Login Register Cart 0
Generic placeholder image

当代阿耳茨海默病研究

Editor-in-Chief

ISSN (Print): 1567-2050
ISSN (Online): 1875-5828

Back
Journal Home About Journal Editorial Board Journal Insight Current Issue Volumes/Issues
Subscribe Translate in English
Research Article

谵妄与认知障碍之间的关联：有联系吗？

卷 19, 期 1, 2022

页: [47 - 55] 页: 9

弟呕挨: 10.2174/1567205019666220120114552

价格: $65

摘要

背景：谵妄和痴呆都是涉及整体认知障碍的疾病，可在老年人中单独或同时发生。目的：本研究的目的是检查从基线（谵妄发作）开始为期五年的前瞻性人群研究中谵妄与认知障碍之间的频率、相关性和相对风险。次要目的是确定谵妄类型与特定类型痴呆之间的任何可能相关性。 材料和方法：我们研究了根据 DSM-IV 诊断的 325 名患者。使用汉密尔顿抑郁评定量表、谵妄评定量表-修订版-98、MMSE、Rey 听觉-语言学习测试、数字跨度、符号数字模态测试、Raven 渐进矩阵、ADL 和 IADL 评估神经心理学、情绪和谵妄障碍。 结果：我们人群中谵妄的患病率为 89 例（27.4%）：78 名患者（48 名女性和 30 名男性）表现出向痴呆的发展（男性平均年龄为 67.9±6.1 岁，女性为 68.4±9.1 岁）， 11 名患者（5 名男性和 6 名女性）仅表现出孤立的谵妄，没有向认知障碍发展（男性的平均年龄为 68.1±5.1 岁，女性为 66.4±7.1 岁）。对患有痴呆演变的谵妄患者的神经心理学研究显示，随着时间的推移存在统计学上的显着差异，具有统计学上显着的组间差异和抑郁倾向。 结论：谵妄与认知障碍之间的关系以及谵妄作为神经退行性疾病早期标志物的可能作用需要在未来进行研究。

