Cognitive differences in dementia patients with autopsy-verified AD, Lewy body pathology, or both
Cognitive differences in dementia patients with autopsy-verified AD, Lewy body pathology, or both
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DOI：
10.1212/01.wnl.0000165987.89198.65
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发表时间：
2005-06-28
期刊：
影响因子：
9.9
通讯作者：
Cherrier, MM
中科院分区：
文献类型：
--
作者：
Kraybill, ML;Larson, EB;Cherrier, MM
目的：通过社区尸检痴呆患者的神经心理特征，比较阿尔茨海默病（AD）、单独的路易体病理（LBP）和LBP合并AD （AD/LBP）。方法：作者回顾了135名来自社区痴呆研究的受试者，他们的尸检和脑组织是可用的。根据标准的神经病理学方法和标准确定诊断组，采用α -突触核蛋白免疫染色法检测lb的存在。神经病理学定义的AD、AD/LBP和LBP诊断组在初始研究入组时检查神经心理测试表现的差异。结果：单纯AD患者48例，LB合并AD病理（AD/LBP）患者65例，单纯LBP患者22例（LBP单独）。两组在人口统计学上或在入组时的简易精神状态检查（MMSE）或痴呆评定量表（DRS）的表现上没有显著差异。AD患者在记忆测试（全对象记忆评估延迟回忆、韦氏记忆量表逻辑记忆即时和延迟回忆，p < 0.05）和命名任务（建立阿尔茨海默病命名注册联盟，p < 0.05）上的表现低于LBP患者。LBP患者在执行功能（Trail Making Test Part B, p < 0.05）和注意任务（Wechsler Adult Intelligence Scale-Revised Digit Span, p < 0.05）上比AD患者受损更严重。AD/LBP患者MMSE和DRS评分随时间的下降幅度最大。结论：在以社区为基础的老年医学并发症痴呆患者样本中，痴呆亚型在诊断时存在神经心理学差异。特别是单独患有阿尔茨海默病（AD）和AD/路易体病理（LBP）的患者比患有LBP的患者有更严重的记忆障碍。单独的腰痛与更严重的执行功能障碍相关。AD/LBP患者的认知能力下降速度最快。
Objective: To examine the neuropsychological profile of dementia patients from a community-based autopsy sample of dementia, comparing Alzheimer disease ( AD), Lewy body pathology (LBP) alone, and LBP with coexistent AD (AD/LBP). Methods: The authors reviewed 135 subjects from a community-based study of dementia for whom autopsy and brain tissue was available. Diagnostic groups were determined according to standard neuropathologic methods and criteria, and the presence of LBs was determined using alpha-synuclein immunostaining. Neuropathologically defined diagnostic groups of AD, AD/LBP, and LBP were examined for differences on neuropsychological test performance at the time of initial study enrollment. Results: There were 48 patients with AD alone, 65 with LB and AD pathology (AD/LBP), and 22 with LBP alone (LBP alone). There were no significant differences between groups demographically or on performance of enrollment Mini-Mental State Examination (MMSE) or Dementia Rating Scale (DRS). AD patients performed worse than the LBP patients on memory measures (Fuld Object Memory Evaluation Delayed Recall, Wechsler Memory Scale Logical Memory Immediate and Delayed Recall; p < 0.05) and a naming task (Consortium to Establish a Registry for Alzheimer's Disease Naming; p < 0.05). LBP patients were more impaired than AD patients on executive function (Trail Making Test Part B; p < 0.05) and attention tasks (Wechsler Adult Intelligence Scale-Revised Digit Span; p < 0.05). Decline in MMSE and DRS scores over time were greatest in the patients with AD/LBP. Conclusions: In a community based sample of older, medically complicated patients with dementia, there are neuropsychological differences between dementia subtypes at the time of diagnosis. In particular, patients with Alzheimer disease (AD) alone and AD/Lewy body pathology (LBP) had more severe memory impairment than patients with LBP. LBP alone was associated with more severe executive dysfunction. Patients with AD/LBP had the most rapid rate of cognitive decline.