【摘要】 目的　了解阿尔茨海默病 (AD)患者的早期征象。方法　在 1997年 6月至 1998年 4月对成都市 5 35 3名年龄≥ 5 5周岁的社区人群进行痴呆患病率调查的基础上 ,于 2 0 0 0年 11月 12日至2 0 0 1年 3月 2 1日仍用两阶段法随访其中的 36 87名正常人群。实际随访 2 86 9名 (77 81% ) ,失访 818名 (2 2 19% )。用美国精神障碍诊断与统计手册第 3版修订本的标准诊断痴呆 ,用美国神经病语言障碍和卒中研究所及阿尔茨海默病与相关障碍协会的AD标准做出可能AD和很可能AD诊断 ,用临床痴呆程度评定量表评定痴呆严重程度。结果　 (1)查出可疑痴呆 5 8例 (2 0 4 % ) ,AD2 5例 (0 88% )。(2 )AD患者年龄 [(79± 6 )岁 ]高于可疑痴呆者 [(76± 8)岁 ]和正常人 [(6 6± 7)岁 ;P <0 0 0 1]。(3)AD患者基线简易精神状态检查 (MMSE)总分及各分项评分均低于可疑痴呆者和正常人 ,均P <0 0 0 1。AD患者随访时的MMSE总分和积木测验评分下降了 [(6 86± 5 77)分和 (4 11± 6 4 1)分 ],下降程度快于可疑痴呆者 [(3 5 5± 4 5 0 )分和 (4 89± 6 89)分 ]和正常人 [(0 5 6± 3 76 )分和 (1 11± 6 86 )分 ;P <0 0 5 ]。有记忆力减退病史者 (2 83例 )中 ,AD患者的比例 (44 0 % )显著高于可疑痴呆者 (32 8% )和正常人 (9更多还原

【Abstract】 ObjectiveTo study the early signs of Alzheimer′s disease (AD) in community population. MethodsFrom June 1997 to April 1998, a population of 5 353 people aged 55 or over was randomly sampled from ten districts in Chengdu to investigate the prevalence of senile dementia. Three years later, 3 687 subjects previously assessed as normal were followed up, in which 2 869 were interviewed with a two-stage survey. The subjects were assessed with the Mini-Mental State Examination (MMSE), Pfeiffer′s Outpatient Disability Questionnaire and a battery of neuropsychological tests. The clinical diagnoses of dementia and AD were made according to the Diagnosis and Statistical Manual of Mental Disorder, Revised Third Edition and National Institute of Neurological and Cmmunicative Disorders and Stroke and the Alzheimer disease and Related Disorders Association criteria. ResultsAltogether 25 subjects with mild AD and 58 with doubtful dementia were screened out. The AD patients (79±6) were older than those with doubtful dementia (76±8) and normal elderly (66±7, P <0.001). The scores of MMSE (19.27±4.65), Orientation to time (2.64±1.53), Delayed recall (1.55±1.10) and Block Design (BD) (5.33±6.48) in patients with AD were significantly lower than that in subjects with doubtful dementia (19.84±3.72, 2.84±1.17, 1.57±1.06, 9.50±6.56) and normal elderly (25.00±3.62, 4.11±1.02, 2.17±0.90, 13.05±9.34; P <0.001) at the first measurement three years ago. The decreased scores of MMSE and BD in AD patients and subjects with doubtful dementia were (6.86±5.77, 4.11±6.41) and (3.55±4.50, 4.89±6.89) respectively, which significantly higher than that of normal elderly (0.56±3.76, 1.11±6.86; all P <0.05). The subjects with memory impairment in AD, doubtful dementia and normal elderly were 44.0%, 32.8% and 9.2% at the first time measurement respectively ( P <0.001). Conclusion Cognitive impairments exist in the preclinical phase of AD. Memory impairment and the lower scores of MMSE and BD may be the early signs of the elderly with AD.更多还原