The Comparison Of Cognitive Impairment Between Alzheimer Disease And Sporadic Cerebral Small Vessel Disease

Background and objectiveCognitive impairment refers to different degree of cognitive damage caused by various reasons.Alzheimer's disease(AD)and sporadic cerebral small disease(sporadic CSVD),both of which are common types of cognitive impairment,can lead to chronic progressive cognitive damage,functional degradation,behavioral abnormalities and other psychiatric symptoms.Hypertension,diabetes,obesity,hyperlipidemia,vascular factors of sporadic CSVD,also often appear in AD patients.Huge studies on the cognitive function of the two diseases were made,and the author finds that the cognitive impairment caused by the two diseases has different manifestations in different cognitive domains through literature reading.This study was designed to compare the differences of cognitive impairment between AD and sporadic CSVD in different cognitive domains.Materials and methodsThe subjects of AD and sporadic CSVD were collected from January 2015 to January 2017 among patients treated in Department of Neurology,Qilu Hospital of Shandong University.The general information,hematological examinations,MMSE and MoCA were collected."AD group"(AD group),"sporadic CSVD group"(CSVD group),and the normal control group(Con group)were screened out,and the differences of cognitive impairment between AD and sporadic CSVD were compared.The history of the subjects was collected,including age,sex,education,smoking,drinking,hypertension,diabetes,hyperlipidemia,hyperhomocysteinemia,and these risk factors were analyzed.According to the scores of MMSE and MoCA,the subjects' orientation,instant memory,attention,calculation,delayed memory,language,abstract thinking,visuospatial perception and execution ability were analyzed.The data was analyzed by SPSS22.0 data software.The measurement data were compared by the chi-square test,and count data by the nonparametric test.The test level was 0.05.P<0.05 indicates a significant difference.ResultIn this study,43 patients were selected in the AD group,45 patients in the CSVD group and 46 patients in the Con group.There were no significant differences in gender,education,hyperlipidemia,hyperhomocysteinemia,smoking and drinking among these three groups.But CSVD group showed statistically significant differences in the prevalence of hypertension and diabetes mellitus with AD group and Con group respectively.Compared with Con group,AD group showed statistically significant differences in total score of MMSE,orientation,attention and calculation,delayed memory,writing and visuospatial perception,and no statistically differences in instant memory,naming,repeating,reading and understanding.Compared with Con group,CSVD group showed statistically significant differences in total score of MMSE,orientation,instant memory,attention and calculation,delayed recall,repeating,understanding,writing and visuospatial perception,and no statistically differences in naming,reading.Compared with AD group,CSVD group shows statistically significant differences in total score of MMSE,orientation,attention and calculation,and repeating,while no statistical difference in instant memory,delayed recall,naming,reading,understanding,writing and visuospatial perception.Compared with Con group,AD group shows statistically significant differences in all sub-terms of MoCA except naming.Compared with Con group,CSVD group shows statistically significant differences in every sub-term of MoCA.There are statistically significant differences between the AD group and the CSVD group in total score of MoCA,and terms of visuospatial perception,executive function,attention and calculation,language,abstract thinking and orientation,but no significant difference in naming and delayed recall.Conclusion1.Compared with AD,the cognitive impairment caused by sporadic CSVD is more related to age,hypertension and diabetes.2.Compared with AD,the domains of cognitive impairment caused by sporadic CSVD are more extensive.MoCA in sporadic CSVD has a lower total score,indicating that MoCA is more sensitive than MMSE in assessing the cognitive function of sporadic CSVD.3.There was no difference in the performance of cognitive impairment caused by sporadic CSVD in terms of naming,repeating and free recall.The damage of sporadic CSVD in instant memory,calculation and attention,verbal fluency,abstract thinking is more heavier than AD,and the behavior of sporadic CSVD is better in the directional performance than AD.