关键词: 谵妄亚型、认知障碍、痴呆筛查、人群、脑病、神经退行性疾病

« Previous Next »
[1]
Morandi A, Pandharipande PP, Jackson JC, Bellelli G, Trabucchi M, Ely EW. Understanding terminology of delirium and long-term cognitive impairment in critically ill patients. Best Pract Res Clin Anaesthesiol 2012; 26(3): 267-76.
[http://dx.doi.org/10.1016/j.bpa.2012.08.001] [PMID: 23040280]
[2]
Witlox J, Slor CJ, Jansen RW, et al. The neuropsychological sequelae of delirium in elderly patients with hip fracture three months after hospital discharge. Int Psychogeriatr 2013; 25(9): 1521-31.
[http://dx.doi.org/10.1017/S1041610213000574] [PMID: 23651760]
[3]
de Lange E, Verhaak PF, van der Meer K. Prevalence, presentation and prognosis of delirium in older people in the population, at home and in long term care: A review. Int J Geriatr Psychiatry 2013; 28(2): 127-34.
[http://dx.doi.org/10.1002/gps.3814] [PMID: 22513757]
[4]
Popp J, Arlt S. Prevention and treatment options for postoperative delirium in the elderly. Curr Opin Psychiatry 2012; 25(6): 515-21.
[http://dx.doi.org/10.1097/YCO.0b013e328357f51c] [PMID: 22992543]
[5]
Vasilevskis EE, Han JH, Hughes CG, Ely EW. Epidemiology and risk factors for delirium across hospital settings. Best Pract Res Clin Anaesthesiol 2012; 26(3): 277-87.
[http://dx.doi.org/10.1016/j.bpa.2012.07.003] [PMID: 23040281]
[6]
American Psychiatric Association Diagnostic and statistical manual of mental disorders. 5th ed. Arlington, VA: American Psychiatric Association 2013.
[7]
Witlox J, Eurelings LS, de Jonghe JF, Kalisvaart KJ, Eikelenboom P, van Gool WA. Delirium in elderly patients and the risk of postdischarge mortality, institutionalization, and dementia: a meta-analysis. JAMA 2010; 304(4): 443-51.
[http://dx.doi.org/10.1001/jama.2010.1013] [PMID: 20664045]
[8]
Davis DH, Muniz Terrera G, Keage H, et al. Delirium is a strong risk factor for dementia in the oldest-old: a population-based cohort study. Brain 2012; 135(Pt 9): 2809-16.
[http://dx.doi.org/10.1093/brain/aws190] [PMID: 22879644]
[9]
American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. 3rd ed. Washington, DC: American Psychiatric Association 1987.
[10]
American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, DC: American Psychiatric Association 1994.
[11]
Lipowski ZJ. Delirium: acute confusional state. Oxford: Oxford University Press 1990.
[12]
Lindesay J, Macdonald A, Starke I. Delirium in the Elderly. Oxford: Oxford University Press 1990.
[13]
Ross CA. CNS arousal systems: Possible role in delirium. Int Psychogeriatr 1991; 3(2): 353-71.
[http://dx.doi.org/10.1017/S1041610291000819] [PMID: 1687443]
[14]
Plum F, Hindfeld B. The neurological complications of liver disease Handbook of Clinical Neurology. New York: Elsevier North-Holland 1976; 27: pp. 349-77.
[15]
Brower KJ, Mudd S, Blow FC, Young JP, Hill EM. Severity and treatment of alcohol withdrawal in elderly versus younger patients. Alcohol Clin Exp Res 1994; 18(1): 196-201.
[http://dx.doi.org/10.1111/j.1530-0277.1994.tb00903.x] [PMID: 8198220]
[16]
Wolff HG, Curran D. Nature of delirium and allied states: The dysergastic reaction. Arch Neurol Psychiatry 1935; 33: 1175-215.
[http://dx.doi.org/10.1001/archneurpsyc.1935.02250180034002]
[17]
Melkas S, Laurila JV, Vataja R, et al. Post-stroke delirium in relation to dementia and long-term mortality. Int J Geriatr Psychiatry 2012; 27(4): 401-8.
[PMID: 21560162]
[18]
Slor CJ, Witlox J, Jansen RW, et al. Affective functioning after delirium in elderly hip fracture patients. Int Psychogeriatr 2013; 25(3): 445-55.
[http://dx.doi.org/10.1017/S1041610212001962] [PMID: 23194775]
[19]
Fong TG, Jones RN, Marcantonio ER, et al. Adverse outcomes after hospitalization and delirium in persons with Alzheimer disease. Ann Intern Med 2012; 156: 848-56.
[http://dx.doi.org/10.7326/0003-4819-156-12-201206190-00005]
[20]
Gross AL, Jones RN, Habtemariam DA, et al. Delirium and long-term cognitive trajectory among persons with dementia. Arch Intern Med 2012; 172(17): 1324-31.
