普通医疗网络中认知障碍的预测因素和临床神经诊断标准的年龄相关发展

E. V. Trofimova, I. V. Reverchuk, A. Tynterova, A. Goncharov, A. H. Dzhigkaev
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引用次数: 0

摘要

背景:老年人认知障碍的普遍性、严重性和异质性以及有限的治疗方案决定了及时诊断认知功能障碍问题的重要性。本研究的目的是找出最能提供信息的模式组合,以便对与年龄相关的认知功能障碍进行有区别的诊断。患者和方法:俄罗斯卫生部 "联邦高科技医疗中心"(加里宁格勒)共对 213 名患者进行了检查(其中 99 名患者为 50-65 岁,114 名患者为 65 岁以上)。所有患者均主诉智力、记忆力和注意力受损。使用以下量表进行了神经心理学测试:蒙特利尔认知评估(MoCA)、医院焦虑抑郁量表(HADS)、多维疲劳量表(MFI-20)和其他认知障碍测试。统计分析使用了机器学习算法、Python 编程语言、Pandas 和 SciPy 库。结果:对于 50-65 岁年龄段的患者,发现执行功能障碍、注意力下降、疲劳、焦虑和内分泌系统紊乱具有高度相关性。对于 65 岁以上的患者,语义性失语、感知和记忆障碍、高脂血症、缺血性中风病史和肥胖是重要特征。年龄指数与抑郁和焦虑参数呈明显负相关;与身体衰弱指数、感知、记忆和语义信息处理障碍呈正相关。结论:研究结果表明,老年患者普遍存在认知功能障碍。评估视觉感知和语义信息处理的测试可用于老年退化性认知障碍的早期诊断。通过对各种年龄相关变量进行判别分析,可以更有效地预测衰老轨迹,而无需采用任何耗时的诊断方法。
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Age-Related Development During Predictors and Clinical Neurodiagnostic Criteria of Cognitive Impairment in the General Medical Network
Background: prevalence, severity and heterogeneity of cognitive impairment in elderlies along with limited therapy options determine the relevance of the problem of timely diagnostics of cognitive disfunction. The purpose of this study is to identify a combination of the most informative patterns that allow a differentiated approach to the diagnosis of age-related cognitive impairment. Patients and methods: 213 patients were examined (99 patients 50–65 years old, 114 patients over 65 years of age) of “Federal Centre for High Medical Technologies” of Russian Ministry of Health (Kaliningrad). All patients complained for impaired mental performance, memory and attention. A neuropsychologic testing was conducted using next scales: Montreal Cognitive Assessment (MoCA), Hospital Anxiety and Depression Scale (HADS), Multidimensional Fatigue Inventory (MFI-20) and additional cognitive impairment tests. For statistical analysis, machine learning algorithms, Python programming language, and Pandas and SciPy libraries were used. Results: for patients in the 50–65 age category, high relevance was found for executive dysfunction, decreased attention span, fatigue, anxiety, and endocrine system disorders. For patients over 65 years of age, significant features were semantic aphasia, perceptual and memory impairment, hyperlipidemia, history of ischemic stroke, and obesity. A significant negative correlation for the age index was found with the parameters of depression and anxiety; a positive correlation was found with the index of physical asthenia, disorders of perception, memory and semantic processing of information. Conclusion: the results demonstrate prevalence of cognitive dysfunctions in elderly patients. The tests assessing visual perception and semantic information processing can be of interest in early degenerative cognitive impairments diagnosis in elderly age. Discriminant analysis of a wide range of age-related variables will allow to make more effective aging trajectories prediction without any time-consuming diagnostic methods.
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