阿尔茨海默病认知功能量表述评

　2．疗效评价［19,20］：在乙酰胆碱酯酶抑制剂特可林（tacrine）、velnacrine 、毒扁豆碱（physostigmine）、多奈哌齐（donepezil）和rivastigmine治疗轻-中度AD的大样本、多中心、随机、双盲、安慰剂对照临床试验中，疗效评价均采用MMSE、ADAS-cog分测验和临床晤谈总体印象量表。Arrieta等［20］总结1981～1997年公开发表的49篇特可林治疗AD的论文，应用的评定工具为：MMSE 16篇，ADAS 4篇，3MS、CASI、AVLT等均有报道。

　　　　六、几点说明

　　　　1． 上述量表对于确定痴呆的病因即鉴别诊断方面作用有限。

　　2． 从55或60岁开始纵向随访认知功能十分重要，尤其是教育程度比较高的老人。

　　3． 认知评定只能作为AD诊断的辅助工具，临床诊断必须结合日常活动能力量表、非认知行为问卷、总体严重度量表、照料者负担量表及脑影像学、电生理学、生化学检查结果，最后确诊依赖于随访和病理检查。

　　4. 躯体状况不佳、情绪障碍、意识不清、受试者不配合等都可以影响认知检查结果。

　　5. 时代在发展，人口的年龄结构和老人素质处在变化之中，对认知功能的认识也在深化，故评定工具也需要不断修订以适应新的要求。由于知识产权等原因，上述大部分测验没有引进。我们介绍这些评定方法，供国内同道在量表编制与使用时参考。

　　参考文献
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