早发性与晚发性阿尔茨海默病日常生活能力损害的特征对比  

Comparison of impairment in activities of daily living between early-onset and late-onset Alzheimer’s disease

作　　者：温咪咪 张晓凡 张旻 Wen Mimi;Zhang Xiaofan;Zhang Min(Department of Neurology,Tongji Hospital of Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]华中科技大学同济医学院附属同济医院神经内科,武汉430030

出　　处：《脑与神经疾病杂志》2021年第5期265-269,共5页Journal of Brain and Nervous Diseases

基　　金：科技部政府间国际科技创新合作重点专项(2018YFE0118900)。

摘　　要：目的比较早发性与晚发性阿尔茨海默病(AD)患者日常生活能力(ADL)损害的特征。方法2018年10月至2020年11月于武汉同济医院神经内科诊断为AD患者共156例;其中早发性AD(EOAD,发病年龄<65岁)70例,晚发性AD(LOAD,发病年龄>65岁)86例。所有患者均进行了简易智能精神状态检查量表(MMSE)、日常生活能力评定量表(由躯体生活自理量表(PSMS)及工具性日常生活活动量表(IADL)组成)的评估;使用SPSS 23软件对两组患者的基本信息及ADL损害特征进行统计分析。结果EOAD与LOAD患者在ADL总体评估上差异无统计学意义。在PSMS评估中,EOAD患者较LOAD患者的PSMS总体受损率及严重程度差异均无统计学意义;在PSMS分项中,EOAD患者穿衣能力的受损率及损害程度显著高于LOAD患者(P=0.005)。在IADL评估中,LOAD患者IADL总体受损率显著高于EOAD患者(P=0.036);在IADL分项中,EOAD患者独自在家能力的受损率、损害程度及独立性降低比例均显著高于LOAD患者(P=0.039,P=0.029,P=0.039);EOAD患者洗衣服时需要帮助的比例显著低于LOAD患者(P=0.033)。结论EOAD与LOAD在日常生活能力受损的特征上存在差异,LOAD患者IADL总体受损率更高,但EOAD患者在穿衣、独自在家能力的受损较LOAD患者更明显,而洗衣服的独立性保持较好。Objective To compare the characteristics of activities of daily living(ADL)impairment between early-onset and late-onset Alzheimer’s disease(AD).Methods From October 2018 to November 2020,156 patients diagnosed as probable AD recruited from the Department of Neurology,Tongji Hospital,Wuhan,including 70 cases of early-onset AD(EOAD,onset age below 65 years old),and 86 cases of late-onset AD(LOAD,onset age above 65 years).All patients were assessed with Mini-Mental State Examination(MMSE),Activities of Daily Living Scale(composed of Physical Self-maintenance Scale,PSMS and Instrumental Activities of Daily Living Scale,IADL).Demographic data and ADL damage characteristics of the two groups were statistically analyzed by SPSS 23 software.Results There was no significant difference in ADL between EOAD and LOAD patients.In PSMS assessment,there was no significant difference in the overall damage rate and severity of PSMS impairment between EOAD patients and LOAD patients;in PSMS sub-items,the damage rate and severity of dressing ability decline in EOAD patients were significantly higher than those in LOAD patients(P=0.005).In IADL assessment,the overall damage rate of IADL in LOAD patients was significantly higher than that in EOAD patients(P=0.036);in IADL sub-items,the damage rate,severity,and the proportion of decreased independence of the ability to be at home alone in EOAD patients were significantly higher than those of LOAD patients(P=0.039,P=0.029,P=0.039);the proportion of patients with EOAD who needed help in the laundry was significantly lower than that in patients with LOAD(P=0.033).Conclusion Patterns of ADL impairment were different between the EOAD and the LOAD patients.The overall damage rate of IADL in LOAD patients was higher than that in EOAD patients,but the impairments of ability in dressing and staying at home alone in EOAD patients were more obvious than those in LOAD patients,and the ability to do laundry independently was better preserved.

关 键 词：早发性阿尔茨海默病 晚发性阿尔茨海默病 日常生活能力 

分 类 号：R749.1[医药卫生—神经病学与精神病学]