痴呆症分期尺度,认知行为尺度和认知障碍患者的功能之间的关系
Fatma Ozge Kayhan Koçak1, Emre Kumral2
1Division of Geriatrics, Department of Internal Medicine, Health Sciences University Tepecik Training and Research Hospital, İzmir, Turkiye.
PloS one
|May 2, 2025
概括
认知和行为症状显著影响认知障碍患者的功能状态. 神经精神症状,如幻觉,强烈预测残疾,突出需要有针对性的管理.
科学领域:
- 神经学 神经学
- 老年病的医生 老年病的医生
- 认知科学 认知科学
背景情况:
- 认知障碍影响着老年人口中的很大一部分.
- 了解影响功能状态的因素对于患者护理至关重要.
研究的目的:
- 评估痴呆阶段,认知/行为尺度和认知障碍患者的功能状态之间的关系.
- 确定这一群体功能衰退的关键预测因素.
主要方法:
- 追溯分析871名认知障碍患者 (年龄大于50岁) 的病历.
- 评估使用临床痴呆症评分 (CDR),全球恶化量表 (GDS),功能评估分期测试 (FAST),迷你精神状态检查 (MMSE),阿尔茨海默病评估量表-认知子评分 (ADAS-Cog),神经精神病 inventory (NPI),阿尔茨海默病评分表中的行为病理学 (BEHAVE-AD) 和日常生活工具活动 (IADL).
主要成果:
- 69.8%的患者出现功能障碍;阿尔茨海默病是最常见的痴呆类型 (64.6%).
- 神经精神症状 (幻觉,妄想,饮食障碍) 与残疾有显著的相关性 (p < 0.001).
- CDR尺度是残疾最强的预测指标 (OR:4.9,AUC = 0.740),表现优于其他分期尺度. MMSE和NPI得分与功能障碍的相关性比痴呆症分期尺度更强.
结论:
- 认知状态和行为症状都是认知障碍中功能障碍的关键决定因素.
- 针对性地管理神经精神病症状至关重要,以减轻它们对功能的影响.
- 需要一个实际的评估工具来评估日常生活活动 (ADL) 在所有痴呆症阶段,考虑到神经心理症状和患者/护理人员的需求.
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