ 何湘军[1] 李亦蕾[1] 

机构地区：[1]南方医科大学南方医院,广州510515 [2]大阪大学大学院医学系研究科

出　　处：《中国神经精神疾病杂志》2011年第9期545-549,共5页Chinese Journal of Nervous and Mental Diseases

基　　金：日本政府文部科学省及厚生劳动科学研究费辅助金项目(编号:20791766);日中笹川医学奖学金资助项目(编号:2009年第32期)

摘　　要：目的比较阿尔茨海默病和额颞叶痴呆徘徊者步行活动水平及活动节律的差异。方法利用电子示踪监测系统对阿尔茨海默病(Alzheimer disease,AD)徘徊者27例及额颞叶痴呆(frontotemporal dementia,FTD)徘徊者7例进行连续30d的24h活动监测,比较两组日、夜活动水平(步行距离),以及活动节律的日间稳定性和日内变异性。结果 AD组和FTD组的年龄分别为(73.89±9.12)岁和(63.43±14.93)岁,而发病年龄分别为(70.16±9.26)岁、(58.17±15.16)岁。AD组的年龄较大而发病年龄较晚(P<0.05)。AD组和FTD组在6:00～23:59的步行距离分别为(2119.39±2535.59)m、(4842.44±2617.94)m,后者较长(P<0.05),但两组在0:00～5:59的活动水平差异无统计学意义(P>0.05)。FTD组活动节律更加稳定[(0.50±0.11)vs(0.29±0.15),P<0.01],日内活动变异片段数更少[(2.80±0.74)vs(4.07±0.95),P<0.01]。结论 AD和FTD两类痴呆的徘徊行为特点不同,提示有必要建立痴呆亚型特异性徘徊行为的非药物干预策略。Objective To delineate the differences in level and rhythm of locomotor activity between wanderers with Alzheimer＇s disease （AD） and those with frontotemporal dementia （FTD）. Methods The study was conducted in a dementia care unit at a hospital in Osaka, Japan from September 2008 to September 2009. Twenty-four-hour movements of 27 ambulatory AD inpatients and 7 FTD inpatients were coded consecutively by the IC tag monitoring system. Results There were no significant differences in the distribution of sex, duration of dementia, clinical dementia rating （CDR） and mini-mental state examination （MMSE） scores between two dementia types. However, patients with FTD were much younger than those with AD [（63.43 ± 14.93） yr vs （73.89 ± 9.12） yr, P 〈 0.05] and age of onset were significantly different between two dementia types [（58.17 ± 15.16） yr vs （70.16± 9.26） yr, P 〈 0.05]. There were increased distances moved during 6：00 - 23：59 in FTD group comparing with AD group （4842.44± 2617.94）m vs （2119.39 ± 2535.59）m, P 〈 0.05] whereas difference in activity level during 0：00 - 5：59 were not significant between two groups. Meanwhile, non-parametric analyses revealed that FTD patients had a more stable and consolidate rhythm of day to day ambulation circles [（0.50 ± 0.11） vs （0.29± 0.15）, P 〈 0.011 and less intra-daily activity fragmentation [（2.80 ± 0.74） vs （4.07 ± 0.95）, P 〈 0.01 ] compared with AD group. Conclusions Patients with AD and those with FTD have different patterns of wandering behaviour, suggesting that it is necessary to develop subtype-specific non-pharmaceutical strategies for wandering behavior in dementia patients.

关 键 词：阿尔茨海默病 额颞叶痴呆 精神行为异常 徘徊行为 活动节律 

分 类 号：R749.1[医药卫生—神经病学与精神病学]