Early Emergence of Neuropsychiatric Symptoms in Cognitively Normal Subjects and Mild Cognitive Impairment.
Early Emergence of Neuropsychiatric Symptoms in Cognitively Normal Subjects and Mild Cognitive Impairment.
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DOI：
10.3233/jad-190669
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发表时间：
2019-11
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通讯作者：
Keiichiro Tsunoda;T. Yamashita;Yosuke Osakada;Ryo Sasaki;Koh Tadokoro;Namiko Matsumoto;Emi Nomura;R. Morihara;Y. Nakano;Yoshiaki Takahashi;N. Hatanaka;Jingwei Shang;Kota Sato;M. Takemoto;N. Hishikawa;Y. Ohta;K. Abe
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作者：
Keiichiro Tsunoda;T. Yamashita;Yosuke Osakada;Ryo Sasaki;Koh Tadokoro;Namiko Matsumoto;Emi Nomura;R. Morihara;Y. Nakano;Yoshiaki Takahashi;N. Hatanaka;Jingwei Shang;Kota Sato;M. Takemoto;N. Hishikawa;Y. Ohta;K. Abe
世界正在迅速老龄化，面临痴呆症患者数量的增加，因此在这些国家检测痴呆症的临床前阶段非常重要。我们使用两种痴呆行为和心理症状(BPSD)评估工具[Abe的BPSD评分(ABS)和轻度行为障碍(MBI)]，对认知正常(n=218)、轻度认知障碍(MCI，n=146)和阿尔茨海默病(AD，n=305)受试者的认知和情感功能进行了检测。BPSD在认知正常者中分别为12.4%(ABS)和9.6%(MBI)，在MCI组中分别为34.9%和32.2%，在AD组中分别为66.2%和51.1%。在BPSD阳性的AD组中，ABS(§p<；0.05)和MBI(§p<；0.01)得分均随着简易智力状态检查的认知减退而表现出更差的分数。在AD组的所有参与者中都发现了类似的相关性(|p<；0.01与ABS和MBI)。在BPSD阳性参与者的子量表中，AD患者ABS的冷漠/冷漠得分和MBI动机降低的得分与对照组和MCI受试者相比有显著差异(**p<；0.01)。此外，子量表分析进一步表明，从对照组到MCI和AD受试者，在四个ABS分量表和三个MBI分量表上有下降的趋势。目前的研究表明，BPSD在认知正常的人中存在，在MCI受试者中更是如此，在所有三组中，ABS检测BPSD比MBI更敏感。
The world is rapidly aging and facing an increase in the number of dementia patients, so it is important to detect the preclinical stage of dementia in such countries. We examined both cognitive and affective functions among cognitively normal control (n = 218), mild cognitive impairment (MCI, n = 146), and Alzheimer's disease (AD, n = 305) subjects using two evaluation tools for behavioral and psychological symptoms of dementia (BPSD) [Abe's BPSD score (ABS) and mild behavioral impairment (MBI)]. BPSD were present in 12.4% (ABS) and 9.6% (MBI) of cognitively normal people, 34.9% and 32.2% in MCI subjects, and 66.2% and 51.1% in AD patients. Both ABS (§p<0.05) and MBI (§§p < 0.01) score showed worse score with cognitive decline of the Mini-Mental State Examination in the AD group in BPSD-positive participants. Similar correlations were found in all participants in AD group (||||p < 0.01 versus ABS and MBI). Among the subscales in BPSD-positive participants, an apathy/indifference score of ABS and a decreased motivation of MBI showed significant differences in AD patients compared to the control and MCI subjects (**p<0.01). In addition, subscale analyses further showed a downward trend from the control to MCI and AD subjects in four ABS subscales and three MBI subscales. The present study showed the preclinical presence of BPSD in cognitively normal people, more so in MCI subjects, and ABS detected BPSD more sensitively than MBI in all three groups.