Neuropsychological Changes In Alzheimer’s Disease And Mild Cognitive Impairment

Alzheimer’s disease is is an unexplained, progressive degenerative disease of the central nervous system, the incidence gradually increased with age. Mild cognitive impairment is a cognitive impairment between normal aging and dementia. Studies have shown that development from healthy older people to MCI and AD often accompanied by a series of cognitive and behavioral changes, this change depends on the assessment of neuropsychological tests. Therefore, the study of neuropsychological changes in AD and MCI is particularly important for the evaluation of patients with disease progression.Purpose:Analysis the results of neuropsychological test in MCI and AD to understand the characteristic of cognitive function in patients with AD and MCI,for the early diagnosis and intervention of AD.Method:Screened AD and MCI patients over 50 years in neurology outpatient,inpatient and memory clinic in the First Hospital of Jilin University from January 2015 to February 2016. All patients completed the MRI, thyroid function, syphilis and other tests, exclude hypertension,diabetes,thyroid disease, stroke, nerve syphilis, traumatic brain injury and other diseases, no history of alcohol abuse, no mental disorders, to exclude other causes of dementia. From the medical center and volunteers screened control group with the same gender, age and education level,the normal control group MMSE score> 24 points, exclude serious physical illness and to actively cooperate with the inspection. Collect relevant clinical information, including:name, gender, age, years of education, occupation, handedness, history of present illness, medication history,past history,history of tobacco and alcohol, family history and so on. Complete all neuropsychological tests, head MRI, and medial temporal lobe atrophy-scale for AD, MCI patients and normal control group, neuropsychological tests, including: MMSE, Mo CA, BNT, TMT,fluency test, AVLT, WMS-RC, WAIS-RC, to assess the cognitive function,memory, language, attention, visuospatial ability, executive function and so on. Rating detection result by SPSS17.0 for statistical analysis, the results with x ± s, comparison between the groups using t test, P <0.05 has statistically significant.Results:AD patients with MMSE, Mo CA, BNT, AVLT, fluency test scores significantly lower than normal MCI patients and the elderly, MCI patients with MMSE, Mo CA, BNT, AVLT total score was significantly lower than the normal elderly; AD patients with delayed recall and total memory significantly lower in patients with MCI, MCI patients was significantly lower than the normal elderly; AD patients’ TMT longer than MCI, MCI patients with normal time; AD patients’ MQ decreased,except experience, orientation, other subtest scores were lower compared with MCI patients and normal elderly; MCI patients’ MQ decreased, the visual regeneration, associative learning, touch memory, understanding and memory scores decreased; FIQ, VIQ and PIQ were reduced in AD patients, except to knowledge and understanding, other sub-item scores were lower; FIQ, VIQ and PIQ were lower in MCI patients, including arithmetic, similarities, digit span, block design,picture arrangement,graphics patchwork.AD Group with MTA graded 2 and above accounted for 92%, graded 3 and above accounted for 44%; MCI group with MTA graded 2 and above accounted for 53.3%, grade 3 or more accounted for13.3%.AD patients with MTA grade 1and 3 have lower IQ, MQ than MCI;MQ of AD group with MTA grade 2 change consistent with MCI,IQ significantly lower than MCI group.Conclusions:1.MMSE, Mo CA, BNT, TMT, fluency test, AVLT scores were significantly lower, IQ、MQ decreased in AD compared to MCI; 2.MMSE,Mo CA, BNT, AVLT scores were significantly lower,IQ、MQ decreased,short-term memory is more obvious in MCI compared with normal group;3.AD patients’ overall cognitive,attention, memory, language,excutive ability decline; 4.MCI patients’ delayed recall,excutive ability, attention,visuospatial ability, language decreased significantly, which delayed recall,visuospatial ability and language is the predictive characteristic from MCI to AD;5.Cognitive changes and radiographic changes in patients with MCI and early AD are similar, but the medial temporal lobe atrophy in AD patients is obvious, some MCI patients without significant image changes; 6. Medial temporal lobe atrophy and cognitive changes have no significant correlation in MCI stage, while the AD stage is more consistency.