可疑痴呆人群中阿尔茨海默氏病临床前的认识损害特征及其与中医证候的关系

To look for predictive markers preceding Alzheimer's dementia. Methods: This study involved multitudinal assessment of individuals in whom there was cognitive impairment that was insufficient to warrant a diagnosis of dementia, which were followed up for mean 11 months. Results: A diagnosis of probable AD was made in 58% of cases, VD in 21 %, FLD in 5% and dementia of uncertain aetiology in the remainder. 42% subjects with memory loss are as result of ageassociated cognitive decline, 25% subjects are due to cerebralvascular accident, 1 .8% subjects due to menopausal symptoms. 30.4% are of memry loss of unknown aetiology. Cognitive markers preceding dementia found within this stUdy actually have discriminant function of the earliest changes of AD from age-associated cognitive decline. The group that developed dementia on follow-up does not differ significanily from the memory loss group on the WAIS-R total scores or on the digit forward , digit backward and picture completion. However, the subtest score for similarities on the WAIS-R is sighficanly lower in patients who became demented comparing with the rest of sample. Verbal memory such as story recall immediate and story recall delayed, verbal learning discriminant index, verbal fluency raw score showed significant lower in patients who became dementia . Moreover digit copy transformed score on the SSRS also is very significanily lower in patients who became demented than those who were stable memory loss. The kidney deficiency syndrom of Chinese medicine was most common in QD, and the phlegm syndrome and the blood stasis syndrome were more common. The scores of the picture completion subtest and the story recall immdiate subtest were significanily correlated to the score of the phlegm syndrome respectively. The scores of the picture completion subtest and the similarities subtest were significanily correlated with the score of the kidney deficiency syndrome respectively .Suggestion: Often a significandy long interval, well in excess of the mean follow up of 11 months in our study, is required before one can he certain that a person with no dementia but with significant memory impairment, is or is not going on to develop a dementia. Folstein MMSE scores are significanily predictive for the outcome of cognitive impairment. The digit copy transformed score and the similarities were more significantly predictive for the outcome than the above four measures of verbal memory. The scores of neuropsychological test were correlated to the scores of syndrome of Chinese medicine.