| Objective: to explore the related factors of cognitive impairment in patients with AD and DLB,and to provide basis and reference for clinical diagnosis and treatment of AD and DLB.Methods: 281 cases of dementia patients treated in Tianjin Huanhu Hospital,Tianjin Institute of dementia from October 2011 to October 2016 were selected as subjects and divided into AD group(n=215 cases)and DLB group(n=66 cases)according to the disease type.The two groups completed relevant examinations,and the patients' cognitive function,activities of daily living and neuropsychiatric symptoms were assessed by MMSE,Mo CA,ADL)and NPI.The sleep quality was evaluated by PSQI.Folate,vitamin B12,ferritin,T3/T4/TSH levels were determined by ARCHITECT i2000 SR automatic immune analyzer.The levels of TC,TG,LDL,HDL,blood glucose,homocysteine and uric acid were determined by a HITACHI7170 automatic biochemical analyzer.The symptom self-rating scale was used to evaluate patients' psychology from the perspectives of compulsion,depression,hostility and anxiety.The incidence of hypertension,diabetes,coronary heart disease,cerebral apoplexy and epilepsy were recorded.Both groups completed eeg examination.The related factors of AD and DLB patients were collected,and the influencing factors of cognitive dysfunction in AD and DLB patients were analyzed by Logistic analysis.All the data were processed by SPSS17.0 statistical software.Results :(1)there was no significant difference in the MMSE scale between AD group and DLB group in terms of naming,retelling,reading,performing operation,writing and visuospatial perception score(P>0.05).The MMSE scores of AD group were lower than those of DLB group(P<0.05).(2)the Mo CA scores of the two groups showed no statistical significance in terms of naming instructions,word fluency,abstraction and delayed recall scores(P>0.05).The Mo CA scores of AD group were lower than those of DLB group(P<0.05).(3)the incidence of hallucinations,sleep,nocturnal behavior abnormalities,fluctuating cognitive impairment,and parkinsonism in the AD group was lower than that in the DLB group(P<0.05).The incidence of agitation,aggression,anxiety,emotional high/euphoria,emotional indifference,indifference,disinhibition,irritability,emotional instability,appetite and eating disorder in AD group was higher than that in DLB group(P<0.05).(4)the scores of sleep efficiency,sleep time,sleep disorder,sleep quality and sleep time in AD group were all lower than those in DLB group(P<0.05).(5)serum TC,TG,LDL,HDL,blood glucose,homocysteine,uric acid,folic acid,vitamin B12,ferritin,T3/T4/TSH in AD group and DLB group were not statistically significant(P>0.05).(6)the scores of compulsion and hostility in AD group were lower than those in DLB group(P<0.05).Depression and anxiety scores in AD group were higher than those in DLB group(P<0.05).(7)The incidence of hypertension and epilepsy in AD group was higher than that in DLB group(P<0.05).(8)GTE2,GTE3,%FIRDA,GTE5,GTE6 and GTE total scores in AD group were all lower than those in DLB group(P<0.05).(9)multivariate Logistic analysis showed that the incidence of cognitive function in AD and DLB patients was statistically significant with occupation,MMSE score,Mo CA score,ADL score,NPI score,PSQI score,compulsion,depression,hostility,anxiety score and EEG(P<0.05).Conclusion:(1)AD patients are often associated with hypertension;DLB patients with fluctuating cognitive impairment,parkinsonism,hallucinations,and abnormal nocturnal sleep behavior were the common prominent manifestations.(2)the cognitive impairment of AD and DLB patients is affected by many factors,and strengthening the EEG and imaging examination of patients is conducive to the identification of the disease. |
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