[http://dx.doi.org/10.1001/archinternmed.2012.3203] [PMID: 23403619]
[21]
Folstein MF, Folstein SE, McHugh PR. “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 1975; 12(3): 189-98.
[http://dx.doi.org/10.1016/0022-3956(75)90026-6] [PMID: 1202204]
[22]
Caltagirone C, Gainotti G. Batteria per la valutazione del Deterioramento Mentale (parte I): descrizione di uno strumento di diagnosi neuropsicologica Archivio di Psicologia, Neurologia e Neuropsichiatria 1995. Available from: https://art.torvergata.it/handle/2108/67950
[23]
Carlesimo GA, Caltagirone C, Gainotti G. The Mental Deterioration Battery: nometive data, diagnostic reability and qualitative analyses pf cognitive impairment. Eur Neurol 1996; 36(6): 374-84.
[http://dx.doi.org/10.1159/000117297] [PMID: 8954306]
[24]
Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged: The index of ADL: A standardized measure of biological and psychosocial function. JAMA 1963; 185: 914-9.
[http://dx.doi.org/10.1001/jama.1963.03060120024016] [PMID: 14044222]
[25]
Lawton MP, Brody EM. Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 1969; 9(3): 179-86.
[http://dx.doi.org/10.1093/geront/9.3_Part_1.179] [PMID: 5349366]
[26]
Hamilton M. Development of a rating scale for primary depressive illness. Br J Soc Clin Psychol 1967; 6(4): 278-96.
[http://dx.doi.org/10.1111/j.2044-8260.1967.tb00530.x] [PMID: 6080235]
[27]
WHO International statistical classification of diseases and related health problems Available from: http://www.who.int/classification/icd/en
[28]
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer’s disease: Report of the NINCDS-ADRDA work group under the auspices of department of health and human services task force on Alzheimer’s disease. Neurology 1984; 34(7): 939-44.
[http://dx.doi.org/10.1212/WNL.34.7.939] [PMID: 6610841]
[29]
Román GC, Tatemichi TK, Erkinjuntti T, et al. Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology 1993; 43(2): 250-60.
[http://dx.doi.org/10.1212/WNL.43.2.250] [PMID: 8094895]
[30]
McKeith IG. Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): Report of the consortium on DLB international workshop. J Alzheimers Dis 2006; 9(3)(Suppl.): 417-23.
[http://dx.doi.org/10.3233/JAD-2006-9S347] [PMID: 16914880]
[31]
Winblad B, Palmer K, Kivipelto M, et al. Mild cognitive impairment--beyond controversies, towards a consensus: Report of the international working group on mild cognitive impairment. J Intern Med 2004; 256(3): 240-6.
[http://dx.doi.org/10.1111/j.1365-2796.2004.01380.x] [PMID: 15324367]
[32]
Trzepacz PT, Baker RW, Greenhouse J. A symptom rating scale for delirium. Psychiatry Res 1988; 23(1): 89-97.
[http://dx.doi.org/10.1016/0165-1781(88)90037-6] [PMID: 3363018]
[33]
Trzepacz PT, Mulsant BH, Dew MA, Pasternak R, Sweet RA, Zubenko GS. Is delirium different when it occurs in dementia? A study using the delirium rating scale. J Neuropsychiatry Clin Neurosci 1998; 10(2): 199-204.
[http://dx.doi.org/10.1176/jnp.10.2.199] [PMID: 9608409]
[34]
Trzepacz PT. The Delirium Rating Scale. Its use in consultation-liaison research. Psychosomatics 1999; 40(3): 193-204.
[http://dx.doi.org/10.1016/S0033-3182(99)71235-1] [PMID: 10341531]
[35]
Morandi A, Rogers BP, Gunther ML, et al. The relationship between delirium duration, white matter integrity, and cognitive impairment in intensive care unit survivors as determined by diffusion tensor imaging: the VISIONS prospective cohort magnetic resonance imaging study. Crit Care Med 2012; 40(7): 2182-9.
[http://dx.doi.org/10.1097/CCM.0b013e318250acdc] [PMID: 22584766]
[36]
Chester JG, Beth Harrington M, Rudolph JL. Serial administration of a modified Richmond Agitation and Sedation Scale for delirium screening. J Hosp Med 2012; 7(5): 450-3.
[http://dx.doi.org/10.1002/jhm.1003] [PMID: 22173963]
[37]
Davis DH, Kreisel SH, Muniz Terrera G, et al. The epidemiology of delirium: challenges and opportunities for population studies. Am J Geriatr Psychiatry 2013; 21(12): 1173-89.
[http://dx.doi.org/10.1016/j.jagp.2013.04.007] [PMID: 23907068]
