A study on the relevance of dementia clinical analysis, neuropsychological tests and molecular genetic examination

• Main Authors: Yu-Chen Hsieh, 謝玉珍
• Other Authors: Chia-Ding Hou
• Format: Others
• Language: zh-TW
• Published: 2008
• Online Access: http://ndltd.ncl.edu.tw/handle/41927572630089341930

碩士 === 輔仁大學 === 應用統計學研究所 === 96 === This research was to conduct a comparative study among patients with amnestic mild cognitive impairment (AMCI), or Alzheimer’s Disease (AD) from the Department of Neurology of a medical center in the northen part of Taiwan and subjects of the normal group for comparison. The purposes of the present study were: 1) to understand the differences and characteristics of these three groups of subjects in terms of genetic patterns and neuropsychological examination performance, 2) to understand whether genetic patterns and neuropsychological examination performance differed in different degrees of AD patients. In this research, a total of 260 samples were collected for analysis and discussion by methods including frequency distribution, Chi-square test, Fisher exact test, analysis of variance, independent sample t test and logistic regression method. The findings showed that ApoE and ApoCI genetic patterns were related to AD. And the e3, e4, A and B patterns of the allelic genes differed in patients with AMCI, AD and normal control. The results of Mini-Mental State Examination,, MMSE composite index and Visual association memory test varied in patients with AMCI, AD and the normal controls. In addition, the items of “time”, “place”, “short-term memory” and “obey orders” of the MMSE differed in the above three groups of subjects. In this study, the severity of AD was categorized as mild and moderate-severe for research. Patients with mild or moderate-severe AD had significant differences in MMSE total scores and MMSE composite indicators while had no significant difference in VAMT. The data indicated that VAMT may be early indicator for AD but was unable to distinguish between mild and moderate-severe AD. Mild and moderate-severe AD patients had no difference only in the “short-term memory” of MMSE items. Other items differed apparently between the two groups. It might be due to the fact that “short-term memory” is impaired at the early stage of the disease. In addition, as comparison between the mild AD patients and the normal controls, there were no differences in “attention registration”, “naming”, “repetition” and “reading comprehension”. However, as comparison between the moderate-servere AD patients and the normal control, most of the items of MMSE differed significantly. Therefore, we conclude that “attention registration”, “naming”, “repetition” and “reading comprehension” might be inmpaired at a later stage of AD. In the genetic analysis, gender and e4 allelic gene are directly related to serverity of Alzheimer’s disease. Regarding the construction of AD predictive models, we propose three ones: in Model I, 3 items of major influence including the VAMT, MMSE total score and e4 gene availability were selected; in Model II, 3 itmes of major influence including the VAMT, MMSE composite indicators and e4 gene availability; in Model III, 4 variables including “place”, “short-term memory”, “time” and the VAMT were selected. From the predictive model comparative analysis, the VAMT is a more appropriate test than MMSE total score in predicting the occurrence of AD.