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目的了解≥50岁离退休职工常规体检人群的认知功能状态,探讨常规体检中增加认知功能检查的意义。方法对2005年8月~10月在我院参与常规体检的秦皇岛港务局≥50岁的离退休职工进行面对面调查。调查分为筛查、复查诊断两个阶段。筛查用简易智能精神状态量表(MMSE)、Hachinski缺血评分、焦虑自评量表、抑郁自评量表;复查诊断用临床痴呆评定量表(CDR)、扩充痴呆量表(ESD)及记忆检查记录。轻度认知功能障碍(MCI)使用Perterson诊断标准、老年性痴呆(Alzheimer’sdisease,以下简称AD)诊断标准使用美国国立神经和语言障碍和卒中——老年性痴呆及相关疾病学会(NINCDS-ADRDA)痴呆诊断标准。结果2269例体检者中,MMSE正常高分组1970人,占86.8%;正常低分126人,占5.6%。MCI70人,检出率3.1%;AD50人,均为轻度痴呆,检出率2.2%。血管性轻度认知功能障碍(VCI)36人,占1.6%。血管性痴呆(VaD)15人,占0.7%。混合性痴呆(MD)2人,占0.1%。各种异常项目检出率随年龄增加而增加,随文化程度的提高而减低。结论≥50岁常规体检人群可检出认知功能障碍,主要表现为MMSE正常低分、MCI和轻度AD。常规体检工作中增加认知功能检查有助于早期发现重点人群,既有利于早预防、早治疗,又便于管理,意义重大。
Objective To understand the cognitive function status of the routine physical examination of retirees aged 50 or older and to explore the significance of increasing cognitive function examination in routine physical examination. Methods A face-to-face investigation was conducted on retirees aged 50 or above from the Qinhuangdao Port Authority who participated in the routine physical examination in our hospital from August to October 2005. The investigation was divided into two stages: screening and re-examination. MMSE, Hachinski Ischemia Score, Anxiety Self-rating Scale, Self-rating Depression Scale for Screening, Clinical Dementia Rating Scale (CDR) for Diagnosis, Extended Dementia Scale (ESD), and Memory check record. Mild cognitive impairment (MCI) uses the Perterson diagnostic criteria, Alzheimer’s disease (AD) diagnostic criteria using the National Institute of Neurological and Language Disorders and Stroke - Alzheimer’s disease and related diseases (NINCDS-ADRDA ) Dementia diagnostic criteria. Results Of the 2269 physical examinations, 1970 were normal high-scoring MMSE, accounting for 86.8%; 126 were normal low-risk, accounting for 5.6%. Among the 70 MCI patients, the detection rate was 3.1%; AD50 individuals were mild dementia with a detection rate of 2.2%. Vascular mild cognitive impairment (VCI) 36 people, accounting for 1.6%. VaD is 15 people, accounting for 0.7%. Mixed dementia (MD) 2 people, accounting for 0.1%. The detection rate of various abnormal items increases with age and decreases with the increase of education level. Conclusions Cognitive dysfunction can be detected in people aged ≥ 50 years old. The main manifestations are normal low scores of MMSE, MCI, and mild AD. The addition of cognitive function tests to routine physical examinations helps early detection of key populations, which is beneficial to early prevention, early treatment, and management. It is of great significance.