[38]
Gunther ML, Morandi A, Krauskopf E, et al. The association between brain volumes, delirium duration, and cognitive outcomes in intensive care unit survivors: The VISIONS cohort magnetic resonance imaging study. Crit Care Med 2012; 40(7): 2022-32.
[http://dx.doi.org/10.1097/CCM.0b013e318250acc0] [PMID: 22710202]
[39]
Adamis D, Sharma N, Whelan PJ, Macdonald AJ. Delirium scales: A review of current evidence. Aging Ment Health 2010; 14(5): 543-55.
[http://dx.doi.org/10.1080/13607860903421011] [PMID: 20480420]
[40]
Brown LJ, Fordyce C, Zaghdani H, Starr JM, MacLullich AM. Detecting deficits of sustained visual attention in delirium. J Neurol Neurosurg Psychiatry 2011; 82(12): 1334-40.
[http://dx.doi.org/10.1136/jnnp.2010.208827] [PMID: 20587493]
[41]
Brown LJE, McGrory S, McLaren L, Starr JM, Deary IJ, Maclullich AM. Cognitive visual perceptual deficits in patients with delirium. J Neurol Neurosurg Psychiatry 2009; 80(6): 594-9.
[http://dx.doi.org/10.1136/jnnp.2008.169078] [PMID: 19237384]
[42]
Popp J. Delirium and cognitive decline: More than a coincidence. Curr Opin Neurol 2013; 26(6): 634-9.
[http://dx.doi.org/10.1097/WCO.0000000000000030] [PMID: 24152819]
[43]
Hughes CG, Patel MB, Pandharipande PP. Pathophysiology of acute brain dysfunction: what’s the cause of all this confusion? Curr Opin Crit Care 2012; 18(5): 518-26.
[http://dx.doi.org/10.1097/MCC.0b013e328357effa] [PMID: 22941208]
[44]
Guenther U, Theuerkauf N, Frommann I, et al. Predisposing and precipitating factors of delirium after cardiac surgery: A prospective observational cohort study. Ann Surg 2013; 257(6): 1160-7.
[http://dx.doi.org/10.1097/SLA.0b013e318281b01c] [PMID: 23426334]
[45]
Cunningham C, Maclullich AM. At the extreme end of the psychoneuroimmunological spectrum: Delirium as a maladaptive sickness behaviour response. Brain Behav Immun 2013; 28: 1-13.
[http://dx.doi.org/10.1016/j.bbi.2012.07.012] [PMID: 22884900]
[46]
Cunningham C. Microglia and neurodegeneration: The role of systemic inflammation. Glia 2013; 61(1): 71-90.
[http://dx.doi.org/10.1002/glia.22350] [PMID: 22674585]
[47]
Eikelenboom P, Hoozemans JJ, Veerhuis R, van Exel E, Rozemuller AJ, van Gool WA. Whether, when and how chronic inflammation increases the risk of developing late-onset Alzheimer’s disease. Alzheimers Res Ther 2012; 4(3): 15.
[http://dx.doi.org/10.1186/alzrt118] [PMID: 22647384]
[48]
Olsson B, Hertze J, Lautner R, et al. Microglial markers are elevated in the prodromal phase of Alzheimer’s disease and vascular dementia. J Alzheimers Dis 2013; 33(1): 45-53.
[http://dx.doi.org/10.3233/JAD-2012-120787] [PMID: 22890100]
[49]
Guerra C, Linde-Zwirble WT, Wunsch H. Risk factors for dementia after critical illness in elderly Medicare beneficiaries. Crit Care 2012; 16(6): R233.
[http://dx.doi.org/10.1186/cc11901] [PMID: 23245397]
[50]
Bromander S, Anckarsäter R, Kristiansson M, et al. Changes in serum and cerebrospinal fluid cytokines in response to non-neurological surgery: An observational study. J Neuroinflammation 2012; 9: 242.
[http://dx.doi.org/10.1186/1742-2094-9-242] [PMID: 23095517]
[51]
Cerejeira J, Batista P, Nogueira V, Vaz-Serra A, Mukaetova-Ladinska EB. The stress response to surgery and postoperative delirium: evidence of hypothalamic-pituitary-adrenal axis hyperresponsiveness and decreased suppression of the GH/IGF-1 Axis. J Geriatr Psychiatry Neurol 2013; 26(3): 185-94.
[http://dx.doi.org/10.1177/0891988713495449] [PMID: 23864592]
[52]
Gore RL, Vardy ER, O’Brien JT. Delirium and dementia with Lewy bodies: distinct diagnoses or part of the same spectrum? J Neurol Neurosurg Psychiatry 2015; 86(1): 50-9.
[http://dx.doi.org/10.1136/jnnp-2013-306389] [PMID: 24860139]
[53]
Hshieh TT, Fong TG, Marcantonio ER, et al. Inouye cholinergic deficiency hypothesis in delirium: A synthesis of current evidence. J Gerontol 2008; 63A(7): 764-72.
[http://dx.doi.org/10.1093/gerona/63.7.764]

Rights & Permissions Print Cite
Article Metrics
35
1
© 2024 Bentham Science Publishers | Privacy Policy