阿爾茨海默病認知功能量表述評

　2．療效評價［19,20］：在乙酰膽堿酯酶抑制劑特可林（tacrine）、velnacrine 、毒扁豆堿（physostigmine）、多奈哌齊（donepezil）和rivastigmine治療輕-中度AD的大樣本、多中心、隨機、雙盲、安慰劑對照臨床試驗中，療效評價均采用MMSE、ADAS-cog分測驗和臨床晤談總體印象量表。Arrieta等［20］總結1981～1997年公開發(fā)表的49篇特可林治療AD的論文，應用的評定工具為：MMSE 16篇，ADAS 4篇，3MS、CASI、AVLT等均有報道。

　　　　六、幾點說明

　　　　1． 上述量表對于確定癡呆的病因即鑒別診斷方面作用有限。

　　2． 從55或60歲開始縱向隨訪認知功能十分重要，尤其是教育程度比較高的老人。

　　3． 認知評定只能作為AD診斷的輔助工具，臨床診斷必須結合日�；顒幽芰α勘�、非認知行為問卷、總體嚴重度量表、照料者負擔量表及腦影像學、電生理學、生化學檢查結果，最后確診依賴于隨訪和病理檢查。

　　4. 軀體狀況不佳、情緒障礙、意識不清、受試者不配合等都可以影響認知檢查結果。

　　5. 時代在發(fā)展，人口的年齡結構和老人素質處在變化之中，對認知功能的認識也在深化，故評定工具也需要不斷修訂以適應新的要求。由于知識產(chǎn)權等原因，上述大部分測驗沒有引進。我們介紹這些評定方法，供國內同道在量表編制與使用時參考。

　　參考文獻
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